镇肝熄风汤联合多巴丝肼片治疗帕金森病的疗效观察及对血清BDNF、IGF-1、NT-3的影响
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摘要
目的观察镇肝熄风汤联合多巴丝肼片治疗帕金森病(PD)的疗效及其对血清脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)、神经营养因子-3(NT-3)的影响。方法选择2015年5月至2016年11月接受治疗的94例PD患者为研究对象,随机分为对照组与治疗组各47例。对照组给予多巴丝肼片治疗,治疗组在对照组的基础上联合镇肝熄风汤治疗,两组治疗均持续3个月。观察治疗前后两组老年颤证功能积分、蒙特利尔认知评估量表(MoCA)评分、血清BDNF、IGF-1、NT-3及不良反应情况,比较两组临床疗效。结果治疗后两组老年颤证功能积分均比治疗前显著降低(P <0. 05),且治疗组显著低于对照组(P <0. 05);治疗后两组MoCA评分均比治疗前显著升高(P <0. 05),且治疗组显著高于对照组(P <0. 05)。治疗后两组血清BDNF、IGF-1、NT-3水平均比治疗前显著升高(P <0. 05),且治疗组显著高于对照组(P <0. 05)。两组治疗中不良反应情况比较,差异无统计学意义(P> 0. 05)。治疗后治疗组总有效率为97. 87%,显著高于对照组的82. 98%(P <0. 05)。结论镇肝熄风汤联合多巴丝肼片治疗PD疗效肯定,能显著改善患者血清BDNF、IGF-1、NT-3水平。
Objective To observe the therapeutic effects on Parkinson's disease( PD) treated with zhengan xifeng decoction and levodopa and benserazide hydrochloride tablets and the impacts on serum BDNF,IGF-1 and NT-3. Methods From May 2015 to November 2016,94 patients with PD were collected as the subjects and randomized into a control group and an treatment group,47 cases in each one. In the control group,levodopa and benserazide hydrochloride tablets were given. In the treatment group,on the base of the medication as the control group,zhengan xifeng decoction was added.The medication was provided consecutively for 3 months in the two groups. Before and after treatment,the score of senile tremor functional disorder,MoCA score,serum BDNF,IGF-1 and NT-3 as well as adverse reactions were observed in the two groups. The clinical therapeutic effects were compared between the two groups. Results After treatment,the scores of senile tremor functional disorder were all reduced significantly as compared the scores before treatment in the two groups( P< 0. 05). The score in the treatment group was lower significantly than the control group( P < 0. 05). After treatment,MoCA scores were all increased significantly as compared with the scores before treatment in the two groups( P < 0. 05). The score in the treatment group was higher significantly than the control group( P < 0. 05). After treatment,the levels of serum BDNF,IGF-1 and NT-3 were all increased significantly as compared with the levels before treatment in the two groups( P < 0. 05). The levels in the treatment group were higher significantly than the control group( P < 0. 05). The difference in the adverse reactions was not significant in comparison between the two groups during treatment( P < 0. 05). After treatment,the total effective rate was 97. 87% in the treatment group,higher significantly than 82. 98% in the control group( P< 0. 05). Conclusion The combined medication with zhengan xifeng decoction and levodopa and benserazide hydrochloride tablets achieves the definite therapeutic effects on PD,significantly improves the levels of serum BDNF,IGF-1 and NT-3 in the patients.
