丘脑底核脑深部电刺激术辅助治疗帕金森病的临床效果
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摘要
目的研究丘脑底核脑深部电刺激术(SNDBS)辅助治疗帕金森病(PD)的临床效果。方法选择2017年2月～2018年4月在广州医科大学附属第一医院治疗的PD患者91例进行研究。根据随机数字表法将患者分成观察组(46例)和对照组(45例),两组患者均常规予以叩背吸痰和吸氧雾化,以及营养支持等措施治疗。对照组另服用多巴丝肼片,观察组在对照组基础上给予SNDBS术式治疗。治疗3个月后比较两组疗效及不良反应,比较两组治疗前及治疗3个月后统一帕金森病评分量表(UPDRS)评分、生活质量评分、尿酸(UA)和丙二醛(MDA)水平。结果观察组总有效率高于对照组(P <0.05)。治疗后,两组UPDRS评分均低于治疗前,且观察组低于对照组;两组生活质量评分高于治疗前,且观察组高于对照组,差异均有统计学意义(P <0.05);两组UA和MDA水平低于治疗前,且观察组低于对照组,差异有统计学意义(P <0.05)。两组不良反应总发生率比较,差异无统计学意义(P> 0.05)。结论应用SNDBS术式辅助治疗PD患者的效果较好,可改善患者的症状及生活质量,并降低氧化应激水平。
Objective To study the clinical effect of subthalamic nucleus deep brain stimulation(SNDBS) in the adjunctive treatment of Parkinson′s disease(PD). Methods Ninety-one cases of PD patients treated in the First Affiliated Hospital of Guangzhou Medical University from February 2017 to April 2018 were selected. According to the random number table method, the patients were divided into the observation group(46 cases)and the control group(45 cases).Patients in both groups were treated by conventional therapy such as back percussion and sputum suction, oxygen inhalation and atomization and nutritional support. The control group was given Levodopa and Benserazide Tablets, the observation group was given SNDBS treatment on the basis of the control group. After 3 months of treatment, the curative effect and adverse reactions of the two groups were compared. The unified Parkinson disease rating scale(UPDRS)score, quality of life score, uric acid(UA) and methane dicarboxylic aldehyde(MDA) level were compared between the two groups before and after 3 months of treatment. Results The total effective rate of the observation group was higher than that of the control group(P < 0.05). After treatment, the UPDRS score of the two groups were lower than those before treatment, and the observation group was lower than that of the control group; the quality of life score of the two groups were higher than those before treatment, and the observation group was higher than that of the control group, the differences were statistically significant(P < 0.05); the UA and MDA level of the two groups were lower than those before treatment, and the observation group was lower than that of the control group, the differences were statistically significant(P < 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P > 0.05). Conclusion SNDBS is effective in the adjunctive treatment of PD patients. It can improve the symptoms and quality of life of patients, and reduce oxidative stress level.
Objective To study the clinical effect of subthalamic nucleus deep brain stimulation(SNDBS) in the adjunctive treatment of Parkinson′s disease(PD). Methods Ninety-one cases of PD patients treated in the First Affiliated Hospital of Guangzhou Medical University from February 2017 to April 2018 were selected. According to the random number table method, the patients were divided into the observation group(46 cases)and the control group(45 cases).Patients in both groups were treated by conventional therapy such as back percussion and sputum suction, oxygen inhalation and atomization and nutritional support. The control group was given Levodopa and Benserazide Tablets, the observation group was given SNDBS treatment on the basis of the control group. After 3 months of treatment, the curative effect and adverse reactions of the two groups were compared. The unified Parkinson disease rating scale(UPDRS)score, quality of life score, uric acid(UA) and methane dicarboxylic aldehyde(MDA) level were compared between the two groups before and after 3 months of treatment. Results The total effective rate of the observation group was higher than that of the control group(P < 0.05). After treatment, the UPDRS score of the two groups were lower than those before treatment, and the observation group was lower than that of the control group; the quality of life score of the two groups were higher than those before treatment, and the observation group was higher than that of the control group, the differences were statistically significant(P < 0.05); the UA and MDA level of the two groups were lower than those before treatment, and the observation group was lower than that of the control group, the differences were statistically significant(P < 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P > 0.05). Conclusion SNDBS is effective in the adjunctive treatment of PD patients. It can improve the symptoms and quality of life of patients, and reduce oxidative stress level.
引文
[1]陆洋,姚晨,卢凤飞,等.丘脑底核脑深部电刺激治疗帕金森病的疗效预测模型[J].中华神经医学杂志,2017,16(5):473-478.
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[10]张华,石林,杨岸超,等.帕金森及肌张力障碍患者丘脑底核脑深部电刺激术中的治疗靶点定位[J].山东医药,2017,57(11):7-10.
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[13]龚大伟,范萍,邱畅,等.丘脑底核脑深部电刺激术治疗帕金森病早期语音声学研究[J].中华神经外科杂志,2018,34(4):369-373.
[14]王海姣,陈邓,朱丽娜,等.丘脑底核脑深部电刺激术联合药物治疗帕金森病有效性和安全性的Meta分析[J].中国现代神经疾病杂志,2017,17(2):110-120.
[15]陈以胜,李强,李建国,等.丘脑底核脑深部电刺激术治疗帕金森病的疗效及其影响因素分析[J].中华神经外科杂志,2018,34(4):374-378.
[16]张宁.普拉克索联合左旋多巴对帕金森病患者情绪及不良反应改善分析[J].医药前沿,2018,8(5):199-200.
[17]滕敬华,程红霞,俞霜.恩他卡朋联用左旋多巴治疗帕金森病系统评价[J].现代中西医结合杂志,2013,22(17):1836-1839.
