针刺颅底七穴干预帕金森病患者生存质量的随机对照研究

The effects of the Seven Acupoints of the Cranial Base on health related quality of life for patients with Parkinson’s disease：a randomized controlled trial

目的：评价针刺颅底七穴在提高帕金森病患者生存质量方面的临床疗效。方法收集2012年5月至2013年4月中国中医科学院望京医院就诊的帕金森病患者70例，按就诊顺序将患者随机分为两组各35例。治疗组隔日针刺“颅底七穴”一次（3次/周），对照组口服多巴丝肼片，两组均治疗6个月。于治疗前及治疗后第1个月、第3个月、第6个月观察39项帕金森病生存质量调查问卷（PDQ-39）、统一帕金森病评定量表第二部分（UPDRSⅡ）和帕金森病睡眠量表（PDSS），并评价临床疗效。结果治疗后6个月治疗组总有效率为85.71%（30/35），对照组为71.43%（25/35），两组总有效率比较，差异有统计学意义（Z＝-3.929，P＜0.01）。治疗组在PDQ-39、UPDRSⅡ、PDSS量表总分[分别为（20.41±11.64）分、（9.09±5.02）分、（126.31±8.37）分]较对照组[分别为（27.48±8.69）分、（10.29±4.93）分、（109.94±8.11）分]明显改善（P＜0.01）。治疗组在生存质量量表（PDQ-39）的情感、耻辱感、认知力、社交、躯体不适5个维度[分别为（8.60±5.07）分、（3.20±2.08）分、（2.34±1.73）分、（1.20±1.68）分、（1.63±1.96）分]以及日常生活活动量表（UPDRSⅡ）中流涎、吞咽困难、言语（接受）障碍、翻身障碍4项[分别为（1.31±0.68）分、（0.77±0.94）分、（0.91±0.74）分、（0.77±0.65）分]改善优于对照组[分别为（11.69±4.11）分、（5.09±3.72）分、（5.37±1.99）分、（2.86±2.33）分、（2.74±2.08）分、（1.74±0.98）分、（1.31±0.93）分、（1.43±0.78）分、（1.20±0.68）分，P＜0.01或0.05]。结论针刺颅底七穴可多维度提高帕金森病患者的生存质量。在睡眠、情感、耻辱感、认知力、社交、躯体不适以及日常生活中流涎、吞咽、言语（接受）、翻身等，颅底七穴临床疗效优于多巴丝肼片。

Objectives To evaluate the effects of“the Seven Acupoints of the Cranial Base”（SACB） in improving quality of life（QOL）of patients with PD. Methods The study Subjects were seventy（70）patients with a diagnosis of Parkinson＇s disease. The Subjects were divided into two groups, i.e. acupuncture group and drug group.The former was treated by SACB every two days,while the latter took Levodopa and Benserazide Tablet250mg tid. The subjects all received treatment for 6 months. PDQ-39,UPDRSⅡand PDSS were adopted to measure quality of life at 4 time points. Results The total effective rate of the treatment group was 85.71%, the control group was 71.43%. And there was a statistical difference of level distribution between the two groups（P〈0.01）. The total score of PDQ-39, UPDRSⅡ and PDSS of patients in the treatment group [（20.41± 11.64）, （9.09±5.02）, （126.31±8.37）]were significantly improved compared with the control group[（27.48± 8.69）, （10.29±4.93）, （109.94±8.11）, P〈0.01]. The 5 dimension score of PDQ-39, and the 4 single item score of UPDRSⅡ in the treatment group[（8.60±5.07）, （3.20±2.08）, （2.34±1.73）, （1.20±1.68）, （1.63±1.96）,（1.31±0.68）, （0.77±0.94）, （0.91±0.74）, （0.77±0.65）]were significantly improved compared with the control group[（11.69±4.11）, （5.09±3.72）, （5.37±1.99）, （2.86±2.33）, （2.74±2.08）, （1.74±0.98）, （1.31±0.93）, （1.43±0.78）, （1.20±0.68）, P〈0.01 or 0.05]. Conclusion SACB can markedly and multi-dimensionally improve the QOL of patients with PD and has a higher efficacy than Levodopa and Benserazide Tablet.