陈新新 金永喜 黄建平

[摘要] 目的 觀察针刺（百会、大椎穴）和康复机器人训练相结合的治疗方式对早期帕金森病非运动症状的治疗效果。 方法 采用队列研究的方法，选取2016年10月至2019年10月温州市中医院66例早期原发性帕金森病患者纳入研究，随机分为试验组和对照组，试验组采用常规抗帕金森药物治疗+针刺结合康复机器人训练，对照组采用常规抗帕金森药物治疗，治疗前后8周评估患者疼痛量表、帕金森睡眠量表、汉密尔顿抑郁量表、汉密尔顿焦虑量表、非运动症状量表、自主神经功能量表的评分。 结果 治疗8周后，试验组与治疗前相比其疼痛量表、汉密尔顿抑郁量表评分未有明显降低，差异无统计学意义（P=0.109，0.066，P>0.05），与对照组治疗后相比评分未有明显降低（P=0.445，0.257，P>0.05）。试验组帕金森睡眠量表评分与治疗前相比升高，差异有统计学意义（P=0.000，P<0.001），且明显高于对照组（P=0.007，P<0.01）。试验组与治疗前相比汉密尔顿焦虑量表、非运动症状量表、自主神经功能量表评分均有降低，差异有统计学意义（P=0.000，0.000，0.000，P<0.001），并且明显低于对照组（P=0.040， 0.041，0.040，P<0.05）。 结论 针刺百会、大椎穴结合康复机器人训练能够改善早期帕金森病患者焦虑、睡眠、自主神经功能，并降低帕金森病患者的非运动症状量表评分，提示可改善帕金森非运动症状的整体评估水平。

[关键词] 帕金森病;针刺;康复机器人;非运动症状

[中图分类号] R246.6          [文献标识码] B          [文章编号] 1673-9701（2021）33-0001-05

[Abstract] Objective To observe the therapeutic effect of acupuncture （Baihui and Dazhui points） combined with rehabilitation robot training on the non-motor symptoms of early Parkinson′s disease. Methods A total of 66 patients with early primary Parkinson′s disease from Wenzhou Hospital of Traditional Chinese Medicine between October 2016 and October 2019 were selected using the cohort study method，and they were randomly divided into the experimental group and the control group.The experimental group used conventional anti-Parkinson drug therapy+acupuncture combined with rehabilitation robot training.The control group was treated with conventional anti-Parkinson′s medication.Before and after 8 weeks of treatment， the scores of the patient′s pain scale，Parkinson′s sleep scale， Hamilton depression scale， Hamilton anxiety scale， non-motor symptom scale， and autonomic nervous function scale were evaluated. Results The pain scale and Hamilton Depression Scale scores of the experimental group after 8 weeks of treatment were not significantly reduced compared with those before treatment（P=0.109，0.066， P>0.05）， and the score of the experimental group did not significantly decrease compared with the control group（P=0.445，0.257，P>0.05），which was not statistically significant. The score of Parkinson′s Sleep Scale increased in the experimental group compared with that before treatment， which was statistically significant（P=0.000， P<0.001）， and was significantly higher than that of the control group（P=0.007，P<0.01）. The scores of the Hamilton Anxiety Scale， Non-motor Symptom Scale，and Autonomic Nerve Function Scale were reduced in the experimental group compared with those before treatment， which was statistically significant （P=0.000，0.000，0.000，P<0.001），and was significantly lower than the control group （P=0.040，0.041， 0.040，P<0.05）. Conclusion Acupuncture at Baihui and Dazhui points combined with rehabilitation robot training can improve anxiety， sleep， and autonomic nerve function in patients with early Parkinson′s disease， and reduce the score of the non-motor symptom scale in patients with Parkinson′s disease， suggesting that it can improve the non-motor symptoms of Parkinson′s disease The overall assessment level.

[Key words] Parkinson′s disease; Acupuncture; Rehabilitation robot; Non-motor symptoms

帕金森病非运动症状主要涉及自主神经功能障碍、感觉障碍、睡眠障碍和精神障碍，是帕金森病在运动症状外另一方面的表达[1]，但其表现方式较运动症状更为复杂，并且可能早于运动症状产生[2]。研究发现，98.6%的患者都存在非运动症状，并且每个帕金森病患者平均存在8～12个非运动症状，且发生非运动症状项目数量随病程的延长及病情的加重而增加[3]。大多数帕金森病患者早期即产生非运动症状[4-5]，主要表现为抑郁、焦虑、便秘、睡眠障碍、疼痛、泌尿系统问题等，严重的影响帕金森病患者的日常生活能力及生活质量。因此，对……