[18]周琛,庞伟,陈明祝,等.普拉克索联合美多芭对老年帕金森患者运动功能的影响[J].中国医药科学,2018,8(1):81-83,87.
[19]王志庆,闫琰.多巴丝肼联合恩他卡朋治疗帕金森病的临床效果[J].中国医药导报,2017,14(29):141-146.
[20]叶静,江璐璐,刘金龙,等.丘脑底核脑深部电刺激治疗原发性帕金森病的不良事件[J].中国神经精神疾病杂志,2016,42(12):715-719.
[21]吴艳,杜娟.美多芭联合恩他卡朋对帕金森患者抗氧化应激的研究[J].药学与临床研究,2017,25(1):6-8.
[22]刘越存,黎展鸿,陈雄辉.美多芭联合盐酸普拉克索治疗对帕金森病患者焦虑抑郁状态及血清炎症因子水平的影响[J].中国医药科学,2017,7(7):12-15.
[23]赵真真,王丽艳,刘佳.盐酸普拉克索缓释片联合多巴丝肼片治疗帕金森病的疗效及安全性[J].中国医院用药评价与分析,2018,18(5):644-645,647.
[24]陈东万,曹红元,严家川,等.帕金森病患者血清氧化应激标志物的变化特点[J].现代生物医学进展,2015,15(34):6671-6674.
[2]曹雄彬,南毛球,匡良洪,等.丘脑底核脑深部电刺激治疗帕金森病的临床分析[J].现代生物医学进展,2015,15(16):3092-3095.
[3]王遣,魏新亭.帕金森病外科治疗研究进展[J].河南医学研究,2016,25(1):86-88.
[4]杨超,冼文彪,陈竹宁,等.帕金森病丘脑底核脑深部刺激术中电极位置的监测和校准[J].临床医学工程,2017,24(10):1333-1334.
[5]Müller EJ,Robinson PA.Quantitative theory of deep brain stimulation of the subthalamic nucleus for the suppression of pathological rhythms in Parkinson′s disease[J].PLoSComput Biol,2018,14(5):6217-6218.
[6]中华医学会神经病学分会帕金森病与运动障碍学组及神经心理学与行为神经病学组.帕金森病痴呆的诊断与治疗指南[J].中华神经科杂志,2011,44(9):635-637.
[7]佚名.帕金森病统一评分量表[J].中国现代神经疾病杂志,2002,2(5):277.
[8]秦朝晖,陈彪,张丽燕,等.早期帕金森病患者非运动性症状与健康相关生活质量的研究:随机对照临床试验[J].中国现代神经疾病杂志,2009,9(3):246-251.
[9]陈美红,邱伟文.多巴丝肼联合米氮平治疗帕金森患者的效果及其对心理状态的影响[J].中国临床保健杂志,2018,21(1):58-61.
[10]张华,石林,杨岸超,等.帕金森及肌张力障碍患者丘脑底核脑深部电刺激术中的治疗靶点定位[J].山东医药,2017,57(11):7-10.
[11]王姝,莫英绪,王大成.帕金森病发病因素的研究现状[J].医学信息,2018,31(1):46-48.
[12]陶英群,王莹,梁国标,等.丘脑底核电刺激术治疗帕金森病的疗效[J].中国微侵袭神经外科杂志,2015,20(1):19-22.
[13]龚大伟,范萍,邱畅,等.丘脑底核脑深部电刺激术治疗帕金森病早期语音声学研究[J].中华神经外科杂志,2018,34(4):369-373.
[14]王海姣,陈邓,朱丽娜,等.丘脑底核脑深部电刺激术联合药物治疗帕金森病有效性和安全性的Meta分析[J].中国现代神经疾病杂志,2017,17(2):110-120.
[15]陈以胜,李强,李建国,等.丘脑底核脑深部电刺激术治疗帕金森病的疗效及其影响因素分析[J].中华神经外科杂志,2018,34(4):374-378.
[16]张宁.普拉克索联合左旋多巴对帕金森病患者情绪及不良反应改善分析[J].医药前沿,2018,8(5):199-200.
[17]滕敬华,程红霞,俞霜.恩他卡朋联用左旋多巴治疗帕金森病系统评价[J].现代中西医结合杂志,2013,22(17):1836-1839.
[18]周琛,庞伟,陈明祝,等.普拉克索联合美多芭对老年帕金森患者运动功能的影响[J].中国医药科学,2018,8(1):81-83,87.
[19]王志庆,闫琰.多巴丝肼联合恩他卡朋治疗帕金森病的临床效果[J].中国医药导报,2017,14(29):141-146.
[20]叶静,江璐璐,刘金龙,等.丘脑底核脑深部电刺激治疗原发性帕金森病的不良事件[J].中国神经精神疾病杂志,2016,42(12):715-719.
[21]吴艳,杜娟.美多芭联合恩他卡朋对帕金森患者抗氧化应激的研究[J].药学与临床研究,2017,25(1):6-8.
[22]刘越存,黎展鸿,陈雄辉.美多芭联合盐酸普拉克索治疗对帕金森病患者焦虑抑郁状态及血清炎症因子水平的影响[J].中国医药科学,2017,7(7):12-15.
[23]赵真真,王丽艳,刘佳.盐酸普拉克索缓释片联合多巴丝肼片治疗帕金森病的疗效及安全性[J].中国医院用药评价与分析,2018,18(5):644-645,647.
[24]陈东万,曹红元,严家川,等.帕金森病患者血清氧化应激标志物的变化特点[J].现代生物医学进展,2015,15(34):6671-6674.