运动障碍疾病Access数据库的建立与应用
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摘要
第一部分运动障碍疾病Access数据库的建立
目的建立运动障碍疾病Access数据库,为注册登记研究提供一个较好的平台。
方法通过了解国外运动障碍疾病前瞻性队列研究现状、甘肃省运动障碍疾病医疗服务的现状及疾病临床特征,制订运动障碍疾病登记表；依据运动障碍疾病登记表的内容,启动Windows XP操作平台,进入Access2003,建立含表、查询、窗体、报表等项目的数据库。
结果建成一个具有存储、数据输入输出、检索查询、统计分析等功能的运动障碍疾病数据库。
结论运动障碍疾病Access数据库将在临床研究、数据管理、教学、临床经验总结等方面起着很重要的的作用。
第二部分与帕金森病相关临床误诊分析
目的分析与帕金森病相关的误诊病人的临床资料,以期提升对该病的认识水平,提高帕金森病的正确诊断率。
方法在兰州大学第二医院运动障碍疾病Access数据库筛选32例误诊患者,结合国内外的参考文献以系统回顾的方法分析疾病误诊原因。
结果特发性震颤、血管性帕金森综合、脑血管病、进行性核上性麻痹、药物性帕金森综合征、多系统萎缩等疾病易与帕金森病相混淆。
结论病史采集不详细、体格检查不仔细、过分依赖辅助检查或缺少必要的辅助检查、对PD认识不足等因素与帕金森病相关误诊有关系。
第三部分帕罗西汀对帕金森病伴抑郁症的疗效分析
目的研究5-羟色胺再摄取抑制剂帕罗西汀治疗帕金森病伴抑郁的临床疗效。
方法从兰州大学第二医院运动障碍疾病Access数据库中筛选59例帕金森病伴抑郁症患者,随机分为治疗组和对照组,治疗组30例患者,对照组29例患者。治疗组加用帕罗西汀(20mg／d),对照组加用安慰剂。评价在8周的时间内汉密尔顿抑郁量及帕金森病运动功能评分量表(MDRSPD)评分的变化。结果治疗组在2、4、8周末的汉密尔顿抑郁量评分与对照组相比并无显著变化(p>0.05),同样两组之间MDRSPD评分前后的变化也无统计学意义。
结论帕罗西汀在治疗帕金森病伴抑郁症方面与对照组相比没有表现显著的治疗效果,对PD的运动症状也无明显影响。
Part 1.The establishment of Movement Disorders Access database.
Objective To establish a Movement Disorders Access database for providing a better platform for register research.
METHODS By understanding foreign prospective cohort study status of movement disorders,the health care services status of Gansu Province and clinical features of movement disorders, developed a movement disorders registration form; According to the contents of the movement disorders registration form started Windows XP operating platform,entered Access 2003,and build a database with tables,queries, forms,reports etc.
RESULTS A movement disorders database having storage,data input and output,search query,statistical analysis function etc.was established.
CONCLUSION Movement Disorders database will play a very important role in clinical studies,data management,teaching,clinical experience and so on.
Part 2. Parkinson's disease-related clinical misdiagnosis analysis
Objective Analysis clinical misdiagnosis data of Parkinson's disease-related patients to update the level of awareness of the disease and improve the rate of correct diagnosis of Parkinson's disease.
METHODS Thirty-two cases misdiagnosed were screened from the movement disorders Access database of The Second Hospital of Lanzhou University Combining references at home and abroad and by the method of systematic review, analysed the causes of the misdiagnosis.
RESULTS Parkinson's disease easily confused with essential tremor,vascular parkinsonism, cerebrovascular disease,progressive supranuclear palsy,multiple system atrophy, drug-induced parkinsonism etc.
CONCLUSION Not detailed history taking,careless physical examination, Over-reliance on auxiliary examination or the lack of the necessary examination, insufficient understanding of Parkinson's disease is related to the clinical misdiagnosis.
Part 3.The efficacy analysis of Paroxetine in Parkinson's disease with depression
Objective To explore the clinical effect of Paroxetine in the patients with Parkinson disease and depression.
