天麻钩藤颗粒联合司来吉兰治疗帕金森病的临床研究

Clinical study on Tianma Gouteng Granules combined with selegiline in treatment of Parkinson's disease

目的研究天麻钩藤颗粒联合盐酸司来吉兰片治疗帕金森病的临床疗效。方法选取2016年12月—2017年9月在郯城县妇幼保健计划生育服务中心进行治疗的帕金森病患者78例为研究对象,采用Excel表法随机分为对照组和治疗组,每组各39例。对照组患者于早餐后1 h口服盐酸司来吉兰片,第1~3天,1片/次,1次/d,第4天后若无异常则调整剂量至2片/次,1次/d。治疗组患者在对照组治疗的基础上口服天麻钩藤颗粒,5 g/次,3次/d。两组患者均持续治疗12周。观察两组的临床疗效,比较两组患者的自主神经症状量表(SPOCA-AUT)评分、帕金森病综合评分量表(UPDRS)评分、改良Webster评分、血清学指标和不良反应情况。结果治疗后,对照组和治疗组的总有效率分别为76.9%、92.3%,两组比较差异有统计学意义(P<0.05)。治疗后,两组SPOCA-AUT、UPDRS和改良Webster评分均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组评分明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、丙二醛(MDA)和血清胱抑素C(Cys-C)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组血清学指标水平明显低于对照组,两组比较差异有统计学意义(P<0.05)。对照组和治疗组的不良反应率分别为7.7%、10.3%,两组不良反应率比较没有统计学意义。结论天麻钩藤颗粒联合盐酸司来吉多片治疗帕金森疗效显著,可降低机体炎症程度,改善患者神经功能、认知功能和运动能力,且安全性较好,具有一定的临床推广运用价值。

Objective To study the clinical effect of Tianma Gouteng Granules combined with Selegiline Hydrochloride Tablets in treatment of Parkinson＇s disease. Methods Patients（78 cases） with Parkinson＇s disease in Tancheng Maternal and Child Health Care Family Planning Service Center from December 2016 to September 2017 were randomly divided into control and treatment groups according to Excel Tablet method, and each group had 39 cases. Patients in the control group were po administered with Selegiline Hydrochloride Tablets 1 h after breakfast, 1 tablet/time, once daily in 1 — 3 d, then dosage changed to 2 tablets/time, once daily if there was no abnormality after 4 days. Patients in the treatment group were po administered with Tianma Gouteng Granules on the basis of the control group, 5 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and the SPOCA-AUT scores, UPDRS scores, improved Webster scores, the serological indexes and adverse reaction in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 76.9% and 92.3%, respectively, and there was differences between two groups（P〈 0.05）. After treatment, the SPOCA-AUT scores, UPDRS scores, and improved Webster scores in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈 0.05）. And these scores in the treatment group were significantly lower than those in the control group（P〈 0.05）. After treatment, TNF-α, IL-6, MDA, and Cys-C levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈 0.05）. And serological indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈 0.05）. The incidence of adverse reaction in the control and treatment groups were 7.7% and 10.3%, respectively, and there was no differences between two groups. Conclusion Tianma Gouteng Granules combined with Selegiline Hydrochloride Tablets has clinical curative effect in treatment of Parkinson＇s disease, can reduce the degree of inflammation, and improve neurological function, cognitive function, and exercise capacity, with good safety, which has a certain clinical application value.