针刺联合半量托特罗定对帕金森病合并膀胱过度活动症排尿及运动功能的影响

Research on the effect of urine and motor function of acupuncture combined with half dose of tolterodine in the treatment of overactive bladder symdrom in Parkinson's Disease

目的观察针刺联合半量托特罗定对帕金森病(PD)合并膀胱过度活动症(OAB)的排尿及运动功能的影响和临床副作用。方法对60例PD合并OAB患者随机分两组,治疗组30例予以针刺联合半量托特罗定(1mg.d-2)治疗6周,对照组予以全量托特罗定(2mg.d-2)6周,两组基础美多巴治疗量一致,停用安坦等抗胆碱药物,观察两组治疗前后平均每次尿量、24小时平均尿次、24小时平均尿失禁次数、OABSS评分及UPDRSⅢ评分并分析临床疗效。结果治疗前后两组排尿变化均有显著性差异(P<0.01),治疗后治疗组较对照组有显著差异(P<0.05);两组OABSS评分治疗后均有下降,治疗组有显著差异(P<0.01);两组UPDRSⅢ评分治疗后均有下降趋势,治疗组治疗前后比较有明显好转(P<0.05),对照组无明显变化;治疗组临床疗效显著(P<0.05)且治疗组副作用明显少于对照组。结论针刺联合半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全量药物组,副作用少,而且对帕金森病的病情有一定的延缓作用。

Objective To evaluate the efficacy of acupuncture combined with half 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 Parkinsong disease patients accompanied with overactive bladder symdrom were divided into two groups randomly . 30 cases in the treatment group were treated with acupuncture in combination with half dose tolterodine 1 mg d-2 for 6 w , while the other 30 cases in the control group were treated with toherodine 2mg d-2 for 6 w , and foundation treatment of Madopar amount between two group healed consistent, and anticholinergic drugs such as AnTan etc were discontinued. 24h average urine times, average number of urinary incontinence, average urine output, OABSS scores and Ⅲ UPDRS scores between the two groups were recorded. Results There was significant difference between the two groups before and after treatment （ P 〈 0.01 ）, and the efficacy in treatment group was superior to the control group . Both OABSS scores and Ⅲ UPDRS scores of treatment groups dropped（with P 〈 0.01 and P＇〈 0.05 separately）. Whats more, the adverse reaction of the treatment group was less than that of the control group. Conclusion The efficacy of acupuncture in combination with half dose tolterodine is better than pure drugs treatment in Parkinsong disease with overactive bladder symdrom, with less side- effects, and function of delaying Parkinson disease .