重复经颅磁刺激对轻中度阿尔茨海默病患者生命质量的影响

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目的:探讨重复经颅刺激(rTMS)对轻中度阿尔茨海默病(AD)患者精神行为症状及生命质量的影响。方法:选取2017年5月至2018年12月在浙江省温州市第七人民医院治疗的轻中度AD患者40例,采用随机数字表法分为对照组与rTMS组,每组20例。两组均给予抗痴呆药物治疗,rTMS组加用rTMS治疗。分别在治疗前后采用阿尔茨海默病评定量表-认知部分(ADAS-cog)、简易精神状态检查量表(MMSE)、神经精神调查量表(NPI)、日常生活能力量表(ADL)、阿尔茨海默病生命质量测量表(QOL-AD)评估两组患者的生命质量和精神行为症状。结果:rTMS组和对照组治疗前ADAS-cog、MMSE、NPI、ADL和QOL-AD评分比较差异无统计学意义(n P>0.05)。治疗后rTMS组MMSE、ADL、QOL-AD评分高于对照组[(22.80 ± 3.83)分比 (20.30 ± 5.49)分、(63.05 ± 17.24)分比(54.15 ± 9.20)分、(37.55 ± 7.94)分比(31.00 ± 11.45)分],ADAS-cog和NPI评分(患者版、知情者版)低于对照组[(18.45 ± 4.16)分比(22.15 ± 5.01)分、(57.2 ± 16.25)分比(72.65 ± 39.37)分、(27.15 ± 7.53)分比(34.65 ± 14.91)分],差异均有统计学意义(n P<0.05);同时rTMS组治疗后MMSE、ADL、QOL-AD评分高于治疗前,ADAS-cog和NPI评分低于治疗前,差异均有统计学意义(n P0.05). After treatment, the MMSE, ADL, and QOL-AD scores of the rTMS group were significantly higher than those of the control group: (22.80 ± 3.83) scores vs.(20.30 ± 5.49) scores, (63.05 ± 17.24) scores vs. (54.15 ± 9.20) scpres, (37.55 ± 7.94) scores vs. (31.00 ± 11.45) scores; the ADAS-cog and NPI scores were significantly lower: (18.45 ± 4.16) scores vs.(22.15 ± 5.01) scores, (57.2 ± 16.25) scores vs. (72.65 ± 39.37) scores, (27.15 ± 7.53) scores vs. (34.65 ± 14.91) scores, and there were significantly differences (n P<0.05). At the same time, the MMSE, ADL, and QOL-AD scores of the rTMS group were significantly higher than those before treatment, the ADAS-cog and NPI scores were significantly lower, and the difference was statistically significant (n P<0.05).n Conclusions:rTMS can effectively improve the behavioral and psychological symptoms of patients with mild to moderate AD and significantly improve the quality of life.
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