高压氧治疗对帕金森病患者情绪及认知障碍的影响

Effects of hyperbaric oxygen therapy on emotion and cognitive disorders in patients with Parkinson’s disease

目的探讨高压氧治疗对帕金森病(PD)患者情绪及认知障碍的影响。方法选取2014年7月至2019年7月广州新海医院神经内科确诊的60例PD患者作为研究对象,在常规药物治疗的基础上给予高压氧治疗,全部入选研究对象均在高压氧治疗前、治疗4个疗程后采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、帕金森病统一评定量表(UPDRS)、H-Y分级和P300波测定判断患者的病情变化,评价高压氧治疗对PD患者情绪、精神行为、运动及认知障碍的影响。结果与高压氧治疗前相比,高压氧治疗4个疗程后60例患者焦虑、抑郁和认知功能障碍发生率降低;HAMD、HAMA评分明显减少,P300波潜伏期显著缩短、波幅显著提高;UPDRS总评分和UPDRSⅠ、UPDRSⅡ、UPDRSⅢ评分明显降低;每日左旋多巴等效剂量显著减少,"关"状态下H-Y分级改善;以上差异均有统计学意义(P<0.05)。结论高压氧治疗对于缓解PD患者情绪及认知功能障碍等非运动症状有较好的治疗作用,能降低PD患者的抑郁及焦虑发生率,控制病情,减轻认知功能障碍的严重程度,提高日常生活能力。

Objective To study the impact of hyperbaric oxygen(HBO)therapy on emotion and cognitive disorders in patients with Parkinson’s disease(PD).Methods A total of 60 patients diagnosed as PD in the Department of Neurology of Guangzhou Xinhai Hospital from July 2014 to July 2019 were selected as study objects and given HBO therapy on the basis of conventional medication.The Hamilton anxiety rating scale(HAMA),the Hamilton depression rating scale(HAMD),the unified Parkinson’s disease rating scale(UPDRS),and P300 wave were used before and after 4 courses of HBO treatment to measure the changes of patients’medical conditions,so as to evaluate the effects of HBO on emotion,mental behavior,motor and cognitive functions of PD patients.Results Compared with those before the 4 courses of HBO treatment,the incidences of anxiety,depression,and cognitive disorder in 60 patients dropped significantly;the HAMA and HAMD scores were significantly decreased;the incubation period of P300 wave was significantly reduced,while its amplitude was significantly increased(P<0.05);the total UPDRS score,and the scores of UPDRSⅠ,UPDRSⅡand UPDRSⅢwere all significantly decreased(P<0.05);the daily levodopa equivalent dosage(DLED)was significantly reduced(P<0.05)and the Hoehn and Yahr scale improved when the medication was"off"(P<0.05).Conclusion HBO therapy can effectively relieve the emotional and cognitive disorders and other non-motor symptoms in PD patients by reducing the incidence of their depression and anxiety,so as to contain the PD condition,lessen the severity of cognitive dysfunction,hence improving their activity of daily living.