102例儿童孤独症综合干预的疗效分析

目的:探讨综合干预训练对儿童孤独症的疗效。方法:102例孤独症患儿采用结构化教育训练、语言训练、家长指导、感觉统合训练、地板时光等综合训练方法进行训练,每周6 d,每天3.5 h,共4个月。在训练前后分别采用波特奇早期发育核查表、孤独症治疗评估量表(ATEC)以及儿童感觉能力发展评定量表评价疗效。结果:在综合训练4个月后,波特奇早期发育核查表各项评分(t=4.93~7.64)以及儿童感觉能力发展评定量表中前庭功能(t=3.766)、触觉防御(t=3.719)、本体功能(t=4.005)评分均较训练前明显升高(P均0.01);ATEC量表总分及语言、社交、感知、行为评分均明显下降(t=2.18~5.81,P0.05或P0.01),其中≤3岁组明显优于3岁组,差异有统计学意义(P0.05)。结论:综合干预训练在一定程度上可以减轻儿童孤独症症状及改善其适应能力;3岁前进行干预疗效更为明显。     

儿童孤独症与感觉统合失调的相关分析

目的:探索儿童孤独症与感觉统合失调的关系.方法:对60例符合国际疾病分类第10版(ICD-10)诊断标准的儿童孤独症患儿(患者组)与60名健康儿童(对照组)填写儿童情况调查表,并分别进行感觉统合评定量表(SIS)、克氏孤独症行为量表(CBRS)及并儿童孤独症评定量表(CARS)评定孤独症患儿症状严重程度.结果:患者组伴感觉统合失调的占95.0%,而对照组存在感觉统合失调的仅占3.3%;患者组与对照组的感觉统合评定结果比较,差异具有显著性(P＜0.01);病程长短不同的患儿感觉统合失调严重度不同,差异具有显著性(P＜0.05);智力水平与感觉统合失调显著相关(P＜0.05);多元逐步回归分析结果:是否诊断为儿童孤独症与CBRS总分、本体感、母孕期有无高危因素、既往有重大疾病史、有无窒息史、母亲文化程度有关.结论:儿童孤独症患儿普遍存在感觉统合失调,在对儿童孤独症患儿进行个别化训练的同时应进行感觉统合训练.     

早期感觉统合训练对病毒性脑炎患儿的干预效应

目的 探讨早期感觉统合训练对病毒性脑炎患儿的干预效应。方法 回顾性分析2018年1月-2019年12月本院儿科住院部收治的重症病毒性脑炎恢复期患儿80例作为研究对象,根据康复干预方案将患者分为研究组(联合早期感觉统合训练,60例)和对照组(常规康复训练,20例),比较2组患儿治疗前和治疗3个月后运动能力、智力发育状况和感觉统合的差异。结果 治疗前2组粗大运动功能测试量表(Gross motor function measure,GMFM-88)、Peabody运动发育量表(Peabody developmental motor scale-Fine motor,PDMS-FM)、丹佛智力发育量表(Denver developmental screening test,DDST)及儿童感觉统合评分比较无明显差异(P>0.05); 治疗3个月后2组上述评分均明显高于治疗前(P<0.05),且研究组上述评分均明显高于对照组(P<0.05)。结论 早期感觉统合训练对病毒性脑炎患儿的干预效应满意,可明显改善运动功能、智力发育及感觉统合水平。     

言语疗法配合视听觉统合康复训练对精神发育迟滞儿童言语认知及社会适应能力的干预效果

目的 分析精神发育迟滞儿童言语疗法配合应用视听觉统合康复训练对患儿言语认知及社会适应能力恢复情况的影响。方法 招募2017年3月～2020年3月间因精神发育迟滞在我院接受治疗的132例患儿作为研究对象,采用随机数字表法的方式将所有患儿分为对照组（66例）和观察组（66例）。其中对照组患儿采用言语疗法,观察组患儿则应用言语疗法+视听觉统合康复训练,对比两组患儿干预前后的格塞尔发育量表（Gesell）评分和社会适应能力评分差异。结果 对照组和观察组患儿干预前的各项观察指标差异无统计学差异（P>0.05）;观察组患儿干预后的各项Gesell评分和社会适应能力评分均要明显高于对照组,差异有统计学意义（P<0.05）。结论 言语疗法与视听觉统合康复训练的配合应用可有效提升精神发育迟滞儿童的认知功能、语言功能和社会适应能力,有助于患儿的健康发育。     

