Parkinson's disease (PD) is one of the most common movement disorders, primarily affecting middle-aged and elderly individuals. With the increasing aging population, the incidence of PD is rising, placing a heavy burden on patients' families and society.

To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with entacapone-levodopa-carbidopa (LCE) on motor and non-motor symptoms in PD patients.

The study employed a randomized, double-blind design. A total of 110 PD patients who visited the Nanjing Drum Tower Hospital Group Suqian Hospital from August 2022 to May 2024 were selected and randomly divided into a control group (n=32) , a LCE group (n=40) , and an observation group (n=38) . The control group received Madopar treatment (0.5 tablet per dose, 3 doses per day) and sham stimulation, the LCE group received LCE treatment (1 tablet per dose, 3 doses per day) and sham stimulation, and the observation group received LCE (1 tablet per dose, 3 doses per day) combined with rTMS treatment (40 sequences per day, once daily, 5 times per week) for 4 weeks. The Unified Parkinson's Disease Rating Scale PartⅢ (UPDRSⅢ) , Hamilton Depression Rating Scale (HAMD) , Hamilton Anxiety Rating Scale (HAMA) , Parkinson's Disease Sleep Scale (PDSS) , Mini-Mental State Examination (MMSE) , Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) , and Activities of Daily Living (ADL) were used to assess improvements in motor and non-motor symptoms before and after treatment.

In the control group, UPDRSⅢ scores decreased and ADL scores increased after treatment compared to pre-treatment (P<0.05) . In the LCE and observation groups, UPDRSⅢ, HAMD, HAMA, and SCOPA-AUT scores decreased, while MMSE, PDSS, and ADL scores increased after treatment compared to pre-treatment (P<0.05) . Post-treatment UPDRSⅢ, HAMD, HAMA, and SCOPA-AUT scores were lower, and PDSS, MMSE, and ADL scores were higher in the LCE and observation groups compared to the control group (P<0.05) . The observation group had lower UPDRSⅢ, HAMD, HAMA, and SCOPA-AUT scores and higher PDSS, MMSE, and ADL scores than the LCE group after treatment (P<0.05) . There was no significant difference in the total incidence of adverse reactions among the three groups after treatment (P>0.05) .

Treatment with rTMS combined with LCE can significantly improve motor and non-motor symptoms in PD patients, with better efficacy than monotherapy.

帕金森病（PD）是常见的运动障碍性疾病之一，多见于中老年人，随着人口老龄化的不断加剧，发病率越来越高，给患者家庭乃至社会均带来沉重的负担。

探讨重复经颅磁刺激联合恩他卡朋双多巴对帕金森病患者运动及非运动症状的疗效。

本研究为随机、双盲设计。选取2022年8月—2024年5月在南京鼓楼医院集团宿迁医院就诊的帕金森病患者共110例。采用随机数字表法分为对照组32例、恩他卡朋双多巴组40例和观察组38例。对照组患者接受多巴丝肼治疗（0.5片/次，3次/d）和假性刺激，恩他卡朋双多巴组患者接受恩他卡朋双多巴治疗（1片/次，3次/d）和假性刺激，观察组患者接受恩他卡朋双多巴（1片/次，3次/d）联合重复经颅磁刺激治疗（40个序列/d，1次/d，5次/周），共治疗4周。分别在治疗前及治疗后采用帕金森病评定量表第三部分（UPDRS Ⅲ）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、帕金森病睡眠量表（PDSS）、简易精神状态量表（MMSE）、自主神经症状量表（SCOPA-AUT）、日常生活能力量表（ADL）评估患者的运动及非运动症状的改善情况。

对照组患者治疗后UPDRS Ⅲ评分低于组内治疗前，ADL评分高于组内治疗前（P<0.05）；恩他卡朋双多巴组、观察组患者治疗后UPDRS Ⅲ、HAMD、HAMA、SCOPA-AUT评分低于组内治疗前，MMSE、PDSS、ADL评分高于组内治疗前（P<0.05）。恩他卡朋双多巴组与观察组患者治疗后UPDRS Ⅲ、HAMD、HAMA、SCOPA-AUT评分低于对照组，PDSS、MMSE、ADL评分高于对照组（P<0.05）。观察组患者治疗后UPDRS Ⅲ、HAMD、HAMA、SCOPA-AUT评分低于恩他卡朋双多巴组，PDSS、MMSE、ADL评分高于恩他卡朋双多巴组（P<0.05）。治疗后三组患者不良反应总发生率比较，差异无统计学意义（P>0.05）。

帕金森病患者予以重复经颅磁刺激联合恩他卡朋双多巴治疗，可以明显改善其运动及非运动症状，且其疗效优于单一药物治疗。