【摘 要】
：
目的观察高频重复经颅磁刺激(rTMS)联合神经肌肉电刺激(NMES)治疗帕金森病吞咽功能障碍的治疗效果。方法纳入符合英国(United Kingdom)脑库原发性帕金森病临床诊断标准的帕金森病伴吞咽障碍患者90例，根据治疗方式的不同按随机数字表法分为rTMS组(采用rTMS联合NMES治疗)和假刺激组(采用NMES联合假rTMS治疗)，每组45例。分别于治疗前、治疗1个疗程、治疗2个疗程及治疗完成
【机 构】
：
213003 江苏常州，解放军第102医院神经内科,213003 江苏常州，解放军第102医院神经内科,213003 江苏常州，解放军第102医院神经内科,213003 江苏常州，解放军第102医院神
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目的观察高频重复经颅磁刺激(rTMS)联合神经肌肉电刺激(NMES)治疗帕金森病吞咽功能障碍的治疗效果。
方法纳入符合英国(United Kingdom)脑库原发性帕金森病临床诊断标准的帕金森病伴吞咽障碍患者90例，根据治疗方式的不同按随机数字表法分为rTMS组(采用rTMS联合NMES治疗)和假刺激组(采用NMES联合假rTMS治疗)，每组45例。分别于治疗前、治疗1个疗程、治疗2个疗程及治疗完成后3个月时，采用洼田饮水试验和标准吞咽功能评定量表(SSA)对2组患者的吞咽障碍严重程度及其吞咽功能进行评定，并比较治疗前后不同时间点2组患者的洼田饮水试验评分、SSA评分及临床疗效。
结果①治疗1个疗程、治疗2个疗程及治疗后3个月时组内比较，rTMS组患者的洼田饮水试验及SSA评分较组内治疗前均有明显改善(F＝82.004，P<0.001；F＝33.753，P<0.001)，假刺激组亦较组内治疗前明显改善(F＝53.673，P<0.001；F＝19.208，P<0.001)；②治疗1个疗程、2个疗程及治疗后3个月时组间比较，rTMS组患者的洼田饮水试验评分明显优于同时间点假刺激组(t＝2.212，P＝0.031；t＝2.398，P＝0.017；t＝2.119，P＝0.028)，且同时间点的SSA评分亦明显优于假刺激组(t＝2.188，P＝0.021；t＝2.417，P＝0.019；t＝2.507，P＝0.016)；③治疗2个疗程后，rTMS组患者的总有效率(95.56%)明显高于假刺激组(80.00%)，组间差异有统计学意义(χ2＝5.075，P＝0.024)。
结论高频重复经颅磁刺激联合神经肌肉电刺激可显著改善帕金森病患者的吞咽功能，提高临床疗效。
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