METHODS Fifty-nine cases of PD with depression were screened from the movement disorders Access database of The Second Hospital of Lanzhou University,and randomly divided into two groups:therapy Group (30 cases),control group (29 cases).On the basic treatment, the therapy group was treated with Paroxetine (20mg/d) additionally, and control group was administered placebo. The primary outcomes were the change in the Hamilton Depression Rating Scale(HAM-D) and motor dysfunction rating scale for Parkinson's disease(MDRSPD) in 8 weeks.
RESULTS Therapy group was not superior to control group for the change in HAM-D and MDRSPD at the end of the 2nd,4th and 8th week of treatment(p> 0.05).
CONCLUSION Paroxetine was not efficacious in the treatment of Parkinson disease with depression.
目的建立运动障碍疾病Access数据库,为注册登记研究提供一个较好的平台。
方法通过了解国外运动障碍疾病前瞻性队列研究现状、甘肃省运动障碍疾病医疗服务的现状及疾病临床特征,制订运动障碍疾病登记表；依据运动障碍疾病登记表的内容,启动Windows XP操作平台,进入Access2003,建立含表、查询、窗体、报表等项目的数据库。
结果建成一个具有存储、数据输入输出、检索查询、统计分析等功能的运动障碍疾病数据库。
结论运动障碍疾病Access数据库将在临床研究、数据管理、教学、临床经验总结等方面起着很重要的的作用。
第二部分与帕金森病相关临床误诊分析
目的分析与帕金森病相关的误诊病人的临床资料,以期提升对该病的认识水平,提高帕金森病的正确诊断率。
方法在兰州大学第二医院运动障碍疾病Access数据库筛选32例误诊患者,结合国内外的参考文献以系统回顾的方法分析疾病误诊原因。
结果特发性震颤、血管性帕金森综合、脑血管病、进行性核上性麻痹、药物性帕金森综合征、多系统萎缩等疾病易与帕金森病相混淆。
结论病史采集不详细、体格检查不仔细、过分依赖辅助检查或缺少必要的辅助检查、对PD认识不足等因素与帕金森病相关误诊有关系。
第三部分帕罗西汀对帕金森病伴抑郁症的疗效分析
目的研究5-羟色胺再摄取抑制剂帕罗西汀治疗帕金森病伴抑郁的临床疗效。
方法从兰州大学第二医院运动障碍疾病Access数据库中筛选59例帕金森病伴抑郁症患者,随机分为治疗组和对照组,治疗组30例患者,对照组29例患者。治疗组加用帕罗西汀(20mg／d),对照组加用安慰剂。评价在8周的时间内汉密尔顿抑郁量及帕金森病运动功能评分量表(MDRSPD)评分的变化。结果治疗组在2、4、8周末的汉密尔顿抑郁量评分与对照组相比并无显著变化(p>0.05),同样两组之间MDRSPD评分前后的变化也无统计学意义。
结论帕罗西汀在治疗帕金森病伴抑郁症方面与对照组相比没有表现显著的治疗效果,对PD的运动症状也无明显影响。
Part 1.The establishment of Movement Disorders Access database.
Objective To establish a Movement Disorders Access database for providing a better platform for register research.
METHODS By understanding foreign prospective cohort study status of movement disorders,the health care services status of Gansu Province and clinical features of movement disorders, developed a movement disorders registration form; According to the contents of the movement disorders registration form started Windows XP operating platform,entered Access 2003,and build a database with tables,queries, forms,reports etc.
RESULTS A movement disorders database having storage,data input and output,search query,statistical analysis function etc.was established.
CONCLUSION Movement Disorders database will play a very important role in clinical studies,data management,teaching,clinical experience and so on.
Part 2. Parkinson's disease-related clinical misdiagnosis analysis
Objective Analysis clinical misdiagnosis data of Parkinson's disease-related patients to update the level of awareness of the disease and improve the rate of correct diagnosis of Parkinson's disease.
METHODS Thirty-two cases misdiagnosed were screened from the movement disorders Access database of The Second Hospital of Lanzhou University Combining references at home and abroad and by the method of systematic review, analysed the causes of the misdiagnosis.
RESULTS Parkinson's disease easily confused with essential tremor,vascular parkinsonism, cerebrovascular disease,progressive supranuclear palsy,multiple system atrophy, drug-induced parkinsonism etc.
CONCLUSION Not detailed history taking,careless physical examination, Over-reliance on auxiliary examination or the lack of the necessary examination, insufficient understanding of Parkinson's disease is related to the clinical misdiagnosis.
