补肾活血颗粒辅助治疗对帕金森病患者脑内多巴胺神经递质及多巴胺转运蛋白的影响

Effect of Bushen Huoxue Granule on Dopamine Neurotransmitter and Dopamine Transporter in the Brain of Patients with Parkinson′s Disease

目的观察补肾活血颗粒辅助治疗对帕金森病患者脑内多巴胺(DA)神经递质及多巴胺转运蛋白(DAT)的影响。方法 94例帕金森病患者随机分成对照组和治疗组,每组47例,两组均以西药美多巴为基础治疗,对照组加服安慰剂,治疗组加用补肾活血颗粒,疗程均为3个月。治疗前后采用脑电超慢涨落图分析仪检测两组患者脑内DA的变化情况,采用正电子发射断层扫描技术及感兴趣区(region of interest,ROI)分析治疗组患者纹状体DAT的改变情况。结果 (1)两组治疗前DA检测值均低于正常值,差异均有统计学意义(P<0.01),两组比较差异无统计学意义(P>0.05);两组治疗后DA值明显升高,与本组治疗前比较差异有统计学意义(P<0.01);与正常值比较差异均无统计学意义(P>0.05),两组比较差异有统计学意义(P<0.05),治疗组优于对照组。(2)治疗后治疗组患者纹状体内DAT放射性浓聚较治疗前明显增加,ROI分析治疗前后纹状体/小脑总比值分别为(1.86±0.32)和(2.61±0.53),差异有统计学意义(P<0.05)。结论补肾活血颗粒能提高帕金森病患者脑内DA水平,增加纹状体DAT含量,从而起到有效治疗帕金森病的作用。

Objective To observe the effect of Bushen Huoxue Granule （BHG） on dopamine （DA） neurotransmitter and dopamine transporter （DAT） in the brain of patients with Parkinson＇s disease （PD） as an adjunctive therapy. Methods Ninety-four PD patients were randomly assigned to two groups, 47 in each group. Madopar was given to all as the basic treatment group. The placebo was given to those in the control group while BHG was given to those in the treatment. The therapeutic course for all was three months. Before and after treatment DA levels in the brain of patients were detected by encephalofluctuograph （EFG） technique. Changes of DAT in the stdatum of patients in the treatment group were detected by positron emission tomography （PET） and region of interest （ ROI ） analysis. Results （1） Before treatment the DA level was lower in the two groups than the normal value, showing significant difference （P 〈0. 01 ）, but with no significant difference between the two groups （P 〉0. 05）. After treatment the DA lev- el obviously increased in the two groups, showing significant difference from that before treatment （P〈0. 01 ）. No sig- nificant difference existed in the DA level in the two groups when compared with the normal value （P〉0. 05）, but with significant difference between the two groups （P 〈0. 05）. Better results were obtained in the treatment group than in the control group. （2） The DAT radioactive accumulation inside the striatum increased obviously in the treatment group after treatment. ROI analysis showed the total ratio of striatum/cerebellum before and after treatment was 1.86±0. 32 and 2. 61±0. 53 respectively, showing statistical difference （ P〈0. 05）. Conclusion BHG could improve the DA level of PD patients, and increasing DAT contents in the striatum, thus playing a role in effectively treating PD.