天麻钩藤颗粒联合美多芭治疗帕金森病的临床研究
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摘要
目的研究天麻钩藤颗粒联合美多芭治疗帕金森病(PD)的临床效果。方法选择2016年4月～2018年2月在杭州市第七人民医院接受治疗的PD患者174例,按照随机数表法将患者分为观察组和对照组,每组各87例。对照组予以美多芭治疗,观察组在对照组的基础上再增服天麻钩藤颗粒治疗,两组均治疗3个月,3个月为1个疗程。对比两组疗效、炎性指标及氧化应激指标,帕金森评分量表(UPDRS)评分和简易智能精神状态检查量表(MMSE)评分,以及用药安全性。结果观察组总有效率为96.55%,明显高于对照组(88.51%),差异有统计学意义(P <0.05)。治疗3个月后两组白细胞介素-4和超氧化物歧化酶水平高于治疗前,且观察组高于对照组;两组肿瘤坏死因子-α和丙二醛水平低于治疗前,且观察组低于对照组,差异有统计学意义(均P <0.05)。治疗3个月后两组MMSE评分明显高于治疗前,且观察组高于对照组;两组UPDRS评分明显低于治疗前,且观察组低于对照组,差异有统计学意义(均P <0.05)。观察组的不良反应总发生率为6.90%,与对照组(9.20%)比较,差异无统计学意义(P> 0.05)。结论天麻钩藤颗粒联合美多芭治疗PD效果显著,可有效改善患者的炎性状态及氧化应激水平,同时改善其认知功能,药物的安全性较好,值得给予推广。
Objective To study the clinical efficacy of Tianma Gouteng Granules combined with Madopar in the treatment of Parkinson disease(PD). Methods From April 2016 to February 2018, 174 patients with PD admitted in Hangzhou Seventh People′ s Hospital were selected. According to the random number table method, the patients were divided into observation group and control group, 87 cases in each group. The control group was treated with Madopar and the observation group was treated with Tianma Gouteng Granules on the basis of the control group. The two groups were treated for 3 months, 3 months was 1 course of treatment. The efficacy, inflammatory index, oxidative stress index,unified parkinson disease rating scale(UPDRS), mini mental state examination(MMSE) and medication safety were compared. Results The total effective rate of the observation group was 96.55%, which was significantly higher than88.51% of the control group, the difference was statistically significant(P < 0.05). After 3 months of treatment, the level of nterleukin-4 and superoxide dismutase in both groups was higher than that before treatment, and the level in the observation group was higher than that in the control group, tumor necrosis factor-α and malonaldehyde level in the two groups was lower than before treatment, and the observation group was lower than the control group, the differences were statistically significant(all P < 0.05). After 3 months of treatment, the MMSE score of the two groups was significantly higher than that before treatment, and the observation group was higher than that of the control group, the UPDRS scores of the two groups were significantly lower than those before treatment, and the observation group was lowerthan that of the control group, the differences were statistically significant(all P < 0.05). The total incidence of adverse reactions in the observation group was 6.90%,compared with 9.20% of the control group, the differ-ence was not statistically significant(P > 0.05). Conclusion Tianma Gouteng Granules combined with Madopar is effective in the treatment of PD. It can effectively improve the inflammatory state and oxidative stress level of patients, and improve their cognitive function. The drug is safe and worthy of promotion.
Objective To study the clinical efficacy of Tianma Gouteng Granules combined with Madopar in the treatment of Parkinson disease(PD). Methods From April 2016 to February 2018, 174 patients with PD admitted in Hangzhou Seventh People′ s Hospital were selected. According to the random number table method, the patients were divided into observation group and control group, 87 cases in each group. The control group was treated with Madopar and the observation group was treated with Tianma Gouteng Granules on the basis of the control group. The two groups were treated for 3 months, 3 months was 1 course of treatment. The efficacy, inflammatory index, oxidative stress index,unified parkinson disease rating scale(UPDRS), mini mental state examination(MMSE) and medication safety were compared. Results The total effective rate of the observation group was 96.55%, which was significantly higher than88.51% of the control group, the difference was statistically significant(P < 0.05). After 3 months of treatment, the level of nterleukin-4 and superoxide dismutase in both groups was higher than that before treatment, and the level in the observation group was higher than that in the control group, tumor necrosis factor-α and malonaldehyde level in the two groups was lower than before treatment, and the observation group was lower than the control group, the differences were statistically significant(all P < 0.05). After 3 months of treatment, the MMSE score of the two groups was significantly higher than that before treatment, and the observation group was higher than that of the control group, the UPDRS scores of the two groups were significantly lower than those before treatment, and the observation group was lowerthan that of the control group, the differences were statistically significant(all P < 0.05). The total incidence of adverse reactions in the observation group was 6.90%,compared with 9.20% of the control group, the differ-ence was not statistically significant(P > 0.05). Conclusion Tianma Gouteng Granules combined with Madopar is effective in the treatment of PD. It can effectively improve the inflammatory state and oxidative stress level of patients, and improve their cognitive function. The drug is safe and worthy of promotion.
