普拉克索联合双侧丘脑底核深部电刺激治疗帕金森病临床研究

Clinical study of pramipexole combined with bilateral subthalamic nucleus deep brain stimulation in the treatment of Parkinsons disease

目的探讨普拉克索联合双侧丘脑底核脑深部电刺激治疗帕金森病患者的临床疗效和安全性.方法将86例帕金森病患者按随机数字表法分为观察组与对照组,每组43例,均口服普拉克索治疗,同时予以医疗体育、日常生活调整、营养支持等综合性干预,观察组在此基础上联合双侧丘脑底核脑深部电刺激治疗,观察12周.治疗前后采用帕金森病统一评分量表评定临床疗效,帕金森病统一评分量表各维度评分判定病情转归状况,日常生活活动能力评定量表评定生活自理能力,帕金森病生活质量问卷评定生活质量,随时记录治疗过程中两组出现的不良反应.结果治疗后两组帕金森病统一评分量表各维度评分均较治疗前显著下降(P<0.01),观察组各维度评分显著低于对照组(P<0.05或0.01);两组日常生活活动能力评定量表评分均较治疗前显著升高(P<0.01),观察组评分显著高于对照组(P<0.01);两组帕金森病生活质量问卷评分均较治疗前显著下降(P<0.01),观察组评分显著低于对照组(P<0.01);观察组治疗总有效率(95.3%)显著高于对照组(79.1%)(P<0.05),不良反应发生率(18.6%)与对照组(16.3%)比较差异无统计学意义(P>0.05).结论普拉克索联合双侧丘脑底核脑深部电刺激治疗帕金森病患者疗效显著,有利于患者疾病转归,提高生活自理能力、改善生活质量,安全性高.

Objective To investigate the clinical efficacy and safety of pramipexole combined with bilateral subthalamic nucleus deep brain stimulation in the treatment of Parkinsons disease. Methods 86 patients with Parkinsons disease were divided into observation group and control group according to the random number table method, with 43 cases in each group. They were all given oral pramipexole treatment and comprehensive interventions such as medical sports, daily life adjustment, and nutritional support. The observation group was given pramipexole combined with bilateral subthalamic nucleus deep brain stimula-tion. The two groups were treated for 12 weeks. UPDRS was used to evaluate the clinical efficacy before and after treatment. UPDRS scores were used to determine the outcome of the disease. ADL assessed the self-care ability, PDQ-39 assessed the quality of life, and adverse reactions occurred in both groups during treatment were recorded at any time. Results After treatment, the scores of UPDRS in each group were significantly lower than those before treatment (P<0. 01). The scores of each dimension in the observa-tion group were significantly lower than those of the control group (P<0. 05 or 0. 01). The ADL scores of the two groups were significantly higher than those before treatment (P<0. 01), and the scores of the ob-servation group were significantly higher than those of the control group (P<0. 01). The scores of PDQ-39 in both groups were significantly lower than those before treatment (P<0. 01), and the scores in the observation group were significantly lower than those of the control group (P<0. 01). The total effective ate of treatment in the observation group (95. 3%) was significantly higher than that in the control group (79. 1 %)(P<0. 05). There was no significant difference in the incidence of adverse reactions (18.6%) compared with the control group (16. 3%)(P>0. 05). Conclusions Pramipexole combined with bilateral subthalamic nucleus deep brain stimulation in the treatment of Parkinsons disease has significant efficacy, it is conducive to promoting the patient's disease outcome, improving self-care ability, improving quality of life and high safety.