缺血调理对帕金森病患者的影响

实验性的：Ischemic conditioning group

Therapy will be performed bilaterally on the upper limbs. The ischemic conditioning group will perform 4 times, 8 cycles with 30 seconds of ischemia (80 - 200 mmHg) with 5 seconds of reperfusion in each cycle. Ischemia cycles are controlled by a device (KAATSU C4 - KAATSU GLOBAL / USA) In the first cycle, participants will be subjected to pressures of 80 to 150 mmHg. In the 3 subsequent cycles, pressures from 130 to 200 mmHg will be applied.

设备：Ischemic conditioning group

The ischemic conditioning protocol will consist of a period of 12 weeks (24 sessions) with a frequency of 2 weekly sessions lasting between 15 and 20 minutes each. Therapy will be performed bilaterally on the upper limbs. The ischemic conditioning group will perform 4 times, 8 cycles with 30 seconds of ischemia (80 - 200 mmHg) with 5 seconds of reperfusion in each cycle. Ischemia cycles are controlled by a device (KAATSU C4 - KAATSU GLOBAL / USA) with customized ischemia programs, partially restricting blood flow through special pressure cuffs that are internally valved, providing greater comfort and safety for these patients who typically have stiffness in the affected limb and localized muscle pain. In the first cycle, participants will be subjected to pressures of 80 to 150 mmHg. In the 3 subsequent cycles, pressures from 130 to 200 mmHg will be applied.

假比较器：Sham group

Participants in the control group (Sham) will perform the same number of sets and 4 cycles, with equalized time to ischemia (4 minutes) and (40 seconds) reperfusion timing, but at a non-occlusive pressure of 30 mmHg (KAATSU C4 device)

设备：Sham group

In the sham group, participants will complete the same number of sets (4) and 4 cycles, with equalized time to ischemia (4 minutes) and (40 seconds) reperfusion timing, but at a non-occlusive pressure of 30 mmHg. Device, cuff placement, instructions, staff contact, and session duration will be standardized across groups.

统一帕金森病评定量表

0-260分：分数越高，损伤越大

蒙特利尔认知评估

最高分：30分；正常认知：26-30分；轻度认知障碍（MCI）：低于26分

细胞和可溶性免疫反应的评估

在应用缺血调理方案12周之前和之后，将患者的外周血收集在三个各5mL的EDTA管中。 从血液样本中获取血浆用于可溶性介质的定量，然后分离/储存外周血单核细胞（PBMC 或外周血单核细胞），用于 T 和 B 淋巴细胞、NK 细胞、骨髓细胞和单核细胞

全身可溶性介质的定量

最初，将含有血液的 EDTA 管在 400 x g、20 ℃ 下离心 5 分钟，以分离血浆。 收集的血浆将被等分到冷冻管中并储存在-80°C直到进行测试。 将使用 MILLIPLEX® 人类细胞因子/趋化因子/生长因子面板 A 试剂盒 H - 免疫学多重测定（Merck Millipore，马萨诸塞州，美国）对全身可溶性介质进行定量。 分析物组包括趋化因子、生长因子、促炎细胞因子和调节性细胞因子：FGF-2/FGF-basic、G-CSF、GM-CSF、IFNa2、IFNy、IL-1a、IL-1b、IL-1RA、 IL-2、IL-4、IL-6、IL-7、IL-8/CXCL8、IL-10、IL-12 (p40)、IL-12 (p70)、IL-13、IL-15、IL - 17A/CTLA8、IL-18、IP-10/CXCL10、MCP-1/CCL2、MCP-3/CCL7、M-CSF、MIG/CXCL9、MIP-1a/CCL3、MIP-1b/CCL4、PDGF-AB / BB、RANTES/CCL5、TNFa、TNFb/淋巴毒素-a、VEGF-A、HIF-1ą。 PCR、BNDF 和 Irisin 蛋白将使用单重测定进行测量。

PBMC 采集和流式细胞术

最后，BD LSRFortessa™ 流式细胞仪 (BD Biosciences) 将采集至少 100,000 个事件。

帕金森病问卷 39

总体得分范围为0%至100%，得分越高表明帕金森病对患者生活质量的负面影响越大。

计时完毕，出发

<10秒：个人通常能够在没有帮助的情况下独立完成大多数日常活动； 10-19 秒：表示在大多数日常活动中能够独立，但可能暗示轻微的行动限制； 20-29秒：表明需要行动协助，特别是对于更具挑战性的任务；

≥30 秒：表明跌倒风险较高，个人可能需要协助完成许多日常任务，并且可能需要行动辅助设备。