引文
[1]王静.美多芭联合普拉克索治疗帕金森病的疗效及安全性[J].临床医药文献电子杂志,2017,4(17):3339-3341.
[2]许程燕.滋阴息风汤联合美多芭治疗肝肾阴虚型帕金森病非运动症状的临床疗效研究[J].中医临床研究,2017,9(30):13-14.
[3]焦娟.归芍柔筋汤加减联合美多芭治疗帕金森病疗效观察[J].深圳中西医结合杂志,2017,27(5):28-29.
[4]中华医学会神经病学分会帕金森病及运动障碍学组.中国帕金森病的诊断标准(2016版)[J].中华神经科杂志,2016,49(4):268-271.
[5]洪雁.帕金森病常用评分量表[J].中国现代神经疾病杂志,2002,2(5):277-277.
[6]周小炫,谢敏,陶静,等.简易智能精神状态检查量表的研究和应用[J].中国康复医学杂志,2016,31(6):694-696,706.
[7]郝俊辉.金刚烷胺联合美多芭对帕金森病患者运动功能的影响[J].国际医药卫生导报,2018,24(5):726-728.
[8]Pan X,Chen C,Huang J,et al.Neuroprotective effect of combined therapy with hyperbaric oxygen and madopar on6-hydroxydopamine-induced Parkinson′s disease in rats[J].Neurosci Lett,2015,23(600):220-225.
[9]冯琬迪,王媛媛,盖聪,等.针刺联合美多芭对帕金森病小鼠脑多巴胺神经元及蛋白激酶B表达的影响[J].北京中医药大学学报,2017,40(3):241-246.
[10]Wang HM,Yang MH,Liu Y,et al.Effectiveness of Bushen Huoxue Granule on 5-serotonin and norepinephrine in the brain of Parkinson′s disease patients with depressive state[J].Chin J Integr Med,2014,20(12):944-948.
[11]马宇,李兴贵,展群岭,等.普拉克索与美多芭合用配合心理治疗应用于帕金森病合并睡眠障碍患者的效果[J].检验医学与临床,2018,15(1):30-33.
[12]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.
[13]杨丽娟,何晓燕,沙晶,等.美多芭联合t DCS治疗PD的疗效及对UPDRS评分的影响分析[J].脑与神经疾病杂志,2017,25(11):661-664.
[14]顾亮亮,付国惠,张保朝,等.天麻钩藤颗粒联合左旋多巴治疗帕金森病的疗效及对血清炎性因子和SOD、MDA、Cys-C的影响[J].中西医结合心脑血管病杂志,2018,16(1):95-97.
[15]张立娟,张倩,王康锋,等.天麻钩藤饮对帕金森病模型大鼠行为学及纹状体内多巴胺含量的影响[J].江苏中医药,2018,50(2):79-82.
[16]张小锋.帕金森病患者采取美多芭联合司来吉兰治疗的效果及安全性观察[J].临床医学研究与实践,2018,3(6):38-39.
[17]Liu H,Chen L,Zhang Z,et al.Effectiveness and safety o acupuncture combined with Madopar for Parkinson′s disease:a systematic review with meta-analysis[J].Acupunc Med,2017,35(6):404-412.
[18]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.
[19]李冬云,韩冰.美多芭联合普拉克索治疗中晚期帕金森病的临床效果及安全性探讨[J].中国实用医药,2018,13(10):143-144.
