补肾疏肝法治疗肝肾阴虚型帕金森病伴轻中度抑郁30例临床观察

Clinical Observation of Kidney-Supplementing Liver-Coursing Therapy for 30 Cases of Parkinson's Disease Complicated by Mild to Moderate Depression with Liver-Kidney Yin Deficiency Syndrome

目的观察补肾疏肝法治疗肝肾阴虚型帕金森病(PD)伴发轻中度抑郁患者的临床疗效。方法将60例患者随机分为治疗组和对照组各30例。对照组口服多巴制剂及盐酸舍曲林片,治疗组在此基础上加用补肾疏肝方药治疗,两组疗程均为12个月。比较两组患者治疗前后帕金森病统一评分量表(UPDRS)、汉密顿抑郁量表(HAMD)总分及HAMD筛选因子评分变化;观察两组患者治疗前后服用盐酸舍曲林和多巴制剂平均剂量及患者轻中度抑郁构成变化。结果治疗组治疗后UPDRS积分低于对照组(P<0.05)。治疗后治疗组HAMD积分低于治疗前,并且明显低于对照组治疗后(P<0.01)。治疗后治疗组患者抑郁消失11例,轻度抑郁15例,中度抑郁4例;对照组患者抑郁消失3例,轻度抑郁16例,中度抑郁11例,两组比较差异有统计学意义(P<0.05)。治疗后对照组HAMD筛选因子评分与本组治疗前比较差异无统计学意义(P>0.05);治疗组HAMD筛选因子评分均低于治疗前,并且低于对照组治疗后(P<0.05或P<0.01)。结论补肾疏肝方药可改善肝肾阴虚型PD伴轻中度抑郁患者的运动症状、抑郁症状,减少患者每日服用盐酸舍曲林及多巴制剂的平均剂量。

Objective To observe the therapeutic effect of kidney-supplementing liver-coursing therapy for Parkinson＇s disease （PD） complicated by mild to moderate depression with liver-kidney yin deficiency syndrome. Methods Sixty PD patients were randomized into the treatment group and control group, with 30 in each. Both groups were given sertraline hydrochloride and levodopa according to the international medication guiding principle for PD. The treatment group was added with kidney- supplementing liver-coursing formula. The treatment course lasted for 12 months. The Unified Parkinson＇s Disease Rating Scale （UPDRS） and Hamilton Depression Rating Scale （HAMD） were used to evaluate the therapeutic effect before and after treatment. The average dosages of sertraline hydrochloride and levodopa were ohserved in both groups before and after treatment. Results The total score of UPDRS was decreased in the treatment group after treatment, but comparison within group showed no significant difference （P〉0.05）. The total score of UPDRS was increased in the control group after treatment, but comparison within group showed no significant difference （P〉0.05）. The total score of UPDRS in the treatment group was lower than that in the control group after treatment （P〈0.05）. The total score of HAMD was significantly decreased in the treatment group after treatment （P〈0.01）. The total score of HAMD was decreased in the control group after treatment, but comparison within group showed no significant difference （P〉0.05）. The total score of HAMD in the treatment group was lower than that in the control group after treatment （P〈0. 01）. There were 11 cases without depression, 15 cases of mild depression and 4 cases of moderate depression in the treatment group after treatment. There were 3 cases without depression, 16 cases of mild depression and 11 cases of moderate depression in the control group after treatment. There were significant differences between groups in the cases of mild and moderate depression after treatment （P〈0.05）. Comparing within the control group, there was no significant difference in each factor score of HAMD （P〉0.05）. All factor scores of HAMD were significantly deceased in the treatment group after treatment （P〈0.05 or P〈0.01）. All factor scores of HAMD in the treatment group were significantly lower than those in the control group after treatment （P〈0. 05 or P〈0.01）. Conclusion Kidneysupplementing liver-coursing therapy can relieve the motor symptoms and depression of PD patients with liver-kidney yin deficiency syndrome and reduce the daily dosage of sertraline hydrochloride and levodopa.