Objective To observe the therapeutic effects on Parkinson's disease( PD) treated with zhengan xifeng decoction and levodopa and benserazide hydrochloride tablets and the impacts on serum BDNF,IGF-1 and NT-3. Methods From May 2015 to November 2016,94 patients with PD were collected as the subjects and randomized into a control group and an treatment group,47 cases in each one. In the control group,levodopa and benserazide hydrochloride tablets were given. In the treatment group,on the base of the medication as the control group,zhengan xifeng decoction was added.The medication was provided consecutively for 3 months in the two groups. Before and after treatment,the score of senile tremor functional disorder,MoCA score,serum BDNF,IGF-1 and NT-3 as well as adverse reactions were observed in the two groups. The clinical therapeutic effects were compared between the two groups. Results After treatment,the scores of senile tremor functional disorder were all reduced significantly as compared the scores before treatment in the two groups( P< 0. 05). The score in the treatment group was lower significantly than the control group( P < 0. 05). After treatment,MoCA scores were all increased significantly as compared with the scores before treatment in the two groups( P < 0. 05). The score in the treatment group was higher significantly than the control group( P < 0. 05). After treatment,the levels of serum BDNF,IGF-1 and NT-3 were all increased significantly as compared with the levels before treatment in the two groups( P < 0. 05). The levels in the treatment group were higher significantly than the control group( P < 0. 05). The difference in the adverse reactions was not significant in comparison between the two groups during treatment( P < 0. 05). After treatment,the total effective rate was 97. 87% in the treatment group,higher significantly than 82. 98% in the control group( P< 0. 05). Conclusion The combined medication with zhengan xifeng decoction and levodopa and benserazide hydrochloride tablets achieves the definite therapeutic effects on PD,significantly improves the levels of serum BDNF,IGF-1 and NT-3 in the patients.
引文
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[2]赵素晨,吴庆文,闫春林,等.唐山市轻度帕金森病患者非运动症状及生活质量的影响因素[J].中国老年学杂志,2015,35(24):7227-7228.
[3]陈宝友,李强,刘爱,等.帕金森病患者血清中脑源性神经营养因子、可溶性肿瘤坏死因子受体1和S-100B的表达及意义[J].中国老年学杂志,2015,35(4):931-932.
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[6]李新丹,王慧新,刘毅.中西医结合治疗帕金森病143例[J].河南中医,2015,35(6):1403-1404.
[7]左冠超,王红艳,何霞,等.天王补心丹汤剂加减治疗帕金森病肝肾阴虚型便秘临床疗效分析[J].世界中医药,2015(10):900-902.
[8]王新德.帕金森病及帕金森综合征的诊断标准和鉴别诊断[J].中华神经精神科杂志,1985,18(4):256-256.
[9]中华全国中医学会老年医学会.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):39-41.
[10]王雁,李馨,李海燕,等.帕金森病非运动症状的量表介绍及评价[J].临床神经病学杂志,2015,28(4):314-316.
[11]张国华.不同发病年龄组帕金森病的临床特点分析[J].中国伤残医学,2014,22(20):121.
[12]张佳,康文岩,刘军.帕金森病患者唾液α-突触核蛋白与纹状体多巴胺摄取功能的相关性研究[J].临床内科杂志,2017,34(1):45-48.
[13]刘佳,但小娟,张慧,等.血尿酸水平及生活环境因素与帕金森病的相关性[J].中华神经科杂志,2016,49(7):548-552.
[14]Kuoppam¨a ki M,Leinonen M,Poewe W. Efficacy and safety of enta-capone in levodopa/carbidopa versus levodopa/benserazide treatedParkinson's disease patients with wearing-off[J]. J Neural Transm(Vienna),2015,122(12):1709-1714.
[15]袁盈,陈枫,杨金生,等.针刺辅助治疗帕金森病49例[J].中国针灸,2014,34(1):53-54.
[16]李哲,胡瀛宇,雒晓东.帕金森病中医治疗进展[J].世界科学技术-中医药现代化,2014,16(4):908-914.
[17]周莹莹,蒋淼,李文,等.怀牛膝与川牛膝功效小考[J].中药与临床,2015,6(5):44-48.
[18]张升,桂雪虹,黄丽平,等.龟板联合β-细辛醚对帕金森病模型大鼠作用及机制的初步研究[J].中药新药与临床药理,2014,25(3):264-268.
[19]Park JB,Lee JS,Cho BP,et al. Adipose tissue-derived mesenchy-mal stem cells cultured at high cell density express brain-derivedneurotrophic factor and exert neuroprotective effects in a 6-hydroxydopamine rat model of Parkinson's disease[J]. Genes Ge-nomics,2015,37(2):213-221.
