帕金森病患者治疗中预防性给予小剂量艾司西酞普兰对PDQ-39、UPDR及HAMD评分的影响分析

Effect of prophylactic administration of low-dose escitalopram on PDQ-39,UPDRS and HAMD scales in patients with Parkinson's disease

目的探讨预防性给予小剂量艾司西酞普兰联合吡贝地尔对帕金森病(PD)治疗中PDQ-39、UPDRS及HAMD量表的影响。方法纳入2012年3月至2015年12月于本院就诊的PD 68例患者作为研究对象,所有患者均伴发Hamilton抑郁量表(HAMD)24项评分15~20分。采用随机数字表法将患者分为研究组(n=36例)和对照组(n=32例),其中研究组患者采用小剂量艾司西酞普兰联合吡贝地尔治疗,对照组患者则单用吡贝地尔治疗。对比2组患者治疗前后PDQ-39评分、UPDRS评分及HAMD评分。结果 2组患者PDQ-39评分治疗前、治疗后2w对比(P>0.05),但治疗后2w均显著低于治疗前(t=4.631,4.077,P<0.05)。研究组患者治疗后6w显著低于对照组(P<0.05),且均各自显著低于治疗前(t=6.021,5.629,P<0.05),2组患者中药物治疗、运动检查及行为情感等维度治疗前后对比(P<0.05),而日常生活维度治疗前后对比(P>0.05)。但研究组患者治疗后运动检查及行为情感维度优于对照组(t=5.522,6.034,P<0.05)。2组患者UPDRS评分及HAMD评分治疗前、治疗2w后对比(P>0.05),但治疗2w后均显著低于治疗前(P<0.05)。研究组患者治疗后6w显著低于对照组(P<0.05),且均各自显著低于治疗前(P<0.05)。结论小剂量艾司西酞普兰预防性应用可对PD患者的生活质量和临床症状进行有效改善,对患者进行预防阶段治疗,对PD患者的轻微抑郁的加重进行有效的早期的控制。

Objective To investigate the effect of prophylactic low dose escitalopram combined with piribedil on PDQ-39, UPDRS and HAMD in Parkinson＇s disease （ PD ） treatment. Method A total of 68 PD were enrolled in our hospital from March 2012 to December 2015. All patients were assessed with a Hamilton Depression Rating Scale （ HAMD ） score of 24-20. The patients were divided into study group （ n=36 ） and control group （ n=32 ）. The patients in the study group were treated with low-dose escitalopram combined with pirihedil, while the control group treatment with piribedil alone. The PDQ-39, UPDRS and HAMD scores were compared between the two groups before and after treatment. Results There was no significant difference in PDQ-39 score before treatment and 2 weeks after treatment （ P〉0.05 ） , but it was significantly lower than that before treatment （ t=4.631, 4.077, P〈0.05 ） . （ t=6.021, 5.629, P〈0.05 ） . The patients in the study group were significantly lower than those in the control group at 6 weeks after treatment （ P〈O.05 ）. The drug treatment,exercise test and behavioral emotion （ P〈0.05 ）, but there was no significant difference between before and after treatment （ P〉0.05 ） . However, the study group had better postoperative motor examination and behavioral emotional dimensions than the control group （ t=5.522, 6.034, P〈0.05 ） . There was no significant difference in UPDRS score and HAMD score between the two groups before and after 2 weeks of treatment （ P〉0.05 ） , but it was significantly lower than that before treatment （ P〈0.05 ） , The patients in the study group were significantly lower than those in the control group at 6 weeks after treatment（ P〈0.05 ）, and they were significantly lower than those before treatment （ P〈0.05 ） . Conclusion The prophylactic use of low-dose escitalopram is effective in improving the quality of life and clinical symptoms in patients with PD disease. It is effective in the early stage of PD treatment of patients with mild depression.