五子衍宗汤治疗肾虚髓减型帕金森病轻度认知功能障碍临床研究

Clinical Study on Wuzi Yanzong Tang for Mild Cognitive Impairment in Parkinson Disease of Kidney Deficiency and Marrow Depletion Type

目的:观察五子衍宗汤治疗肾虚髓减型帕金森病轻度认知功能障碍(PD-MCI)对患者血清尿酸(UA)、同型半胱氨酸(Hcy)含量的影响。方法:选取符合纳入标准的PD-MCI肾虚髓减型患者91例,采用随机数字表法将所有研究对象分为2组。对照组45例给予盐酸多奈哌齐片治疗,观察组46例在对照组治疗方案的基础上给予五子衍宗汤治疗。观察2组治疗6周后、治疗12周后的临床疗效、中医证候积分、简易智力状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、血清UA以及血清Hcy的含量。结果:临床总有效率观察组93.48%,高于对照组71.11%,差异有统计学意义(P<0.05)。治疗6周后、治疗12周后,2组中医证候积分、血清Hcy含量较治疗前明显降低,呈逐渐降低趋势,观察组中医证候积分、血清Hcy含量均显著低于同期对照组,差异均有统计学意义(P<0.01);2组MMSE、MoCA评分及血清UA含量均较治疗前明显提高,呈逐渐升高趋势,观察组MMSE、MoCA评分及血清UA含量均显著高于同期对照组,差异均有统计学意义(P<0.01)。治疗后,2组经血常规、肝功能、肾功能、心电图、血压、心率等检查,均未发现异常现象。结论:针对肾虚髓减型PD-MCI患者给予五子衍宗汤治疗可提高临床疗效,缓解患者临床症状,改善患者认知功能障碍及血清UA、Hcy含量,且安全性良好。

Objective:To observe the effect of Wuzi Yanzong tang on the contents of uric acid(UA) and homocysteine(Hcy)in serum in the treatment of patients with mild cognitive im pairment in parkinson disease(PD-MCI) of kidney deficiency and marrow depletion type. Methods:A total of 91 PD-MCI patients of kidney deficiency and marrow depletion type who met inclusion criteria were selected and divided into two groups according to the random number table method. The control group(45 cases) was given donepezil hydrochloride tablets, and the observation(46 cases) was additionally given Wuzi Yanzong tang based on the treatment of the control group. After six-week and twelve-week treatment,the clinical effect,Chinese medicine syndrome score,Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),as well as the contents of UA and Hcy in serum were observed in the two groups. Results:The total clinical effective rate was 93.48% in the observation group,significantly higher than that of 71.11% in the control group,the difference being significant(P<0.05).After six-week and twelve-week treatment,Chinese medicine syndrome scores and the contents of Hcy in serum in the two groups were significantly decreased when compared with those before treatment, with a trend of progressive decrease,and the two indexes above in the observation group were significantly lower than those in the same period in the control group, differences being significant(P<0.01). After six-week and twelve-week treatment, scores of MMSE and MoCA as well as the content of UA in serum in the two groups were significantly increased when compared with those before treatment,with a trend of progressive increase,and the three indexes above in the observation group were significantly high than those in the same period in the control group,differences being significant(P<0.01). After treatment,blood routine,the liver function and the kidney function,electrocardiogram,blood pressure,heart rate,and other tests were examined,and no abnormal events occurred in the two groups. Conclusion: For patients with Parkinson disease-mild cognitive impairment of kidney deficiency and marrow depletion type, Wuzi Yanzong tang can significantly enhance clinical effect,relieve their clinical symptoms,and improve cognitive impairment and the contents of uric acid and homocysteine in serum,with safety.