萨提亚家庭治疗对慢性精神分裂症患者的效果研究

目的观察萨提亚家庭治疗模式对慢性精神分裂症患者的干预效果,为慢性精神分裂症的治疗提供参考。方法 2016年5月-2017年5月在兰州市第三人民医院选取符合《国际疾病分类(第10版)》(ICD-10)诊断标准的慢性精神分裂症住院患者66例,采用随机数字表法分为研究组和对照组各33例。两组均接受抗精神病药物治疗和常规护理,在此基础上,研究组给予萨提亚家庭治疗,对照组给予支持性心理治疗。两组均干预6周。于干预前和干预6周后,采用自尊量表(SES)、症状自评量表(SCL-90)和家庭环境量表中文版(FES-CV)分别评定患者的自尊、心理状态及家庭环境。结果干预前,两组SES评分比较,差异无统计学意义(P 0. 05);研究组SCL-90总评分及躯体化、强迫、人际敏感、焦虑、敌对、恐怖、其他因子评分均高于对照组,差异均有统计学意义(P均0. 05);研究组成功性分量表评分低于对照组,差异有统计学意义(t=-2. 722,P 0. 01)。干预6周后,研究组SCL-90总评分及其除敌对因子外的9个因子评分均低于干预前(P均0.01);研究组SES总评分、FES-CV中的独立性、成功性、道德宗教观分量表评分均高于干预前,差异均有统计学意义(P均0. 01);FES-CV中的独立性分量表评分高于对照组(t=-2. 095,P 0. 05)。结论萨提亚家庭治疗可提高慢性精神分裂症患者的心理健康水平和自尊水平,改善患者家庭环境。     

一次偶发劫持事件后对儿童心理卫生状况影响的对照研究

目的了解劫持事件对儿童心理卫生状况的影响。方法在上海某小学发生学生被劫持事件后的一月,对被劫持事件发生班级中暴露于劫持事件的全体39名学生使用Achenbach儿童行为量表（CBCL）,儿童焦虑性情绪障碍筛查量表（SCARED）,Rutter父母及教师问卷进行评估。选取同年级的另外一个班级的所有45名学生作为对照组,采用同样方法进行评估。结果除研究组女生CBCL社交退缩因子与对照组之间有统计学差异外（分别为1．4±1．8,3．1±2．6;t=2．218,P=0．033）,研究组与对照组在其他CBCL因子、SCARED和Rutter父母及教师问卷得分差异无统计学意义。结论本次研究未发现偶发劫持事件对儿童心理卫生状况的影响。     

艾司西酞普兰对慢性精神分裂症阴性症状的作用

目的:观察艾司西酞普兰对慢性精神分裂症阴性症状的作用. 方法:以阴性症状为主的83例慢性精神分裂症患者随机分为研究组和对照组;两组在原有抗精神病药物的基础上,研究组加用艾司西酞普兰10～ 20 mg/d,共12周.于治疗前后分别进行阴性症状量表(SANS)、治疗中出现的症状量表(TESS)和洛文斯顿作业疗法用认知功能评定成套测验(LOTCA). 结果:12周后,研究组SANS总分及情感平淡、意志缺乏、兴趣缺乏评分明显低于对照组(P ＜0.05 ～0.01);LOTCA评分显著高于治疗前及对照组(t=-10.45,P=0.000;t =2.17,P=0.033);药物不良发生率两组间差异无统计学意义.结论:艾司西酞普兰对慢性精神分裂症阴性症状及认知功能有一定改善作用,不良反应轻微.     

舍曲林单用与合并奎硫平治疗脑卒中后抑郁障碍患者的疗效

目的:探讨舍曲林联合奎硫平治疗脑卒中后抑郁的疗效. 方法:将76例脑卒中后抑郁患者随机分为研究组(舍曲林合并奎硫平治疗)39例和对照组(单用舍曲林治疗)37例.疗程8周.于治疗前和治疗后采用汉密尔顿抑郁量表(HAMD)及治疗中出现的症状量表(TESS)评定疗效及不良反应.结果:两组疗效差异无统计学意义(x2=0.69,P＞0.05).两组HAMD评分治疗后均显著降低(P均＜0.05);以研究组在治疗1周和治疗2周时HAMD评分降分显著(t=2.89,2.73;P均＜0.05),治疗4周和治疗8周,两组差异无统计学意义(t=1.22,1.07;P均＞0.05). 结论:舍曲林联合奎硫平治疗脑卒中后抑郁障碍与单用舍曲林疗效相当,但起效更快.     

