度洛西汀与多巴丝肼联用对帕金森病并发抑郁患者的临床疗效研究

Study on the clinical efficiency of duloxetine combined with madopar in patients with Parkinson's disease complicated with depression

目的：探讨度洛西汀与多巴丝肼联用治疗帕金森病患者的临床效果。方法：将2010年6月-2013年6月间在某院就诊的帕金森病患者109例随机分为对照组53例和观察组56例,对照组患者给予多巴丝肼,初始剂量125 mg·d-1,根据病情变化增加至500~1 000 mg·d-1,tid;观察组在对照组基础上加服度洛西汀60 mg·d-1;8周为1个疗程;用药前和用药后2,4,8周采用汉密尔顿抑郁量表（HAMD）和UPDRS（Ⅰ~Ⅳ）评分对疗效进行评价。结果：观察组疗效明显优于对照组（89.3%vs 75.5%）,差异有统计学意义（P〈0.05）;2组患者的HAMD评分与治疗前相比也明显降低（P〈0.05）;治疗后2组患者的UPDRS评分均有不同程度下降,观察组下降更明显,与对照组相比差异有统计学意义（P〈0.05）;对照组与观察组不良反应发生率（26.4%vs 32.1%）无明显差别（P〉0.05）。结论：度洛西汀联合多巴丝肼可有效改善帕金森病患者的运动障碍和抑郁评分,不良反应轻微,疗效好于单用多巴丝肼。

OBJECTIVE To investigate the clinical efficiency of duloxetine combined with madopar in patients with Parkinson＇s disease.METHODS 109 Parkinson＇s disease patients from Jun.2010 to Jun.2013 in our hospital were randomly divided into observation group with 56 cases and control group with 53 cases.The patients of control group were treated by madopar with initial dose of 125 mg·d-1,according to the condition increased to 500-1 000 mg·d-1,3 times per day;the patients of observation group were treated by duloxetine 60 mg·d-1 additional on the basis of the control group.Both groups were treated for 8 weeks,then the Unified Parkinson Disease Rating Scale（UPDRS（Ⅰ-Ⅳ））,HAMD scores and adverse reactions of the patients were recorded before treatment and 2 w,4 w,12 w after treatment respectively.RESULTS Compared with the control group,the curative effect of observation group was better than the control group（89.3%vs 75.5%）obviously,there was significant difference between the two groups（P〈0.05）.Compared with before treatment,HAMD scores in both groups decreased significantly（P〈0.05）;UPDRS scores in the two groups patients decreased after treatment,and compared with the control group,the observation group declined more obviously,which showed a significant difference between the two groups（P〈0.05）.The incidence of adverse reactions between control group and observation group（26.4%vs 32.1%）had no significant difference（P〉0.05）.CONCLUSION Duloxetine combined with madopar can effectively improve dyscinesia and the score of depression in patients with Parkinson＇s disease;the adverse reactions is slight,has good curative effect than the therapeutic efficiency of madopar used alone.