CAJ | 학술논문

目的：系统评价高、低频重复经颅磁刺激（rTMS）对帕金森病（PD）患者运动功能障碍的疗效。方法通过计算机检索Pubmed、Cochrane图书馆、EMbase、Web of Science、中国知网（CNKI）、中国生物医学文献数据库（CBM）等数据库中关于rTMS治疗PD患者运动功能障碍的随机对照试验（RCT）。截止时间设为2013年4月。由2名研究者根据纳入、排除标准筛选文献和提取数据，并相互验证。将统一帕金森病评定量表（UPDRS）中的运动功能评分（UPRDSⅢ）作为疗效的主要评价指标。结果经筛选纳入高质量RCT文献14篇，其中1篇英文文献无法直接提取数据，与作者邮件联系也未得到数据。因此，最终纳入RCT文献13篇用于meta分析，共601例PD患者。rTMS能显著改善PD患者运动功能障碍，差异有统计学意义[加权均数差（WMD）=-3.97，95%可信区间（95%CI）：-5.79~-2.16，P<0.01]。高、低频rTMS均能显著降低UPDRSⅢ的评分，高频rTMS效果（WMD=-5.86，95%CI：-7.22~-4.50）优于低频（WMD=-2.66，95%CI：-4.17~-1.15）。结论 PD患者接受rTMS治疗可有效缓解运动功能障碍。
목적：계통평개고、저빈중복경로자자격（rTMS）대파금삼병（PD）환자운동공능장애적료효。방법통과계산궤검색Pubmed、Cochrane도서관、EMbase、Web of Science、중국지망（CNKI）、중국생물의학문헌수거고（CBM）등수거고중관우rTMS치료PD환자운동공능장애적수궤대조시험（RCT）。절지시간설위2013년4월。유2명연구자근거납입、배제표준사선문헌화제취수거，병상호험증。장통일파금삼병평정량표（UPDRS）중적운동공능평분（UPRDSⅢ）작위료효적주요평개지표。결과경사선납입고질량RCT문헌14편，기중1편영문문헌무법직접제취수거，여작자유건련계야미득도수거。인차，최종납입RCT문헌13편용우meta분석，공601례PD환자。rTMS능현저개선PD환자운동공능장애，차이유통계학의의[가권균수차（WMD）=-3.97，95%가신구간（95%CI）：-5.79~-2.16，P<0.01]。고、저빈rTMS균능현저강저UPDRSⅢ적평분，고빈rTMS효과（WMD=-5.86，95%CI：-7.22~-4.50）우우저빈（WMD=-2.66，95%CI：-4.17~-1.15）。결론 PD환자접수rTMS치료가유효완해운동공능장애。
Objective To systematically evaluate the curative effect of high and low frequency repetitive transcranial magnetic stimulation(rTMS) on Parkinson disease(PD) patients′dyskinesia. Methods Used computer to search randomized con-trolled trial (RCT) on PD patients treated with rTMS in Pubmed,Cochrane Library,EMbase,Web of Science,CNKI,and CBM. The deadline was set to April,2013. 2 researchers screened references and extracted data on the basis of inclusion and exclusion criteria, and did mutual verification. Used UPRDSⅢin unified parkinson disease rating scale as major assessment criteria of cu-rative effect. Results Included 14 high quality RCT references after screening. 1 English reference could not directly extract data. Contacted with the author via E-mail and still did not get the data. Therefore ,there were eventually 13 RCT references used for meta-analysis and 601 PD patients in total. rTMS could remarkably improve PD patients′dyskinesia,differences showing sta-tistical significance(WMD=-3.97,95%credibility interval:-5.79--2.16,P<0.01). High and low frequency rTMS could both re-markably lower UPRDSⅢscore. High frequency rTMS′effect (WMD=-5.86,95%credibility interval:-7.22--4.50) was better than low frequency rTMS′(WMD=-2.66,95%credibility interval:-4.17--1.15). Conclusion rTMS can effectively relieve PD patients′dyskinesia.