喹硫平联合帕罗西汀治疗脑卒中后抑郁的效果

目的探讨喹硫平联合帕罗西汀治疗脑卒中后抑郁(PSD)患者的有效性和安全性,为PSD的药物治疗提供参考。方法收集符合《中国急性缺血性脑卒中诊治指南2014》和《国际疾病分类(第10版)》(ICD-10)诊断标准的PSD患者100例,采用随机数字表法分为研究组和对照组各50例。两组均维持卒中后常规治疗,在此基础上,研究组接受喹硫平联合帕罗西汀治疗,对照组接受帕罗西汀治疗,均治疗8周。于治疗前和治疗2、4、8周后,采用汉密尔顿抑郁量表17项版(HAMD-17)、美国国立卫生研究院卒中量表(NIHSS)和日常生活能力量表(ADL)评定疗效,于治疗8周后采用副反应量表(TESS)评定不良反应。结果治疗2、4、8周后,两组HAMD-17和NIHSS评分均低于治疗前,ADL评分高于治疗前,差异均有统计学意义(P均0. 01);研究组HAMD-17评分低于对照组,ADL评分高于对照组,差异均有统计学意义(P 0. 05或0. 01)。治疗4、8周后,研究组NIHSS评分低于对照组,差异均有统计学意义(P均0. 01)。研究组总有效率高于对照组,差异有统计学意义(t=5. 950,P 0. 05)。两组不良反应总发生率比较差异无统计学意义(χ~2=0. 633,P=0. 528)。结论喹硫平联合帕罗西汀与单用帕罗西汀治疗均能改善PSD患者的抑郁症状、神经功能和生活自理能力,但联合治疗的效果更佳。     

个性化水中游戏指导对全面性发育迟缓患儿的效果

目的 研究个性化水中游戏指导对全面性发育迟缓（GDD）患儿运动功能发育和智力发育的影响。方法 将我院113例GDD患儿随机分为对照组56例和研究组57例。对照组实施早期作业治疗,研究组增加个性化水中游戏指导。对比两组患者的运动功能、智力发育水平和本体感觉的不同。结果 干预后观察组患者儿童感觉统合评定量表（CSIRS）各项评分高于对照组,社会交往、语言能力、适应性评分、粗大运动发育商（GMQ）、总体运动发育商（TMQ）评分高于对照组（P<0.05）,精细运动发育商（FMQ）评分、粗大运动和精细运动评分高于对照组,但比较无意义（P>0.05）。结论 个性化水中游戏指导可以提高GDD患儿的运动能力和智力发育水平,促进患儿康复。     

Bone mineral density in a population of children and adolescents with cerebral palsy and mental retardation with or without epilepsy

Purpose: The present study aimed to assess bone mineral density (BMD) in a population of children and adolescents with cerebral palsy and mental retardation with or without epilepsy. Methods: One hundred thirteen patients (63 male and 50 female) were recruited for evaluation. Patients were divided in three groups: 40 patients (group 1) were affected by cerebral palsy and mental retardation; 47 (group 2) by cerebral palsy, mental retardation, and epilepsy; and 26 (group 3) by epilepsy. The control group consisted of 63 healthy children and adolescents. Patients underwent a dual‐energy x‐ray absorptiometry (DEXA) scan of the lumbar spine (L1–L4), and z‐score was calculated for each patient; t‐score was considered for patients 18 years of age and older. Key Findings: Abnormal BMD by DEXA was found in 17 patients (42.5%) in group 1, in 33 (70.2%) in group 2, and in 3 (11.5%) in group 3. In groups 1 and 2, tetraparesis and severe/profound mental retardation were related to a significantly abnormal BMD (p = 0.003). The multivariate analysis of independent factors on BMD (z‐score) revealed a significant correlation between BMD (z‐score) and age (p = 0.04), body mass index (BMI; p = 0.002), severe/profound mental retardation (p = 0.03), and epilepsy (p = 0.05). Significance: A significantly lower BMD z‐score value was found in patients with cerebral palsy, mental retardation, and epilepsy compared with those without epilepsy. The epileptic disorder appears to be an aggravating factor on bone health when comorbid with cerebral palsy and mental retardation.     

Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotonergic symptoms in newborns and cord blood monoamine and prolactin concentrations

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have gained wide acceptance in the treatment of mental disorders in pregnant women, but there seems to be an increased risk for neonatal adaptation problems after exposure to SSRIs in late pregnancy. We aimed to investigate the perinatal sequelae of infants exposed to SSRIs during their fetal life and the relationship of these symptoms to the cord blood monoamine and prolactin concentrations. METHODS: We conducted a prospective, controlled, follow-up study with 20 mothers taking 20 to 40 mg/d of either citalopram or fluoxetine for depression (n = 10) or panic disorder (n = 10) and their infants and 20 matched controls not receiving psychotropic medication for confounding obstetric characteristics. Maternal cord blood and infant citalopram, fluoxetine, and norfluoxetine, cord blood monoamine and metabolite, and prolactin concentrations were measured. The newborns underwent standard clinical examination and specific assessment of serotonergic symptoms during the first 4 days of life and at the ages of 2 weeks and 2 months. RESULTS: There was a statistically significant (P =.008, V = 15, n = 20 for both groups), 4-fold difference in the serotonergic symptom score during the first 4 days of life between the SSRI group and the control group. The SSRI-exposed infants had significantly lower cord blood 5-hydroxyindoleacetic acid (5-HIAA) concentrations (P =.02, t31 = 2.57) compared with the control group. A significant inverse correlation (rs = -0.66, P =.007, n = 15) was seen between the serotonergic symptom score and the umbilical vein 5-HIAA concentrations in the SSRI-exposed but not the control infants. CONCLUSIONS: Infants exposed to SSRIs during late pregnancy are at increased risk for serotonergic central nervous system adverse effects, and the severity of these symptoms is significantly related to cord blood 5-HIAA levels.     

心理干预对云南苦聪族人心理健康的影响

目的：探讨心理干预对苦聪族人心理健康的影响。方法：对679名云南省普洱市镇沅县苦聪族居民进行横断面调查,并随机分成研究组340人（给予心理干预）和对照组339人（不给予心理干预）,采用症状自评量表（SCL-90）于干预前和干预后1个月进行测评。结果：干预前研究组和对照组SCL-90总分平均分别为（58.14±38.45）分和（51.84±25.11）分（t=0.68,P〉0.05）,干预后研究组和对照组SCL-90总分平均分别为（32.84±25.11）分和（58.14±38.45）分（t=2.68,P〈0.01）;研究组除人际关系和敌对因子分外其他因子分均显著低于对照组（P〈0.01）。结论：心理干预可以显著提高苦聪族人的心理健康水平。     

The efficacy of ECT in adults with mental retardation experiencing psychiatric disorders

There is a paucity of empirical data establishing the efficacy of electroconvulsive therapy (ECT) in patients with mental retardation and psychiatric disorders. This study examines the efficacy of ECT on specific symptoms and between psychiatric diagnoses in patients with mental retardation who are psychiatrically ill. A chart review was performed on 20 inpatients who had received ECT on a dedicated Mental Retardation-Dual Diagnosis Unit and were divided into 3 categories: mood disorders (n = 12), psychotic disorders (n = 6), and intermittent explosive disorder (n = 2). Ratings were performed 1 week before ECT treatment and 1-week after its termination using the Aberrant Behavior Checklist and the Clinical Global Impressions Severity Scale. A repeated-measures analysis of variance comparing Aberrant Behavior Checklist scale scores revealed a significant time-by-treatment interaction (F = 75.43, df = 1,9, P = 0.000, 2 t). The mood disorder and psychotic disorder groups had significantly lower irritability and hyperactivity scores after treatment compared with the intermittent explosive disorder group. The Clinical Global Impressions Severity Scale rating scores showed significant improvement in the mood disorders group (67%), in contrast to the intermittent explosive disorder group (0%). Our data suggests the utility of ECT for patients with mental retardation who also have treatment-resistant mood disorders and psychotic disorders, particularly with symptoms of hyperactivity and irritability. The data are sufficiently encouraging to justify prospective research of this question.     

