度洛西汀联合乙哌立松治疗帕金森病腰背痛的疗效分析

Efficacy of duloxetine combined with eperisone in Parkinson's disease patients with low back pain

目的探讨度洛西汀联合乙哌立松治疗帕金森病患者腰背痛的疗效及安全性。方法将75例伴有腰背痛的帕金森病中晚期患者随机分为乙哌立松组(A组)、度洛西汀组(B组)及联合治疗组(C组),每组25例。比较3组治疗前后临床疗效及不良反应。结果 3组在基线性别构成、年龄、病程、HY分级、VAS评分、HAMA-14评分、HAMD-24评分、UPDRS-Ⅲ评分比较无显著差异(P> 0.05)。与治疗前相比,3组VAS评分均较前降低,治疗第8 w时C组VAS评分最低(P <0.05)。B组及C组治疗后HAMA-14评分及HAMD-24评分较前均下降(P<0.05)。3组治疗前后UPDRS-Ⅲ评分无明显变化(P> 0.05)。A组有1例患者有乏力的副反应,B组有3例,C组有5例患者在治疗初期感恶心,但3组的不良反应率比较无明显差异(P> 0.05)。结论乙哌立松、度洛西汀均可改善中晚期PD患者的腰背痛,两者联合治疗较单用更佳,其安全性及耐受性可。

Objective To explore the efficacy and safety of duloxetine combined with eperisone on Parkinson’s disease(PD)patients with low back pain.Methods A total of 75 PD patients with low back pain were randomized to eperisone group(group A),duloxetine group(group B) or combined treatment group(group C),25 patients in each group.The clinical efficacy and adverse reactions of the three groups before and after treatment were compared.Results There were no significant differences among the three groups in baseline sex ratio,age,clinical course,Modified Hoehn and Yahr scale,Visual Analogue Scale(VAS) scores,Hamilton Anxiety Rating Scale-14 Items(HAMA-14) scores,Hamilton Depression Rating Scale-24 Items(HAMD-24) scores and Unified Parkinson’s Disease Rating Scale-Ⅲ(UPDRS-Ⅲ) scores(P> 0.05).The VAS scores after treatment were significantly lower than those before treatment in all the three groups,and the VAS scores of group C was lowest at week 8 of treatment(P <0.05).The HAMA-14 scores and HAMD-24 scores after treatment were lower than those before treatment in group B and group C(P <0.05).There were no significant changes in the UPDRS-Ⅲ scores before and after treatment in all groups(P> 0.05).One patient in group A felt weak,while three patients in group B and five patients in group C experienced nausea at the beginning of treatment,but there was no significant difference in the incidence of adverse reactions among the three groups(P> 0.05).Conclusion Eperisone and duloxetine can relieve the low back pain in patients with mid to advanced PD.The combination of eperisone and duloxetine has better safety and tolerability than single therapy.