补疏通定汤治疗肾虚肝郁型老年帕金森病失眠
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摘要
目的:探讨补疏通定汤治疗肾虚肝郁型老年帕金森病失眠的疗效及安全性。方法:将患者随机分为两组,对照组给予盐酸普拉克索片口服,治疗组加用补疏通定汤,8周为1个疗程,比较两组患者临床症状改善情况、临床疗效、中医证候积分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、WHO生存质量测定量表(WHO quality of life,WHOQOL-BREF)、安全性检查及不良反应。结果:治疗组有效率为87.88%,高于对照组69.70%,两组比较差异有统计学意义(P<0.05);两组PSQI和WHOQOL-BREF评分较治疗前,均有明显改善,且治疗组改善幅度明显优于对照组,差异有统计学意义(P<0.05)。两组均未见不良反应。结论:补疏通定汤应用于帕金森病失眠患者,能滋补肝肾、疏肝通络、熄风定颤、重镇安神,与单纯应用西药比较,能提高临床疗效,有效缓解症状,提高患者睡眠质量和生存质量,改善预后。
Objective:To investigate the efficacy and safety of Bushu Tongding Decoction in the treatment of insomnia in elderly patients with Parkinson′s disease.Methods Patients were randomly divided into two groups.The control group received pramexole hydrochloride tablets orally.The treatment group was treated with Bushu Tongding Decoction for 8 weeks.The clinical symptoms,clinical efficacy,TCM syndrome scores of the two groups were compared.Pittsburgh sleep quality index(PSQI) score,WHO quality of life(WHOQOL-BREF),safety check and adverse reactions.Results:The effective rate of the treatment group was 87.88%,which was higher than that(69.70%) of the control group.The difference between the two groups was statistically significant(P<0.05).The PSQI and WHOQOL-BREF scores of the two groups were significantly improved compared with those before treatment.The improvement rate of the treatment group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).No adverse reactions were observed.Conclusion:Bushu Tongding decoction is applied to patients with insomnia caused by Parkinson′s disease.It can improve clinical efficacy,relieve symptoms and improve patients by nourishing liver and kidney,soothing liver and collaterals,quenching wind and calming tremors,and calming the nerves.Sleep quality and quality of life improve prognosis.
Objective:To investigate the efficacy and safety of Bushu Tongding Decoction in the treatment of insomnia in elderly patients with Parkinson′s disease.Methods Patients were randomly divided into two groups.The control group received pramexole hydrochloride tablets orally.The treatment group was treated with Bushu Tongding Decoction for 8 weeks.The clinical symptoms,clinical efficacy,TCM syndrome scores of the two groups were compared.Pittsburgh sleep quality index(PSQI) score,WHO quality of life(WHOQOL-BREF),safety check and adverse reactions.Results:The effective rate of the treatment group was 87.88%,which was higher than that(69.70%) of the control group.The difference between the two groups was statistically significant(P<0.05).The PSQI and WHOQOL-BREF scores of the two groups were significantly improved compared with those before treatment.The improvement rate of the treatment group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).No adverse reactions were observed.Conclusion:Bushu Tongding decoction is applied to patients with insomnia caused by Parkinson′s disease.It can improve clinical efficacy,relieve symptoms and improve patients by nourishing liver and kidney,soothing liver and collaterals,quenching wind and calming tremors,and calming the nerves.Sleep quality and quality of life improve prognosis.
引文
[1]张俊红,孔莎,杜红妍,等.伴失眠老年帕金森病患者生存质量的调查研究[J].医药论坛杂志,2014,35(7):167-168.
[2]董新刚,贾奎.中西医结合治疗早中期帕金森病临床研究[J].中医学报,2016,8(31):1191.
[3]邢歆,朱晓峰.帕金森病病患睡眠障碍的临床特征分析[J].中国老年保健医学,2017,15(1):67-69.
[4]周荣,胡万华,陈克龙.耳穴埋豆配合安神方治疗帕金森病失眠(肝肾阴虚型)疗效观察[J].辽宁中医药大学学报,2016,18(2):64-67.
[5]许玉珉,黑赏艳,章时杰,等.中西医结合治疗帕金森病睡眠障碍随机对照试验的Meta分析[J].广州中医药大学学报,2018,35(3):540-548.
[6]陆麒,姜柏生.谈《涉及人的生物医学研究伦理审查办法》的修订对我国伦理审查工作的影响[J].医学与哲学,2017,38(21):1-4.
[7]中华医学会神经病学分会运动障碍及帕金病学组.帕金森病西医诊断标准[J].中华神经杂志,2006,39(6):408-409.
[8]中华医学会精神病分会.CCMD3中国精神障碍与分类及诊断标准[J].中华神经科杂志,2001,34(3):184-188.
[9]隆呈祥.中医老年颤证诊断和疗效评定标准[J].北京中医学院学报,1992,15(4):39.
[10]邓铁涛,郭振球.中医诊断学[M].上海:上海科学技术出版社,1983:118.
[11]汪向东,王希林,马弘.心理卫生评定量表手册增订版[M].北京:中国心理卫生杂志社,1999:375-378.
[12]方积乾.生存质量测定方法及应用[M].北京:北京医科大学出版社,2000:29.
[13]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:222-224.
[14]程力群,俞佳,吴丹岭.帕金森病患者睡眠障碍相关因素分析[J].中国实用神经疾病杂志,2013,16(23):17-18.
[15]SALAWU F K,DANBURAM A,OLOKOBA A B.Non-motor symptoms of Parkinson′s diserse:diagnosis and management[J].Niger J Med,2010,19:126-131.