认知行为治疗对伴自杀行为精神分裂症患者的影响

目的：探讨短程认知行为治疗对自杀未遂精神分裂症患者的心理健康状况和生命质量改善的效果。方法：将130例自杀未遂精神分裂症患者随机分为认知行为治疗组66例（实际完成63例）和对照组64例（实际完成59例）,治疗12周并随访6个月。分别于治疗前、治疗12周和随访6个月末进行抑郁自评量表（SDS）、社会支持评定量表（SSRS）、WHO健康量表（WHOQOL—BREF）、生命质量量表（QOLS）的评定。结果：两组脱落率比较差异无统计学意义（P〉0．05）。治疗12周和随访6个月,两组再次自杀率比较,以对照组高于治疗组（x2=4．366,x2=5．779;P〈0．05）。治疗12周和随访6个月,QOLS总分（t=2．34,3．49）、SDS总分（t=2．12,2．65）、WHOQOL—BREF总分（t=2．06,2．46）两组间比较差异有统计学意义（P〈0．05或P〈0．01）;SSRS总分差异无统计学意义（t=0．81,0．25;P〉0．05）。结论：认知行为治疗有助于改善自杀未遂精神分裂症患者的心理健康状况和生命质量,降低再次自杀率。     

Recombinant human fibroblast growth factor-2 promotes nerve regeneration and functional recovery after mental nerve crush injury

Several studies have shown that fibroblast growth factor-2(FGF2) can directly affect axon regeneration after peripheral nerve damage. In this study, we performed sensory tests and histological analyses to study the effect of recombinant human FGF-2(rh FGF2) treatment on damaged mental nerves. The mental nerves of 6-week-old male Sprague-Dawley rats were crush-injured for 1 minute and then treated with 10 or 50 μg/m L rh FGF2 or PBS in crush injury area with a mini Osmotic pump. Sensory test using von Frey filaments at 1 week revealed the presence of sensory degeneration based on decreased gap score and increased difference score. However, at 2 weeks, the gap score and difference score were significantly rebounded in the mental nerve crush group treated with 10 μg/m L rh FGF2. Interestingly, treatment with 10 μg/m L rh FGF had a more obviously positive effect on the gap score than treatment with 50 μg/m L rh FGF2. In addition, retrograde neuronal tracing with Dil revealed a significant increase in nerve regeneration in the trigeminal ganglion at 2 and 4 weeks in the rh FGF2 groups(10 μg/m L and 50 μg/m L) than in the PBS group. The 10 μg/m L rh FGF2 group also showed an obviously robust regeneration in axon density in the mental nerve at 4 weeks. Our results demonstrate that 10 μg/m L rh FGF induces mental nerve regeneration and sensory recovery after mental nerve crush injury.     

Efficacy of splinting and oral steroids in the treatment of carpal tunnel syndrome: a prospective randomized clinical and electrophysiological study

OBJECTIVE: To study the efficacy of splinting and oral steroids in the management of carpal tunnel syndrome (CTS). DESIGN: Prospective, randomized, open-label, clinical and electrophysiological study with 3-month follow-up. MATERIALS AND METHODS: Forty patients with CTS were randomly divided into splint group (N-20), wearing splint in neutral position for 4 weeks; and steroid group (N-20), who received oral prednisolone 20 mg/day for 2 weeks followed by 10 mg/day for 2 weeks. Clinical and electrophysiological evaluations were done at baseline and at 1-month and 3-month follow-up. Independent 't' test and paired 't' test were used for statistical analysis. OUTCOME MEASURES: Primary outcome measure was the symptom severity score and functional status score. Secondary outcome measures were median nerve sensory and motor distal latency and conduction velocity. RESULTS: At the end of 3 months, statistically significant improvement was seen in symptom severity score and functional status score in both groups (P<0.001). Median nerve sensory distal latency and conduction velocity also improved significantly in both the groups at 3 months. Improvement in motor distal latency was significant (P=0.001) at 3 months in steroid group, while insignificant improvement (P=0.139) was observed in splint group. On comparing the clinical and electrophysiological improvement between the two groups, except for the functional status score, there was no significant difference at 3-month follow-up. Improvement in functional status score was significantly more in steroid group (P=0.03). CONCLUSION: There was significant improvement in both groups, clinically as well as electrophysiologically, at 3 months. On comparing the efficacy of the two treatment methods, except for the functional status score, there was no significant difference between the two groups.     

