加味五虎追风散对肾虚血瘀型帕金森病非运动症状影响的临床研究

Clinical study on effect of modified Wuhu Zhuifeng Powder on non-motor symptoms of Parkinson’s disease patients with kidney deficiency and blood stasis syndrome

目的观察加味五虎追风散治疗肾虚血瘀型帕金森病非运动症状的临床疗效。方法将84例肾虚血瘀型帕金森病患者随机分为对照组和治疗组,每组42例。对照组予多巴丝肼片治疗,治疗组在对照组治疗基础上加服加味五虎追风散。两组疗程均为3个月,观察临床疗效及用药安全性,比较帕金森病非运动症状问卷(NMS-Quest)、汉密尔顿抑郁量表(HAMD)、帕金森病睡眠量表(PDSS)、简明精神状态量表(MMSE)评分以及血清脂联素(APN)、尿酸(UA)水平的变化情况。结果 (1)试验期间,两组均未出现脱落病例,最终完成试验者84例。(2)治疗组、对照组总有效率分别为83.33%、26.19%;组间临床疗效比较,差异有统计学意义(P<0.05)。(3)治疗前后组内比较,两组NMS-Quest、HAMD评分均差异有统计学意义(P<0.05),但治疗组明显降低,对照组明显升高;组间治疗后比较,治疗组NMS-Quest、HAMD评分明显低于对照组(P<0.05)。(4)治疗前后组内比较,治疗组PDSS、MMSE评分差异有统计学意义(P<0.05),而对照组差异无统计学意义(P>0.05);组间治疗后比较,治疗组PDSS、MMSE评分明显高于对照组(P<0.05)。(5)治疗前后组内比较,治疗组APN、UA水平差异有统计学意义(P<0.05),而对照组差异无统计学意义(P>0.05);组间治疗后比较,治疗组APN、UA水平明显高于对照组(P<0.05)。(6)两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论加用加味五虎追风散能更显著改善肾虚血瘀型帕金森病患者的抑郁、失眠、认知功能障碍等非运动症状,提升血清APN、UA水平,且安全性良好。

Objective To observe the clinical effect of modified Wuhu Zhuifeng Powder on non-motor symptoms of Parkinson’s disease(PD) patients with kidney deficiency and blood stasis syndrome. Methods Eighty-four PD cases of kidney deficiency and blood stasis syndrome were randomly divided into control group(n=42) and treatment group(n=42). The control group was administered with levodopa and benserazide hydrochloride tablets, while the treatment group was additionally administered with modified Wuhu Zhuifeng Powder besides the basic treatment of the control group. The course of treatment in both groups was 3 months. The clinical effect and medication safety were observed, and the changes of scores of Non-motor Symptom Quest(NMS-Quest), Hamilton Depression Scale(HAMD), Parkinson’s Disease Sleep Scale(PDSS), and Mini-Mental State Examination(MMSE), as well as the changes of serum adiponectin(APN) and uric acid(UA) levels were compared. Results(1)During the trial, there was no drop-out case in both groups,and 84 cases finally completed the trial.(2) The total effective rates of the treatment group and the control group were 83. 33% and 26. 19% respectively;The difference in the clinical effect between two groups was statistically significant( P<0.05).(3)The scores of NMS-Quest and HAMD in the two groups were significantly different before and after treatment( P < 0. 05),and the scores in the treatment group decreased significantly and those in the control group increased significantly.After treatment,the scores of NMS-Quest and HAMD in the treatment group were significantly lower than those in the control group( P<0.05).(4)There were significant differences in PDSS and MMSE scores in the treatment group before and after treatment( P<0.05),while there was no significant difference in the control group before and after treatment( P>0.05). After treatment,the scores of PDSS and MMSE in the treatment group were significantly higher than those in the control group( P < 0. 05).(5)There were significant differences in APN and UA levels in the treatment group before and after treatment( P<0.05),while there was no significant difference in the control group before and after treatment( P>0.05). After treatment,the levels of APN and UA in the treatment group were significantly higher than those in the control group( P<0.05).(6)There was no significant difference in the incidence of adverse reactions between the two groups( P>0.05). Conclusion Combined use of modified Wuhu Zhuifeng Powder can significantly relieve non-motor symptoms such as depression,insomnia,cognitive dysfunction in patients with Parkinson’s disease of kidney deficiency and blood stasis syndrome,and up-regulate the serum levels of APN and UA with satisfactory medication safety.