普拉克索联合美多巴治疗帕金森病非运动症状疗效
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摘要
目的 :探讨普拉克索联合美多巴治疗帕金森病非运动症状的临床疗效。方法 :收集2016年1月至2018年4月治疗的帕金森病非运动症状患者66例,分为观察组和对照组各33例。对照组给予美多巴0.125 g/次,3次/d;1周后日口服量加0.125 g,逐步累加,直至达到患者的合适剂量。观察组在对照组基础上,同时给予普拉克索0.125 mg/次,3次/d;然后每周增加1次剂量,直至0.5 mg/次。两组均治疗8周。观察两组治疗前后汉密尔顿抑郁量表(HAMD)、非运动症状(NMS)、帕金森病睡眠量表(PDSS)、简易精神量表(MMSE)和生活质量评分。结果 :治疗后,观察组的HAMD和NMS评分低于治疗前[(7.12±2.15)分比(41.37±7.55)分,(12.47±2.03)分比(17.96±3.58)分,P <0.05]和对照组[(7.12±2.15)分比(16.82±7.46)分,(12.47±2.03)分比(15.35±3.33)分,P <0.05];PDSS和MMSE评分高于治疗前[(113.15±15.34)分比(86.41±5.89)分,(26.84±5.16)分比(10.47±3.66)分]和对照组[(113.15±15.34)分比(100.27±10.49)分,(26.84±5.16)分比(20.05±5.26)分,P <0.05]。观察组治疗后生活质量评分高于治疗前和对照组(P <0.05)。结论 :普拉克索联合美多巴治疗帕金森病非运动症状有积极效果,能够改善患者HAMD、NMS、PDSS和MMSE评分,提高患者的生活质量。
Objective: To explore the clinical efficacy of pramipexole combined with madopar in the treatment of nonmotor symptoms of Parkinson's disease. Methods: From January 2016 to April 2018, 66 patients with non-motor symptoms of Parkinson's disease treated were collected and divided into an observation group with 33 cases and a control group with 33 cases. The control group was given madopar 0.125 g/time, 3 times a day; after 1 week, the oral dose was increased by 0.125 g,and gradually increased until the appropriate dose of the patient was reached. The observation group was given pramipexole0.125 mg/time, 3 times a day on the basis of the control group; then the dose was increased once a week until 0.5 mg/time. Both groups were treated for 8 weeks. The Hamilton depression scale(HAMD), non-motor symptoms(NMS), Parkinson's disease sleep scale(PDSS), minimum mental state examination(MMSE), and scores of life quality of the two groups were observed before and after treatment. Results: After treatment, the HAMD and NMS scores in the observation group were lower than those before treatment[(7.12±2.15) vs.(41.37±7.55),(12.47±2.03) vs.(17.96±3.58), P<0.05] and those in the control group[(7.12±2.15)vs.(16.82±7.46),(12.47±2.03) vs.(15.35±3.33), P<0.05]. The scores of PDSS and MMSE in the observation group were higher than those before treatment[(113.15±15.34) vs.(86.41±5.89),(26.84±5.16) vs.(10.47±3.66)] and those in the control group[(113.15±15.34) vs.(100.27±10.49),(26.84±5.16) vs.(20.05±5.26), P<0.05]. The score of life quality in the observation group after treatment was higher than that before treatment and in the control group(P<0.05). Conclusion: Pramexex combined with madopar has a positive effect in the treatment of non-motor symptoms of Parkinson's disease, which can improve patients' HAMD, NMS, PDSS, MMSE scores and improve their quality of life.
Objective: To explore the clinical efficacy of pramipexole combined with madopar in the treatment of nonmotor symptoms of Parkinson's disease. Methods: From January 2016 to April 2018, 66 patients with non-motor symptoms of Parkinson's disease treated were collected and divided into an observation group with 33 cases and a control group with 33 cases. The control group was given madopar 0.125 g/time, 3 times a day; after 1 week, the oral dose was increased by 0.125 g,and gradually increased until the appropriate dose of the patient was reached. The observation group was given pramipexole0.125 mg/time, 3 times a day on the basis of the control group; then the dose was increased once a week until 0.5 mg/time. Both groups were treated for 8 weeks. The Hamilton depression scale(HAMD), non-motor symptoms(NMS), Parkinson's disease sleep scale(PDSS), minimum mental state examination(MMSE), and scores of life quality of the two groups were observed before and after treatment. Results: After treatment, the HAMD and NMS scores in the observation group were lower than those before treatment[(7.12±2.15) vs.(41.37±7.55),(12.47±2.03) vs.(17.96±3.58), P<0.05] and those in the control group[(7.12±2.15)vs.(16.82±7.46),(12.47±2.03) vs.(15.35±3.33), P<0.05]. The scores of PDSS and MMSE in the observation group were higher than those before treatment[(113.15±15.34) vs.(86.41±5.89),(26.84±5.16) vs.(10.47±3.66)] and those in the control group[(113.15±15.34) vs.(100.27±10.49),(26.84±5.16) vs.(20.05±5.26), P<0.05]. The score of life quality in the observation group after treatment was higher than that before treatment and in the control group(P<0.05). Conclusion: Pramexex combined with madopar has a positive effect in the treatment of non-motor symptoms of Parkinson's disease, which can improve patients' HAMD, NMS, PDSS, MMSE scores and improve their quality of life.
