针刺联合小剂量托特罗定治疗帕金森病合并膀胱过度活动症

Research on acupuncture combined with small dose of tolterodine in the treatment of overactive bladder symdrom in Parkinson's disease

目的观察针刺联合小剂量托特罗定对帕金森病(PD)合并膀胱过度活动症(OAB)的疗效以及运动功能变化和临床不良反应。方法对60例帕金森病合并膀胱过度活动症患者随机分2组,治疗组30例予以针刺联合小剂量托特罗定(1mg,2/d)治疗6周,对照组予以全量托特罗定(2 mg,2/d)6周,2组基础美多巴治疗量一致,停用安坦等抗胆碱药物,观察2组治疗前后24 h平均尿次,24 h平均尿失禁次数,平均每次尿量及UPDRSⅢ评分。结果治疗前后2组排尿变化后差异有统计学意义(P<0.01),治疗组较对照组治疗后差异有统计学意义(P<0.05),同时2组UPDRSⅢ评分治疗组有下降趋势,与本组治疗前比较P<0.05,与对照组比较差异有统计学意义P<0.05,且治疗组不良反应明显少于对照组。结论针刺联合小剂量托特罗定治疗帕金森病合并膀胱过度活动症疗效优于单纯药物组,不良反应少,而且对帕金森病的病情有一定延缓作用。

Objective To evaluate the efficacy of acupuncture combined with small dose of tolterodine in the treatment of overactive bladder symdrom in Parkinson＇s disease, and observe the movement function change and adverse reactions as well. Methods Sixty cases of Parkinson＇s disease patients accompanied with overactive bladder symdrom were divided into two groups randomly. Thirty cases in the treatment group were treated with acupuncture in combination with small dose tolterodine （1 mg twice per day） for 6 weeks, while the other 30 cases in the control group were treated with tolterodine （2 rag, twice per day） for six weeks, and foundation treatment of Madopar amount between two group healed consistent, and anticho/inergic drugs such as Antan etc were discontinued. 24 hour average urine times,average number of urinary incontinence and average u- rine output andⅢ UPDRS scores between the two groups were recorded. Results There was significant difference between the two groups before and after treatment （P〈0.05）, and the efficacy in treatment group was superior to the control group And ]]I UPDRS scores of treatment groups dropped, while control group without obvious change trend, and there were significant differences between the treatment group and the control group （P〉0.05）. whafs more, the adverse reaction of the treatment group was less than the control group. Conclusion The efficacy of acupuncture in combination with small dose tolterodine is better than pure drugs treatment in Parkinsoffs disease with overactive bladder syndrome, with less side-effects, and function of delaying Parkinson＇s disease.