普拉克索联合艾司西酞普兰治疗帕金森病轻度认知障碍伴发抑郁疗效的临床研究

Clinical study of effect of pramipexole combined with escitalopram on patients with mild cognitive impairment in Parkinson's disease and depression

目的探讨普拉克索联合艾司西酞普兰治疗帕金森病轻度认知障碍伴发抑郁的临床效果。方法将我院2014年2月至2015年2月收治的80例帕金森病轻度认知障碍伴发抑郁的患者,随机均分为实验组和对照组。对照组患者给予普拉克索治疗,实验组患者在此基础上加用艾司西酞普兰,比较2组治疗效果。结果治疗前两组患者精神、行为和情绪、日常活动、运动功能评分和治疗的并发症评分、39项帕金森病调查问卷(PDQ-39)评分、汉密顿抑郁量表(HAMD)评分对比,差异无统计学意义(P>0.05);两组患者治疗后8周精神、行为和情绪、日常活动和运动功能评分均显著低于治疗前,差异有统计学意义(P<0.05);且实验组患者治疗后8周上述指标均显著低于对照组(P<0.05)。两组患者治疗后4周、8周PDQ-39评分、HAMD评分均显著低于治疗前,差异有统计学意义(P<0.05);且实验组患者治疗后8周PDQ-39评分均显著低于对照组,治疗后4周和8周HAMD评分均显著低于对照组,差异均有统计学意义(P<0.05)。实验组患者临床控制率和总有效率均显著高于对照组,差异有统计学意义(P<0.05);2组患者不良反应发生率对比,差异无统计学意义(P>0.05)。结论普拉克索联合艾司西酞普兰治疗帕金森病轻度认知障碍伴发抑郁临床疗效显著,能够更有效改善患者抑郁状态和帕金森病病情,可作为优选治疗方案。

Objective To explore effect of pramipexole combined with escitalopram on patients with mild cog- nitive impairment in Parkinson＇s disease and depression. Methods 80 cases of patients with mild cognitive impair- ment in Parkinson＇s disease and depression were selected from February 2014 to February 2015 in our hospital and then randomly divided into experiment group and control group. The control group were treated by pramipexole, while the experiment group were treated by pramipexole combine with escitalopram. Then the clinical effects of the two groups were compared. Results The scores of moral, behavior and emotion, daily activity, motor function, PDQ-39 and HAMD before the treatment between the two groups had no significant differences（P〉 0.05）; The scores of moral, behavior and emotion, daily activity and motor function of the two groups after 8 weeks treatment were both lower than that before the treatment（P 〈 0.05）; and the indexes mentioned above t of the experiment group were lower than the control group（P〈0.05）. The scores of PDQ-39 and HAMDof the two groups were both lower after 4、 8 weeks treatment than that before the treatment（P 〈 0.05）; and after 8 weeks treatment the scores of PDQ-39 of the experiment group were lower than that of the control group（P〈 0.05）,the scores of HAMD after 4 、 8 weeks treatment of the experiment group were lower than that of the control group（P〈0.05）; The control rate, total effective rate of the experiment group were higher than that of the control group （P 〈 0.05）; There was no significant difference on the rate of adverse reactions between the two groups after medical treatment（P〉 0.05）. Conclusion Pramipexole combined with escitalopram has a better clinical effects on patients with mild cognitive impairment in Parkinson＇s disease and depression than the treatment of pramipexole only and, it can be more effective to improve the depression and parkinsoncs disease.Thus it can be used as the prior optimal treatment plan.