引文
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[11]李子悦,尤浩军,孙志宏.环境和遗传因素在帕金森病中的作用[J].延安大学学报(医学科学版),2017,15(1):70-72.
[12]梁建庆.帕金森病的发病机制、诊断标准及治疗策略[J]解放军医学杂志,2018,43(8):631-635.
[13]齐月.美多芭联合盐酸普拉克索对帕金森症的治疗价值研究[J].中国医药指南,2017,15(36):57-58.
[14]刘学昌.左旋多巴联合普拉克索对帕金森病患者应激反应的影响[J].中国实用神经疾病杂志,2018,21(16):1792-1797.
[15]王晓巍,崔宏福,姚素艳,等.左旋多巴治疗前后帕金森大鼠脑内γ-氨基丁酸A受体的变化[J].中国临床解剖学杂志,2015,33(6):677-680.
[16]朱锦莉.左旋多巴/苄丝肼治疗帕金森病37例临床疗效观察[J].当代医学,2017,23(4):68-69.
[17]潘溢丹.普拉克索联合认知行为疗法对改善早发帕金森病患者非运动症状及生活质量的应用价值[J].实用药物与临床,2018,21(9):1021-1024.
[2]韩韦姣.治疗帕金森病非运动症状研究进展[J].中医研究2018,31(10):66-68.
[3]黄建平,朱文宗.帕金森病诊疗与康复[M].北京:人民军医出版社,2015:3-4.
[4]Worboys M.The Hamilton Rating Scale for Depression:The making of a“gold standard”and the unmaking of a chronic illness,1960-1980[J].Chronic Illn,2013,9(3):202-219.
[5]陆耀军.帕金森病(PD)患者的非运动症状(NMS)及影响评分因素分析[J].中国继续医学教育,2015,7(27):119-120.
[6]Sung YH,Kim HJ,Koh SB,et al.Validation of the Korean Version of the Scales for Outcomes in Parkinson’s DiseaseSleep[J].J Korean Med Sci,2018,33(2):e14.
[7]高明月,杨珉,况伟宏,等.简易精神状态量表得分的影响因素和正常值的筛查效度评价[J].北京大学学报(医学版),2015,47(3):443-449.
[8]杨小湜,王阳,李秀君,等.SF-36量表的信度和效度评价[J].解剖科学进展,2009,15(4):383-385.
[9]崔亚欢,陈乃耀.帕金森病的发病机制研究[J].中华老年心脑血管病杂志,2019,21(1):106-110.
[10]苏英,黄睿,罗永杰.不同发病年龄段帕金森病伴轻度认知功能障碍的特点及相关因素分析[J].实用医院临床杂志2018,15(2):108-113.
[11]李子悦,尤浩军,孙志宏.环境和遗传因素在帕金森病中的作用[J].延安大学学报(医学科学版),2017,15(1):70-72.
[12]梁建庆.帕金森病的发病机制、诊断标准及治疗策略[J]解放军医学杂志,2018,43(8):631-635.
[13]齐月.美多芭联合盐酸普拉克索对帕金森症的治疗价值研究[J].中国医药指南,2017,15(36):57-58.
[14]刘学昌.左旋多巴联合普拉克索对帕金森病患者应激反应的影响[J].中国实用神经疾病杂志,2018,21(16):1792-1797.
[15]王晓巍,崔宏福,姚素艳,等.左旋多巴治疗前后帕金森大鼠脑内γ-氨基丁酸A受体的变化[J].中国临床解剖学杂志,2015,33(6):677-680.
[16]朱锦莉.左旋多巴/苄丝肼治疗帕金森病37例临床疗效观察[J].当代医学,2017,23(4):68-69.
[17]潘溢丹.普拉克索联合认知行为疗法对改善早发帕金森病患者非运动症状及生活质量的应用价值[J].实用药物与临床,2018,21(9):1021-1024.