[20]Picillo M,Erro R,Santangelo G,et al. Insulin-like growth factor-1 and progression of motor symptoms in early,drug-naive Parkin-son's disease[J]. J Neurol,2013,260(7):1724-1730.
[21]赵会芬,孙振涛,闫金海.首发抑郁症患者血清NGF及NT-3水平的研究[J].贵州医药,2015,39(4):328-329.
[2]赵素晨,吴庆文,闫春林,等.唐山市轻度帕金森病患者非运动症状及生活质量的影响因素[J].中国老年学杂志,2015,35(24):7227-7228.
[3]陈宝友,李强,刘爱,等.帕金森病患者血清中脑源性神经营养因子、可溶性肿瘤坏死因子受体1和S-100B的表达及意义[J].中国老年学杂志,2015,35(4):931-932.
[4]Rodrigues TM,Jerónimo-Santos A,Outeiro TF,et al. Challenges andpromises in the development of neurotrophic factor-based therapiesfor Parkinson's disease[J]. Drugs Aging,2014,31(4):239-261.
[5]王秀丽,刘紫阳.滋阴补肾方治疗肾阴亏虚型帕金森病临床研究[J].中医学报,2014,29(5):746-747.
[6]李新丹,王慧新,刘毅.中西医结合治疗帕金森病143例[J].河南中医,2015,35(6):1403-1404.
[7]左冠超,王红艳,何霞,等.天王补心丹汤剂加减治疗帕金森病肝肾阴虚型便秘临床疗效分析[J].世界中医药,2015(10):900-902.
[8]王新德.帕金森病及帕金森综合征的诊断标准和鉴别诊断[J].中华神经精神科杂志,1985,18(4):256-256.
[9]中华全国中医学会老年医学会.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):39-41.
[10]王雁,李馨,李海燕,等.帕金森病非运动症状的量表介绍及评价[J].临床神经病学杂志,2015,28(4):314-316.
[11]张国华.不同发病年龄组帕金森病的临床特点分析[J].中国伤残医学,2014,22(20):121.
[12]张佳,康文岩,刘军.帕金森病患者唾液α-突触核蛋白与纹状体多巴胺摄取功能的相关性研究[J].临床内科杂志,2017,34(1):45-48.
[13]刘佳,但小娟,张慧,等.血尿酸水平及生活环境因素与帕金森病的相关性[J].中华神经科杂志,2016,49(7):548-552.
[14]Kuoppam¨a ki M,Leinonen M,Poewe W. Efficacy and safety of enta-capone in levodopa/carbidopa versus levodopa/benserazide treatedParkinson's disease patients with wearing-off[J]. J Neural Transm(Vienna),2015,122(12):1709-1714.
[15]袁盈,陈枫,杨金生,等.针刺辅助治疗帕金森病49例[J].中国针灸,2014,34(1):53-54.
[16]李哲,胡瀛宇,雒晓东.帕金森病中医治疗进展[J].世界科学技术-中医药现代化,2014,16(4):908-914.
[17]周莹莹,蒋淼,李文,等.怀牛膝与川牛膝功效小考[J].中药与临床,2015,6(5):44-48.
[18]张升,桂雪虹,黄丽平,等.龟板联合β-细辛醚对帕金森病模型大鼠作用及机制的初步研究[J].中药新药与临床药理,2014,25(3):264-268.
[19]Park JB,Lee JS,Cho BP,et al. Adipose tissue-derived mesenchy-mal stem cells cultured at high cell density express brain-derivedneurotrophic factor and exert neuroprotective effects in a 6-hydroxydopamine rat model of Parkinson's disease[J]. Genes Ge-nomics,2015,37(2):213-221.
[20]Picillo M,Erro R,Santangelo G,et al. Insulin-like growth factor-1 and progression of motor symptoms in early,drug-naive Parkin-son's disease[J]. J Neurol,2013,260(7):1724-1730.
[21]赵会芬,孙振涛,闫金海.首发抑郁症患者血清NGF及NT-3水平的研究[J].贵州医药,2015,39(4):328-329.