目的:观察肝豆灵汤联合认知行为疗法(CBT)治疗痰瘀互结型Wilson病(WD)患者冲动控制障碍的临床疗效。方法:前瞻性纳入2018年8月至2023年2月就诊于安徽中医药大学第一附属医院脑病科的90例痰瘀互结型WD伴冲动控制障碍(ICD)患者,随机分为...目的:观察肝豆灵汤联合认知行为疗法(CBT)治疗痰瘀互结型Wilson病(WD)患者冲动控制障碍的临床疗效。方法:前瞻性纳入2018年8月至2023年2月就诊于安徽中医药大学第一附属医院脑病科的90例痰瘀互结型WD伴冲动控制障碍(ICD)患者,随机分为对照组、CBT组和观察组各30例。对照组予西药常规治疗(基础驱铜),CBT组在对照组基础上加用CBT,观察组在CBT组基础上加用肝豆灵汤。8d为1个疗程,治疗4个疗程。分析治疗前后3组患者24h尿铜(24 h U-Cu)、游离铜(NCC)、中医证候积分量表、统一WD评定量表Ⅲ部分(UWDRSⅢ)、Barratt冲动量表中文版(第11版)(BIS-11)、Buss-Perry攻击问卷(BPAQ)、修订版外显攻击行为量表(MOAS)、副反应量表(TESS)评分。结果:治疗前,3组患者间24 h U-Cu和NCC水平比较,差异无统计学意义,资料具有可比性。与本组治疗前比较,3组患者24 h U-Cu均有显著升高(P<0.01),NCC水平均有明显降低(P<0.05,P<0.01)。治疗后3组间患者24 h U-Cu水平差异无统计学意义;与对照组治疗后比较,观察组患者NCC水平明显降低(P<0.05),CBT组NCC水平差异无统计学意义;与CBT组比较,观察组患者NCC水平明显降低(P<0.05)。治疗前,3组患者间中医证候积分比较,差异无统计学意义。与本组治疗前比较,3组患者中医证候积分均有显著下降(P<0.01)。与对照组和CBT组比较,观察组患者中医证候积分明显降低(P<0.05)。治疗前,3组患者各项评分比较,差异均无统计学意义。与本组治疗前比较,3组各项评分均明显降低(P<0.05)。与对照组比较,CBT组和观察组患者UWDRSⅢ、BIS-11、BPAQ和MOAS评分均明显降低(P<0.05);与CBT组比较,观察组患者BIS-11和BPAQ评分明显降低(P<0.05),UWDRSⅢ和MOAS评分差异无统计学意义。结论:肝豆灵汤联合CBT治疗能够更好的改善痰瘀互结型WD患者的冲动控制障碍。展开更多
Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The...Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The aim of this study is to analyze the association between these two non-motor symptoms. Methods: Consecutive subjects with Parkinson’s disease attending the Movement Disorders Outpatient Clinic were included. The presence of ICDs was assessed using the Questionnaire for Impulse Control Disorders Rating Scale. RBD was diagnosed by an overnight, single night polysomnography. Results: Fifty-five consecutive subjects with Parkinson’s disease were included. The prevalence of ICDs and related behaviors was 23.6% (ICD in 14.5% and related behaviors in 9.1%). RBD was diagnosed in 47.2% of the patients. No differences were found in the frequency of ICDs and related behaviors when comparing subjects with and without RBD (23% versus 24.1%, p = 0.926, respectively). Conclusion: No association between the presence of RBD and the frequency of ICDs in subjects with Parkinson’s disease was found.展开更多
泌乳素瘤是最常见的功能性垂体腺瘤,首选多巴胺受体激动剂作为一线治疗方案。在接受多巴胺受体激动剂治疗的泌乳素瘤患者中可能出现各种类型的冲动控制障碍(impulse control disorders,ICDs),如病理性赌博、强迫性购物、性欲亢进、强迫...泌乳素瘤是最常见的功能性垂体腺瘤,首选多巴胺受体激动剂作为一线治疗方案。在接受多巴胺受体激动剂治疗的泌乳素瘤患者中可能出现各种类型的冲动控制障碍(impulse control disorders,ICDs),如病理性赌博、强迫性购物、性欲亢进、强迫性进食等。这些不良反应会对患者的工作和生活造成严重的影响。然而目前国内缺少相关研究报道,内分泌学界对冲动控制障碍的临床表现、诊断及治疗缺乏全面的认识。本文就泌乳素瘤中ICDs的发生比例、发生机制、危险因素、诊断及治疗等方面展开综述,以深入了解泌乳素瘤多巴胺受体激动剂治疗相关ICDs,为今后在临床诊治中筛查识别及诊治提供帮助。展开更多
