六味地黄丸对帕金森患者认知功能的影响

The Influence of Cognitive Function in Parkinson’s Patients with Liu Wei Di Huang Wan

目的评估六味地黄丸对已接受左旋多巴治疗的帕金森病(PD)患者认知功能方面的影响。方法 85例应用左旋多巴治疗的原发性PD患者,随机分为两组,进行首次神经心理学评估,对照组40例单用左旋多巴制剂治疗,六味地黄丸组45例在左旋多巴制剂基础上合用六味地黄丸。并设无PD的正常组对照。在治疗6个月后进行第二次评估。结果研究开始时的第一次神经心理学评估显示,正常组在词语流畅性测验、连线测验、STROOP干扰测验均优于两组PD患者,有显著性差异。经6个月治疗后的第二次评估,两组PD患者在连线测验A和B表现有统计学差异,合用六味地黄丸组明显优于单用左旋多巴的对照组(P<0.05),但治疗后评分仍与正常组有显著性差异(P<0.05)。其他测试项目在PD患者两组组间和两次评估前后无显著性差异(P>0.05),但在合用六味地黄丸组,词语流畅性试验也有改善趋势。结论 PD患者显示出明显的执行功能损害和视空间障碍。本研究证实六味地黄丸可在执行功能方面改善PD认知功能。在认知方面,轻度PD患者联合应用六味地黄丸与左旋多巴是安全的。

Objective To evaluate the influence of Liu Wei Di Huang Wan on cognitive functions in PD patients already treated with levodopa. Methods The cognitive performance of 85 non-demented idiopathic Parkinson＇s disease （PD） patients treated with levodopa alone or receiving Lin Wei Di Huang Wan as add-on therapy to levodopa was evaluated in the present study during 6 months of treatment. Neuropsychological tests were administered two times. Results In the first assessment to differentiate test sensitive to cognitive changes typical for PD normal group was also assessed. After 6 months of treatment PD patients were retested only with tests that differentiate them from normal group. Compared to normals PD patients showed inferior performance on Stroop Interference test, Trail Making test, letter fluency and Hooper Visual Organization Test. Trail Making test A and B are lower in Liu Wei Di Huang Wan group compared with those receiving levodopa only after 6 months（P〈0.05）. No other statistically significant differences between two groups and first and secon.d neuropsychological assessment were found, but there was a trend for a rise on letter fluency and in group additionally treated with Liu Wei Di Huang Wan. Conclusion Liu Wei Di Huang Wan as add-on therapy to levodopa shows beneficial influence on executive function in PD patients. It is safe in non-demented PD patients in terms of the effect on cognitive performance.