补肾填精方治疗髓海不足型帕金森病伴轻度认知功能障碍的临床研究

Efficacy of BuShen TianJing Decoction for Mild Cognitive Impairment in Parkinson′s Disease Patients with Sui-Hai Deficiency

目的观察补肾填精方治疗髓海不足型帕金森病伴轻度认知功能障碍(PD-MCI)的临床疗效。方法将103例髓海不足型PD-MCI患者随机分为西药组(51例)和中西医组(52例)。西药组根据国际帕金森病治疗指南进行治疗,中西医组在西药组基础上加用补肾填精方,连续服用48周。在治疗前及治疗24、48周分别进行帕金森病统一评分量表(UPDRS)、蒙特利尔认知评估量表(MoCA)、简易智能精神状态检查量表(MMSE)、日常生活能力量表(ADL)评分;记录治疗前后左旋多巴每日用量。结果与治疗前比较,西药组治疗48周UPDRS评分增加(P<0.01);西药组治疗24、48周MoCA评分、MMSE评分降低(P<0.05,P<0.01);两组治疗48周左旋多巴每日用量均增加(P<0.01),但两组间比较差异无统计学意义(P>0.05)。与西药组同期比较,治疗48周中西医组UPDRS总分及ADL评分显著降低(P<0.05,P<0.01),MoCA及MMSE评分升高(P<0.01)。结论在西医规范化治疗的基础上,加用补肾填精方治疗能有效改善髓海不足型PD-MCI患者的运动症状、认知功能障碍和日常生活能力。

Objective To investigate the efficacy of BuShen Tianjing Decoction for mild cognitive impairment in Parkinson＇s disease（ PD-MCI） patients with Sui-H ai deficiency. Methods Totally 10 3 PDMCI patients with Sui-Hai deficiency were radomly assigned to the Western medicine（ WM） group（51 cases） and combination of traditional Chinese medicine and W estern medicine（ TCM-W M） group（52 cases）.WM group patients were treated following the international treatment guidelines for PD. Based on the treatment in WM group, TCM-WM group patients were prescribed BuShen Tianjing Decoction additionally. The treatment course lasted for 4 8 consecutive weeks. U nified Parkinson＇s disease Rating Scale（UPDRS）scores, Montreal Cognitive Assessment Scale（MoCA） scores, Minimum M ental State Examination（MMSE） scores,and Activity of Daily Living Scale（ADL） scores were evaluated before treatment,as well as 2 4-week and 4 8-week after treatment. The average daily levodopa dosage was documented before and after 4 8-week treatment. Results Compared with before treatment period,UPDRS scores of the WM group increased after 48-week treatment（P〈0.01）,MoCA and MMSE scores of the WM group decreased after24-and 48-week treatment（P〈0.05,P〈0.01）. After 48-week treatment,the average daily levodopa dosage increased significantly in both groups（P〈0.01）,but there was no significant difference between two groups（P〉0.05）. After 48-week treatment,UPDRS and ADL scores of the TCM-WM group were lower than the WM group（P〈0.05,P〈0.01）, while MoC A and M MSE scores of the TCM-WM group were higher than the W M group（P〈0.01）. Conclusion On the basis of the international treatment guidelines for PD, BuShen Tianjing Decoction could effectively reduce motor and cognitive impairments, and improve activities of daily living in PD-MCI patients with Sui-Hai deficiency.