Part 3.The efficacy analysis of Paroxetine in Parkinson's disease with depression
Objective To explore the clinical effect of Paroxetine in the patients with Parkinson disease and depression.
METHODS Fifty-nine cases of PD with depression were screened from the movement disorders Access database of The Second Hospital of Lanzhou University,and randomly divided into two groups:therapy Group (30 cases),control group (29 cases).On the basic treatment, the therapy group was treated with Paroxetine (20mg/d) additionally, and control group was administered placebo. The primary outcomes were the change in the Hamilton Depression Rating Scale(HAM-D) and motor dysfunction rating scale for Parkinson's disease(MDRSPD) in 8 weeks.
RESULTS Therapy group was not superior to control group for the change in HAM-D and MDRSPD at the end of the 2nd,4th and 8th week of treatment(p> 0.05).
CONCLUSION Paroxetine was not efficacious in the treatment of Parkinson disease with depression.
引文
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11.刘红岩.数据库技术及应用[M].北京：清华大学出版社,2007：1-5.
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14.王伊龙等.中国七城市卒中患者急诊溶栓情况分析[J].中国卒中杂志,2009,4(1)：23-7.
15. Louis ED,Benito-Leon J,Bermejo-Pareja F. Population-based study of baseline ethanol consumption and risk of incident essential tremor. [J]. Neurol Neurosurg Psychiatry,2009,80(5):494-7.
16.邓海军,黄祥成,韩述岭.大型教学医院应加强肿瘤疾病数据库的建设[J].医学与哲学(临床决策论坛版),2008,29(7)：4.
17.张宇,李秀疆,刘向东,等.Access数据库应用技术[M].北京：中国铁道出版社,2006：98-118.
18.姚普选.数据库原理及应用(Access)[M].第二版.北京：清华大学出版社,2006：166-182.
19.但汉雷,孙凤蓬,张亚历,等.大肠息肉病例数据库系统的建立与应用[J].第一军医大学学报,2002,22(2)：177-8.
20. Pulignano G, Del Sindaco P, Tavazzi L, et al.Clinical features and outcomes of elderly outpatients with heart failure followed-up in Hospital cardiology units:data from a large nationwide cardiology database(IN-CHE Registry).[J].Am Heart,2002,143(1):45-55.
21.李强.循证医学[M]北京：科学出版社,2001：6-7.
22.Hughes AJ, Daniel SE, Iees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson's disease. [J].Neurology,2001,57(8):1497-9.
23.Calne DB, Snow BJ, Lee Cl.Criteria for diagnosing Parkinson's disease. [J].Ann Neurol,1992,32:125-7.
24.蒋雨平,王坚,丁正同,等.原发性帕金森病的诊断标准(2005年)[J].中国临床神经科学,2006,14：40.
25.中华医学会神经病学分会帕金森病及运动障碍学组.帕金森病的诊断[J].中华神经科杂志,2006,39(6)：408-409.
26.陈生弟主编.帕金森病[M].北京：人民卫生出版社.2006：149-154.
27.Leslie JF.Epidemiology and genetics of essential tremor[J].Neurology, 2000,54(4):8-13.
28.Benito-Leon J, Louis ED,Bermejo-Pareja F. Risk of incident Parkinson' s disease and parkinsonism in essential tremor:a population based study.[J].Neurol Neurosurg Psychiatry,2009,80(4):423-5.
29.陈生弟,王丽娟,张玉虎等.帕金森病临床诊治手册[M].北京：人民卫生出 版社,2008：19.
30. Zhang ZX, Roman GC, Hong Z, et al. Parkinson's disease in China:prevalence in Beijing, Xian, and Shanghai.[J].Lancet,2005, 365:595-7.
31.中国人民解放军神经病流调组.中国震颤麻痹患病及发病调查[J].中华流行病学杂志,1991,12(6)：363.
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50.陈海波,曾湘豫,张文记,等.帕金森病运动功能评分量表及一致性和敏感 性检验[J].卒中与神经疾病,2001,8(1)：1-4.
2.Brainin M. Overview of stroke data banks. [J].Neuroepidemiology,1994,13(6): 250-258.
3.杨玲.国际与国内肿瘤登记概况[J].中国肿瘤,2005,14(12)：772-775.
