微电极引导的苍白球腹后部毁损术与中医药治疗帕金森病的对比研究

目的 :通过微电极引导的苍白球腹后部毁损术和中医药疗法治疗帕金森病的对比研究 ,探讨手术疗法和中医药疗法各自的疗效特点和治疗适应证。方法 :应用微电极引导的苍白球腹后部毁损术治疗帕金森病 34例 ,手术包括同期双侧、分期双侧和单侧手术。针刺配合中药治疗帕金森病 5 6例。Webster帕金森病功能障碍记分法评分 ,将治疗前后和两组之间治疗结果进行对比。结果 :手术治疗组 34例帕金森病病人中 ,有 33例患者在手术过程中震颤、僵直、运动迟缓等主要症状均有不同程度的缓解 ,手术后这些症状也持续好转 ,但其症状缓解程度在不同的病人中有所不同。Webster帕金森病功能障碍记分法评分 ,术后 1周进步率为 5 0 %～ 99%者 2 6例 ,1%～ 49%者 7例 ,<1%者 1例 ,总有效率 97%。中医药治疗组 80 %以上的患者治疗一个月后主观症状改善 ,主要体征好转 ,基本生活能力得到提高。治疗 3个月后Webster帕金森病功能障碍记分法评分 ,进步率为 5 0 %～ 99%者 6例 ,1%～ 49%者 39例 ,<1%者 11例 ,总有效率为 80 4%。两组患者治疗前、后评分结果进行t检验 ,P <0 0 1,两组之间治疗结果的总有效率进行 χ2 检验校正 ,P <0 0 5。结论 :微电极引导的苍白球腹后部毁损术和中医药治疗帕金森病均可取得较为满意的疗效。手术组对

Contrast study of microelectrode guided post-ventrual pallidotomy and Chinese medicine for treatment in Parkinson disease

Objective:To Explore the effects and the feature of microelectrode guided post-ventural pallidotomy and Chinese medicine for treatment in Parkinson disease.Methods:Thirty-four PD patients in whom microelectrode guided postventural pallidotomy was performed and 56 PD patients are treated with Chinese medicine and acupuncture are included in this study.The surgical procedures consist of contemporaneous bilateral pallidotomy,simultaneous bilateral pallidotomy and unilateral pallidotomy.Result:The patients were evaluated by a neurologist using Webster scale for PD patients before and after treatment.Every patient who underwent surgery shows obvious alleviation of the major symptoms except one with hemorrhage in target area during the surgery.The patients treated by Chinese medicine also had a good outcome after average 35 times treament.The better change rated of the whole scale of webster in both groups are 97% and 80.4% separately.Conclusions:Both posteroventral pallidotomy and Chinese medicine treatment have clinical benefit in treating Parkinson's Disease.The major symptoms such as tremor,rigidity,dyscanisia were alleviated during and after surgery.The complication of surgery occurred accidentally.The better change rate of Chinese medicine group is lower than the surgery group.But there are no any complication occurred.This kind of procedure is accommodate for any PD patients.