补肾疏肝方药治疗肝肾阴虚型帕金森病伴发轻中度抑郁障碍

Clinical Trial of Bushen Shugan Decoction on Mild to Moderate Level of Depression in Parkinson Disease with Liver and Kidney Yin Deficiency

目的:观察补肾疏肝方药治疗肝肾阴虚型帕金森病伴发轻中度抑郁障碍的临床疗效。方法:将109例肝肾阴虚型帕金森病伴发轻中度抑郁障碍患者随机分为治疗组和对照组。对照组根据国际帕金森病治疗指南用药原则进行治疗,治疗组在此基础上加用补肾疏肝方药,连续服用9个月,试验终点时间为9个月。在治疗前、入组后每隔3个月及试验终点时间分别对帕金森病统一评分量表(UPDRS)、Hamilton抑郁量表(HAMD)、日常生活能力量表(ADL)、中医肝肾阴虚症状评分等进行比较。结果:治疗后,两组UPDRS总分及ADL评分均有升高趋势,治疗组较对照组评分上升缓慢,试验终点时,治疗组评分显著低于对照组(P<0.05或P<0.01)。治疗后,两组HAMD评分均显著下降(P<0.01),两组同期评分比较无显著差异。治疗后,治疗组中医肝肾阴虚症状评分显著下降(P<0.01),对照组评分显著上升(P<0.05或P<0.01)。试验终点时,治疗组中医肝肾阴虚症状评分显著低于对照组(P<0.01)。结论:补肾疏肝方药能有效改善肝肾阴虚型帕金森病伴发轻中度抑郁障碍患者的运动、抑郁等症状,提高日常生活能力,缓解肝肾阴虚症状。

Objective： To observe the curative effect of Bushen Shugan decoction on mild to moderate level of depression in Parkinson disease （PD）with liver and kidney yin deficiency. Method： One hundred and nine PD patients were randomly assigned to the treated group and the control group. Both were treated according to the international medication guiding principle for PD treatment, and the treated group was administered with Bushen Shugan decoction additionally. The treatment course lasted for 9 consecutive months, and the end point was the end of the 9th month. The scores of unified Parkinson＇s disease rating scale （UPDRS）, Hamilton depression rating scale （HAMD）, activities of daily living （ADL） and liver and kidney yin scale of traditional Chinese medicine （TCM） were evaluated before treatment, every 3 months of the treatment and at the end point. Result： After treatment, UPDRS total scores and ADL scores in both groups showed a significant ascending trend at a slower rate in the treated group than in the control group;At the end point, the scores in the treatment group were lower than the control group, there was a significant difference between the two groups （P〈0.05 or P〈0.01）. After treatment, HAMD scores in both groups showed an descending trend in both groups, but there was no significant difference between the two groups at the same period. After treatment, the TCM scores decreased in the treatment group while increased in the control group;At the end point, the TCM scores in the treatment group were much lower than the control group, there was a significant difference between the two groups （P〈0.01）. Conclusion： The recipe for Bushen Shugan decoction could improve the motor and depressive symptoms, as well as the liver and kidney yin deficiency symptoms of traditional Chinese medicine, which could enhance PD patients＇ activities of daily life.