Mood symptoms in children and adolescents with autism spectrum disorders

Asperger Syndrome (AS) and High Functioning Autism (HFA) are psychiatric conditions belonging to the Autistic Spectrum Disorders (ASDs), characterized by social dysfunction and focused interest, in the absence of mental retardation. Previous reports suggest that AS/HFA may be associated with important psychiatric comorbidities. Among the psychiatric internalizing disorders, depression and anxiety are probably the most common disorders. The aim of this study is to evaluate the prevalence of mood disorders and identifying peculiar clinical features in subjects suffering from AS and HFA. 30 male patients with AS/HFA, 30 male patients affected by Major Depression (MD) and 35 male Typically Developing (TD) comparison were assessed with the CDI and the CDRS-R. Participants’ parents were invited to complete the CBCL and the P-YMRS. Moreover, the CGAS was rated by the clinicians. The evaluation of depressive symptoms showed that AS/HFA group reported higher depressive symptoms, as showed by CDI total, CBCL internalizing and CDRS-R total, compared to the TD group. No significant difference of depressive symptoms was found between the AS/HFA and the MD group, with the exception of CDRS-R total score. Moreover, linear regression analysis in the AS/HFA group between CGAS and depressive symptoms revealed that a higher level of depressive symptoms increased the risk of poorer global functioning. These results suggest that the depressive symptoms in AS/HFA patients may be associated with poorer global functioning, with a consequent impairment in their psychological profile and social adjustment, and should alert clinicians to the importance of assessing mood disorders in order to choose the appropriate treatment.     

Somatosensory and brainstem auditory evoked potential studies in nontraumatic coma

We believe that somatosensory and brainstem auditory evoked response studies help in the understanding of the dysfunction of the ascending sensory pathyways at various levels. In some patients where EEGs showed a significant contamination of muscle and background noise, the SEP studies helped to identify the level of dysfunction. The severity of the clinical condition (GCS score) correlated significantly (p = 0.003) with the prolongation of the CCT. Asymmetries in CCTs were more frequent in the stroke group than in the other groups. The presence of asymmetries in CCT in diffuse encephalopathies indicated a variable degree of dysfunction in the ascending sensory pathways, which clinically were not easily identifiable. This fact raised the possibility of either pre-existing lesion(s) or recent insult(s) such as ischemia. The presence or absence of N20 appeared to influence the duration of survival in subgroups. Some degree of difference in duration of survival was noted among the metabolic group with and without N20 potential. The subset of patients with N20 potential survived relatively longer than the group without it. A suggestion of influence was seen in the stroke group, but caution must be exercised because the absence of N20 was compatible with survival. The hypoxic group did not show any difference. A combination of prolonged interpeak EP-N13 and N13-N20 indicated a poor prognosis. A distinct absence of Wave I in BAER limited its usefulness on some occasions. A combination of abnormal interpeak III-V and abnormal CCT seemed to suggest a poor prognosis. Although death generally occurred earlier in the stroke group, age did not seem to influence the mortality in the first 10 days. Similarly, the cause of death also did not seem to influence the course in those 10 days. None of the adult patients survived.     

暗示策略对帕金森病患者平衡功能和步态的康复作用

目的探讨暗示策略对帕金森病患者平衡功能和步态的康复作用。方法共40例原发性帕金森病患者随机接受常规抗帕金森病药物治疗和常规康复训练以及在此基础上联合暗示策略,分别于训练前和训练4周时采用Berg平衡量表(BBS)、10米步行试验(10MWT)、起立-行走计时测验(TUGT)和冻结步态问卷(FOGQ)评价平衡功能和步态,10MWT计算步长和步速。结果与训练前相比,训练4周时两组患者BBS评分(P=0.000)、10MWT之步长(P=0.000)和步速(P=0.000)均增加,TUGT时间(P=0.000)和FOGQ评分(P=0.000)减少;与对照组相比,观察组患者仅10MWT之步长(P=0.048)和步速(P=0.025)均增加、TUGT时间(P=0.023)和FOGQ评分(P=0.034)减少。结论常规康复训练联合暗示策略可以明显改善帕金森病患者平衡功能和步态,尤其对步态的康复治疗效果优于常规康复训练。