[20]岳亚男,郑晨星,李雷申,等.熄风止震汤加减联合天麻钩藤颗粒对帕金森病患者日常生活能力及睡眠质量的影响[J].亚太传统医药,2017,13(22):160-161.
[21]黄月芳,楼招欢.天麻钩藤颗粒对偏头痛模型小鼠的活血、抗炎、镇痛作用观察[J].浙江中医杂志,2013,48(12):908-909.
[22]刘晓玲.健脾益肾活血方联合美多芭治疗早期帕金森病的疗效观察[J].中国中医药科技,2017,24(2):228-229.
[2]许程燕.滋阴息风汤联合美多芭治疗肝肾阴虚型帕金森病非运动症状的临床疗效研究[J].中医临床研究,2017,9(30):13-14.
[3]焦娟.归芍柔筋汤加减联合美多芭治疗帕金森病疗效观察[J].深圳中西医结合杂志,2017,27(5):28-29.
[4]中华医学会神经病学分会帕金森病及运动障碍学组.中国帕金森病的诊断标准(2016版)[J].中华神经科杂志,2016,49(4):268-271.
[5]洪雁.帕金森病常用评分量表[J].中国现代神经疾病杂志,2002,2(5):277-277.
[6]周小炫,谢敏,陶静,等.简易智能精神状态检查量表的研究和应用[J].中国康复医学杂志,2016,31(6):694-696,706.
[7]郝俊辉.金刚烷胺联合美多芭对帕金森病患者运动功能的影响[J].国际医药卫生导报,2018,24(5):726-728.
[8]Pan X,Chen C,Huang J,et al.Neuroprotective effect of combined therapy with hyperbaric oxygen and madopar on6-hydroxydopamine-induced Parkinson′s disease in rats[J].Neurosci Lett,2015,23(600):220-225.
[9]冯琬迪,王媛媛,盖聪,等.针刺联合美多芭对帕金森病小鼠脑多巴胺神经元及蛋白激酶B表达的影响[J].北京中医药大学学报,2017,40(3):241-246.
[10]Wang HM,Yang MH,Liu Y,et al.Effectiveness of Bushen Huoxue Granule on 5-serotonin and norepinephrine in the brain of Parkinson′s disease patients with depressive state[J].Chin J Integr Med,2014,20(12):944-948.
[11]马宇,李兴贵,展群岭,等.普拉克索与美多芭合用配合心理治疗应用于帕金森病合并睡眠障碍患者的效果[J].检验医学与临床,2018,15(1):30-33.
[12]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.
[13]杨丽娟,何晓燕,沙晶,等.美多芭联合t DCS治疗PD的疗效及对UPDRS评分的影响分析[J].脑与神经疾病杂志,2017,25(11):661-664.
[14]顾亮亮,付国惠,张保朝,等.天麻钩藤颗粒联合左旋多巴治疗帕金森病的疗效及对血清炎性因子和SOD、MDA、Cys-C的影响[J].中西医结合心脑血管病杂志,2018,16(1):95-97.
[15]张立娟,张倩,王康锋,等.天麻钩藤饮对帕金森病模型大鼠行为学及纹状体内多巴胺含量的影响[J].江苏中医药,2018,50(2):79-82.
[16]张小锋.帕金森病患者采取美多芭联合司来吉兰治疗的效果及安全性观察[J].临床医学研究与实践,2018,3(6):38-39.
[17]Liu H,Chen L,Zhang Z,et al.Effectiveness and safety o acupuncture combined with Madopar for Parkinson′s disease:a systematic review with meta-analysis[J].Acupunc Med,2017,35(6):404-412.
[18]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.
[19]李冬云,韩冰.美多芭联合普拉克索治疗中晚期帕金森病的临床效果及安全性探讨[J].中国实用医药,2018,13(10):143-144.
[20]岳亚男,郑晨星,李雷申,等.熄风止震汤加减联合天麻钩藤颗粒对帕金森病患者日常生活能力及睡眠质量的影响[J].亚太传统医药,2017,13(22):160-161.
[21]黄月芳,楼招欢.天麻钩藤颗粒对偏头痛模型小鼠的活血、抗炎、镇痛作用观察[J].浙江中医杂志,2013,48(12):908-909.
[22]刘晓玲.健脾益肾活血方联合美多芭治疗早期帕金森病的疗效观察[J].中国中医药科技,2017,24(2):228-229.