4. Hughes AJ, Daniel SE, Kilford L, et al.Accuracy of clinical diagnosis of idiopathic Parkinson's disease:a clinico-pathological study of 100 cases.[J].Neurol Neurosurg Psychiatry.1992,55(3):181-4.
5.杨杰,姜建东,潘雷.脑卒中数据库[J].卒中与神经疾病,2006,13(2)：127.
6.王建华.流行病学[M].第六版.北京：人民卫生出社,2004：151-152.
7. Bronstein K, Murray P, Licata-Gehr E, et al.The Stroke Data Bank project: implications for nursing research[J].Neurosci Nurs,1986,18 (3): 132-134.
8.Oxfordshire Community Stroke Project.Incidence of stroke in Oxford-shire:first year eperience of a community stroke register.[J].BrMed, 1983,287(6394):713-717.
9.张媛,刘新峰,徐格林.南京卒中注册项目的初步研究结果[J].中国卒中,2006,12-14.
10.高晓兰,王文志,胡长梅,等.脑卒中数据库研究的方法学及基线资料分析[J].中华神经外科杂志,1999,15(1)：38-41.
11.刘红岩.数据库技术及应用[M].北京：清华大学出版社,2007：1-5.
12.钟洪才,方驰华,巨邦律,等.Access原发性肝癌数据库的建立及其应用价值初探[J].第四军医大学学报,2004,25(21)：2011-3.
13.余江,卿三华,黄祥成,等.大肠癌Access数据库的建立及其应用[J].第一军医大学学报,2003,23(1)：78-9.
14.王伊龙等.中国七城市卒中患者急诊溶栓情况分析[J].中国卒中杂志,2009,4(1)：23-7.
15. Louis ED,Benito-Leon J,Bermejo-Pareja F. Population-based study of baseline ethanol consumption and risk of incident essential tremor. [J]. Neurol Neurosurg Psychiatry,2009,80(5):494-7.
16.邓海军,黄祥成,韩述岭.大型教学医院应加强肿瘤疾病数据库的建设[J].医学与哲学(临床决策论坛版),2008,29(7)：4.
17.张宇,李秀疆,刘向东,等.Access数据库应用技术[M].北京：中国铁道出版社,2006：98-118.
18.姚普选.数据库原理及应用(Access)[M].第二版.北京：清华大学出版社,2006：166-182.
19.但汉雷,孙凤蓬,张亚历,等.大肠息肉病例数据库系统的建立与应用[J].第一军医大学学报,2002,22(2)：177-8.
20. Pulignano G, Del Sindaco P, Tavazzi L, et al.Clinical features and outcomes of elderly outpatients with heart failure followed-up in Hospital cardiology units:data from a large nationwide cardiology database(IN-CHE Registry).[J].Am Heart,2002,143(1):45-55.
21.李强.循证医学[M]北京：科学出版社,2001：6-7.
22.Hughes AJ, Daniel SE, Iees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson's disease. [J].Neurology,2001,57(8):1497-9.
23.Calne DB, Snow BJ, Lee Cl.Criteria for diagnosing Parkinson's disease. [J].Ann Neurol,1992,32:125-7.
24.蒋雨平,王坚,丁正同,等.原发性帕金森病的诊断标准(2005年)[J].中国临床神经科学,2006,14：40.
25.中华医学会神经病学分会帕金森病及运动障碍学组.帕金森病的诊断[J].中华神经科杂志,2006,39(6)：408-409.
26.陈生弟主编.帕金森病[M].北京：人民卫生出版社.2006：149-154.
27.Leslie JF.Epidemiology and genetics of essential tremor[J].Neurology, 2000,54(4):8-13.
28.Benito-Leon J, Louis ED,Bermejo-Pareja F. Risk of incident Parkinson' s disease and parkinsonism in essential tremor:a population based study.[J].Neurol Neurosurg Psychiatry,2009,80(4):423-5.
29.陈生弟,王丽娟,张玉虎等.帕金森病临床诊治手册[M].北京：人民卫生出 版社,2008：19.
30. Zhang ZX, Roman GC, Hong Z, et al. Parkinson's disease in China:prevalence in Beijing, Xian, and Shanghai.[J].Lancet,2005, 365:595-7.
31.中国人民解放军神经病流调组.中国震颤麻痹患病及发病调查[J].中华流行病学杂志,1991,12(6)：363.
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