摘要
目的:评价滋阴祛痰开窍方结合常规西药治疗肝肾阴虚型帕金森病伴轻度认知功能障碍(PD-MCI)患者的临床疗效。方法:纳入102例肝肾阴虚型PD-MCI患者,随机分为治疗组50例和对照组52例。所有患者均给予多巴胺能药物进行抗PD治疗,在此基础上,治疗组患者给予滋阴祛痰开窍方口服,两组治疗周期均为24周。治疗前及治疗24周后评价两组患者的蒙特利尔认知评估(MoCA)量表评分、统一帕金森病评分量表(UPDRS)总分与运动功能部分(UPDRS-PartⅢ)评分;所有患者服用的多巴胺能药物每日剂量均换算为左旋多巴等效剂量,比较两组患者的左旋多巴等效剂量的变化。结果:①治疗后,两组患者的MoCA评分较治疗前均降低(P<0.05),而治疗组患者的评分高于对照组(P<0.05)。②治疗后,两组患者的UPDRS总分及UPDRS-PartⅢ评分较治疗前均升高(P<0.05),而治疗组患者的UPDRS总分及UPDRS-PartⅢ评分低于对照组(P<0.05)。③治疗后,两组患者的左旋多巴等效剂量较治疗前均增加(P<0.05),而治疗组患者的左旋多巴等效剂量低于对照组(P<0.05)。结论:在常规抗PD治疗基础上加服中药滋阴祛痰开窍方,能够在一定程度上改善PD-MCI患者的认知功能,延缓PD疾病的进展,减少多巴胺能药物的服用剂量。
Objective:To evaluate the clinical efficacy of Ziyin Qutan Kaiqiao Decoction combined with conventional western medicine in the treatment of Parkinson’s disease with mild cognitive impairment(PD-MCI)(syndrome of yin deficiency of liver and kidney).Methods:One hundred and two patients of PD-MCI with syndrome of yin deficiency of liver and kidney were included and randomly divided into the treatment group(50 cases)and the control group(52 cases).All the patients were treated with dopaminergic drug for anti-PD,and the patients in the treatment group were orally treated with Ziyin Qutan Kaiqiao Decoction based on above,with a course of 24 weeks.Before treatment and after treatment for 24 weeks,the Montreal cognitive assessment(MoCA)score,the total score of unified Parkinson’s disease rating scale(UPDRS)and the score of motor function part(UPDRS-PartⅢ)were assessed;the daily dose of dopaminergic drug was converted to the levodopa equivalent dose,and the levodopa equivalent doses were compared between the two groups.Results:(1)After treatment,the score of MoC A in both groups was decreased compared with that before treatment(P<0.05),and the score of the treatment group was higher than that of the control group(P<0.05).(2)After treatment,the total scores of UPDRS and the score of UPDRS-PartⅢin both groups were increased compared with those before treatment(P<0.05),and the total scores of UPDRS and the score of UPDRS-PartⅢin the treatment group were lower than those in the control group(P<0.05).(3)After treatment,the levodopa equivalent dose in both groups was increased compared with that before treatment(P<0.05),and the levodopa equivalent dose of the treatment group was less than that of the control group(P<0.05).Conclusion:Ziyin Qutan Kaiqiao Decoction combined with conventional anti-PD therapy can improve the cognitive function of patients with PD-MCI to a certain extent,delay the progress of PD,and reduce the dose of dopaminergic drug.
作者
沈丽萍
乔向阳
王萍
顾竞
陈雪莲
沈利荣
邬渊敏
杨周剑
许佩佩
姚晓庆
王厹东
SHEN Liping;QIAO Xiangyang;WANG Ping;GU Jing;CHEN Xuelian;SHEN Lirong;WU Yuanmin;YANG Zhoujian;XU Peipei;YAO Xiaoqing;WANG Qiudong(Neurology Department of Integrated Chinese and Western Medicine,Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 201209,China;Department of Neurology,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Laboratory of Electroneurophysiology,Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 201209,China)
出处
《上海中医药大学学报》
CAS
2020年第4期11-14,共4页
Academic Journal of Shanghai University of Traditional Chinese Medicine
基金
上海市卫计委中医优势病种培育项目(ZYBZ-2017049)
上海市浦东新区卫计委临床中医高原学科建设项目(PDZY-2018-0606)
上海市浦东新区中医学科人才培养项目(PDZYXK-3-2014008)。
关键词
帕金森病
轻度认知功能障碍
肝肾阴虚型
滋阴祛痰开窍方
中西医结合
Parkinson’s disease
mild cognitive impairment
syndrome of yin deficiency of liver and kidney
Ziyin Qutan Kaiqiao Decoction
integrated Chinese and western medicine