文摘目的:观察肝豆灵汤联合认知行为疗法(CBT)治疗痰瘀互结型Wilson病(WD)患者冲动控制障碍的临床疗效。方法:前瞻性纳入2018年8月至2023年2月就诊于安徽中医药大学第一附属医院脑病科的90例痰瘀互结型WD伴冲动控制障碍(ICD)患者,随机分为对照组、CBT组和观察组各30例。对照组予西药常规治疗(基础驱铜),CBT组在对照组基础上加用CBT,观察组在CBT组基础上加用肝豆灵汤。8d为1个疗程,治疗4个疗程。分析治疗前后3组患者24h尿铜(24 h U-Cu)、游离铜(NCC)、中医证候积分量表、统一WD评定量表Ⅲ部分(UWDRSⅢ)、Barratt冲动量表中文版(第11版)(BIS-11)、Buss-Perry攻击问卷(BPAQ)、修订版外显攻击行为量表(MOAS)、副反应量表(TESS)评分。结果:治疗前,3组患者间24 h U-Cu和NCC水平比较,差异无统计学意义,资料具有可比性。与本组治疗前比较,3组患者24 h U-Cu均有显著升高(P<0.01),NCC水平均有明显降低(P<0.05,P<0.01)。治疗后3组间患者24 h U-Cu水平差异无统计学意义;与对照组治疗后比较,观察组患者NCC水平明显降低(P<0.05),CBT组NCC水平差异无统计学意义;与CBT组比较,观察组患者NCC水平明显降低(P<0.05)。治疗前,3组患者间中医证候积分比较,差异无统计学意义。与本组治疗前比较,3组患者中医证候积分均有显著下降(P<0.01)。与对照组和CBT组比较,观察组患者中医证候积分明显降低(P<0.05)。治疗前,3组患者各项评分比较,差异均无统计学意义。与本组治疗前比较,3组各项评分均明显降低(P<0.05)。与对照组比较,CBT组和观察组患者UWDRSⅢ、BIS-11、BPAQ和MOAS评分均明显降低(P<0.05);与CBT组比较,观察组患者BIS-11和BPAQ评分明显降低(P<0.05),UWDRSⅢ和MOAS评分差异无统计学意义。结论:肝豆灵汤联合CBT治疗能够更好的改善痰瘀互结型WD患者的冲动控制障碍。
文摘Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The aim of this study is to analyze the association between these two non-motor symptoms. Methods: Consecutive subjects with Parkinson’s disease attending the Movement Disorders Outpatient Clinic were included. The presence of ICDs was assessed using the Questionnaire for Impulse Control Disorders Rating Scale. RBD was diagnosed by an overnight, single night polysomnography. Results: Fifty-five consecutive subjects with Parkinson’s disease were included. The prevalence of ICDs and related behaviors was 23.6% (ICD in 14.5% and related behaviors in 9.1%). RBD was diagnosed in 47.2% of the patients. No differences were found in the frequency of ICDs and related behaviors when comparing subjects with and without RBD (23% versus 24.1%, p = 0.926, respectively). Conclusion: No association between the presence of RBD and the frequency of ICDs in subjects with Parkinson’s disease was found.
文摘泌乳素瘤是最常见的功能性垂体腺瘤,首选多巴胺受体激动剂作为一线治疗方案。在接受多巴胺受体激动剂治疗的泌乳素瘤患者中可能出现各种类型的冲动控制障碍(impulse control disorders,ICDs),如病理性赌博、强迫性购物、性欲亢进、强迫性进食等。这些不良反应会对患者的工作和生活造成严重的影响。然而目前国内缺少相关研究报道,内分泌学界对冲动控制障碍的临床表现、诊断及治疗缺乏全面的认识。本文就泌乳素瘤中ICDs的发生比例、发生机制、危险因素、诊断及治疗等方面展开综述,以深入了解泌乳素瘤多巴胺受体激动剂治疗相关ICDs,为今后在临床诊治中筛查识别及诊治提供帮助。
