益肾疏肝法辨治帕金森病与抑郁共病40例临床观察

The clinical study of Parkinson's disease combined with depression with the method of tonifying the kidney for dispersing stagnated liver qi in 40 cases

目的观察益肾疏肝法辨治帕金森病与抑郁共病的临床疗效。方法将符合帕金森病与抑郁诊断标准且24项汉密尔顿抑郁量表(HAMD-24)≥20分的40例患者作为观察对象,随机分为治疗组和对照组,每组20例。2组均维持基础性用药,另外,对照组予养血柔肝法,治疗组予益肾疏肝法,疗程2个月。于治疗前、治疗1个月、2个月各评定1次统一帕金森病评定量表运动检查部分(UPDRS-III)、HAMD-24、抑郁自评量表(SDS)、汉密尔顿焦虑量表(HARS)、焦虑自评量表(SAS)、帕金森病睡眠量表(PDSS)、简易精神状态量表(MMSE)、39项帕金森病生存质量问卷(PDQ-39)评分。结果 2组组内比较HAMD,SDS,SAS,PDQ-39评分均下降(P<0.05);组间比较1个月时,治疗组评分下降程度大于对照组(P<0.05)。2组组内比较HARS评分均下降(P<0.05);组间比较治疗组评分下降程度均大于对照组(P<0.05)。2组组内比较PDSS评分均上升(P<0.05);组间比较1个月时,治疗组评分上升程度大于对照组(P<0.05)。结论益肾疏肝法能改善帕金森病与抑郁共病患者的抑郁、焦虑、睡眠等症状,且显效较快。

Objective To observe the curative effect of tonifying the kidney for dispersing stagnated liver-qi in the treatment of Parkinson＇ s disease combined with depression. Methods 40 patients who met the diagnosis standard of Parkinson＇ s disease and depression and scored more than 20 in Hamilton Depression Scale-24 （HAMD-24） were randomly divided into two groups, the treatment group （n=20）, treated with tonifying the kidney for dispersing stagnated liver-qi, and the control group （n=20）, treated with nourishing blood and liver, both the two groups were given regular medications. The treatment lasted for two months. The patients took the tests in terms of Unified Parkinson＇s Disease Rating Scale-III（UPDRS-III）, HAMD-24, Self-Rating Depression Scale （SDS）, Hamilton Anxiety Rating Scale （SARS）, Self Rating Anxiety Scale（SAS）, Parkinson＇s disease sleep scale （PDSS）, Simple mental state scale （MMSE）, 39 Parkinson＇ s quality of life questionnaire （PDQ-39） before the treatment, 1 month after and 2 month after the treamtment. Results The scores of HAMD, SDS, SAS and PDQ-39 decreased significantly in each group （P 〈 0.05）. Compared to the control group, the scores of the treatment group decreased significantly （P 〈 0.05）. HARS scores decreased significantly in each group （P 〈 0.05）. Compared to the control group, HARS scores of the treatment group decreased significantly （P 〈 0.05）. PDSS scores increased significantly before and after the treatment of two groups, and the PDSS scores of treatment group increased significantly compared to the control group one month after the treatment （P 〈 0.05）. Conclusion Tonifying the kidney for dispersing stalemated liver-qi could improve depression, anxiety and sleep in Parkinson＇ s disease combined withdepression patients fast.