[16]EXNER N,LUTZ A K,HAASS C,et al.Mitochondrial dysfunction inParkinson′s disease:molecular mechanisms and pathophysiological conse-quences[J].EMBO J,2012,31(14):3038-3062.
[17]TRENKWALDER C,KIES B,RUDZINSKA M,et al.Rotigotine effectson earlymorning motor function and sleep in Parkinson′sdis-ease:adouble-blind,randomized,placebo-controlled study(RECOVER)[J].Mov Disord,2011,26(1):90-99.
[18]路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,43(3):260-263.
[19]刘嘉欣,夏萍.WHO生存质量量表在我国患者中的应用现状[J].中国社会医学杂志,2013,30(3):203-206.
[20]王慧新.帕金森病的中医治疗[J].吉林中医药,2015,35(8):791-792.
[21]于磊.补肾活血颗粒治疗帕金森病的作用机制研究[D].北京:中国人民解放军总医院解放军医学院,2016.
[22]常学辉,宁亚红.帕金森病“肾脑相关”理论浅析[J].中医学报,2015,30(2):230-231.
[23]张宏武,邹忠梅.柴胡疏肝散的临床应用及现代研究进展[J].时珍国医国药,2007,18(5):1234-1236.
[24]罗恩丽,鲍春龄,王德生.熄风定颤汤对PD模型大鼠单氨类神经递质的影响[J].辽宁中医杂志,2010,37(12):2313-2315.
[25]丁宏娟,何建成.涤痰汤对帕金森病大鼠神经细胞凋亡及相关基因表达的影响[J].辽宁中医杂志,2010,37(4):740-742.
[26]古春青,金杰.滋肾疏肝、清热养血法治疗帕金森病临床研究[J].中医学报,2017,32(7):1257-1261.
[2]董新刚,贾奎.中西医结合治疗早中期帕金森病临床研究[J].中医学报,2016,8(31):1191.
[3]邢歆,朱晓峰.帕金森病病患睡眠障碍的临床特征分析[J].中国老年保健医学,2017,15(1):67-69.
[4]周荣,胡万华,陈克龙.耳穴埋豆配合安神方治疗帕金森病失眠(肝肾阴虚型)疗效观察[J].辽宁中医药大学学报,2016,18(2):64-67.
[5]许玉珉,黑赏艳,章时杰,等.中西医结合治疗帕金森病睡眠障碍随机对照试验的Meta分析[J].广州中医药大学学报,2018,35(3):540-548.
[6]陆麒,姜柏生.谈《涉及人的生物医学研究伦理审查办法》的修订对我国伦理审查工作的影响[J].医学与哲学,2017,38(21):1-4.
[7]中华医学会神经病学分会运动障碍及帕金病学组.帕金森病西医诊断标准[J].中华神经杂志,2006,39(6):408-409.
[8]中华医学会精神病分会.CCMD3中国精神障碍与分类及诊断标准[J].中华神经科杂志,2001,34(3):184-188.
[9]隆呈祥.中医老年颤证诊断和疗效评定标准[J].北京中医学院学报,1992,15(4):39.
[10]邓铁涛,郭振球.中医诊断学[M].上海:上海科学技术出版社,1983:118.
[11]汪向东,王希林,马弘.心理卫生评定量表手册增订版[M].北京:中国心理卫生杂志社,1999:375-378.
[12]方积乾.生存质量测定方法及应用[M].北京:北京医科大学出版社,2000:29.
[13]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:222-224.
[14]程力群,俞佳,吴丹岭.帕金森病患者睡眠障碍相关因素分析[J].中国实用神经疾病杂志,2013,16(23):17-18.
[15]SALAWU F K,DANBURAM A,OLOKOBA A B.Non-motor symptoms of Parkinson′s diserse:diagnosis and management[J].Niger J Med,2010,19:126-131.
[16]EXNER N,LUTZ A K,HAASS C,et al.Mitochondrial dysfunction inParkinson′s disease:molecular mechanisms and pathophysiological conse-quences[J].EMBO J,2012,31(14):3038-3062.
[17]TRENKWALDER C,KIES B,RUDZINSKA M,et al.Rotigotine effectson earlymorning motor function and sleep in Parkinson′sdis-ease:adouble-blind,randomized,placebo-controlled study(RECOVER)[J].Mov Disord,2011,26(1):90-99.
[18]路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,43(3):260-263.
[19]刘嘉欣,夏萍.WHO生存质量量表在我国患者中的应用现状[J].中国社会医学杂志,2013,30(3):203-206.
[20]王慧新.帕金森病的中医治疗[J].吉林中医药,2015,35(8):791-792.
[21]于磊.补肾活血颗粒治疗帕金森病的作用机制研究[D].北京:中国人民解放军总医院解放军医学院,2016.
[22]常学辉,宁亚红.帕金森病“肾脑相关”理论浅析[J].中医学报,2015,30(2):230-231.
[23]张宏武,邹忠梅.柴胡疏肝散的临床应用及现代研究进展[J].时珍国医国药,2007,18(5):1234-1236.
[24]罗恩丽,鲍春龄,王德生.熄风定颤汤对PD模型大鼠单氨类神经递质的影响[J].辽宁中医杂志,2010,37(12):2313-2315.
[25]丁宏娟,何建成.涤痰汤对帕金森病大鼠神经细胞凋亡及相关基因表达的影响[J].辽宁中医杂志,2010,37(4):740-742.
[26]古春青,金杰.滋肾疏肝、清热养血法治疗帕金森病临床研究[J].中医学报,2017,32(7):1257-1261.