美多巴联合普拉克索治疗帕金森病的疗效及对患者运动功能、血清同型半胱氨酸和血尿酸水平的影响

Curative efficacy of madopar combined with pramipexole in the treatment of Parkinson's disease and its influence on motor function,serum homocysteine,and blood uric acid

目的观察美多巴联合普拉克索治疗帕金森病(PD)的疗效及对患者运动功能、血清同型半胱氨酸(Hcy)和血尿酸(UA)水平的影响。方法选取2019年9月至2020年10月间延安大学咸阳医院收治的90例PD患者为研究对象,按随机数表法分为观察组和对照组,每组45例。对照组患者采用美多巴治疗,观察组患者在对照组治疗的基础上联合普拉克索治疗,两组均持续治疗12周,比较两组患者治疗后的临床效果、治疗前后的自主神经功能障碍程度[PD自主神经症状量表(SCOPA-AUT)]、运动功能[PD统一评分(UPDRSⅢ)量表]和血清指标[Hcy、UA]水平,并记录治疗期间不良反应发生情况。结果治疗后,观察组患者的治疗总有效率为95.56%,明显高于对照组的77.78%,差异有统计学意义(P<0.05);治疗后,观察组患者的SCOPA-AUT评分、UPDRS总评分分别为(16.24±3.06)分、(24.58±1.76)分。明显低于对照组的(21.21±4.82)分、(29.31±1.86)分,差异均有统计学意义(P<0.05);治疗后,观察组患者的血清Hcy水平为(11.05±1.12)μmol/L,明显低于对照组的(27.58±6.61)μmol/L,而血UA水平为(324.24±21.96)μmol/L,明显高于对照组的(260.11±31.85)μmol/L,差异均有统计学意义(P<0.05);观察组患者治疗期间的总不良反应总发生率为13.33%,明显低于对照组的31.11%,差异有统计学意义(P<0.05)。结论美多巴联合普拉克索治疗PD可有效改善患者的自主神经系统障碍及运动功能,临床治疗效果显著,且安全性较高。

Objective To observe the curative efficacy of madopar combined with pramipexole in the treatment of Parkinson's disease(PD)and its influence on motor function,serum homocysteine(Hcy),and blood uric acid(UA).Methods A total of 90 patients with PD admitted to Xianyang Hospital of Yan'an University were enrolled as the research objects between September 2019 and October 2020.They were divided into an observation group and a control group by random number table method,with 45 patients in each group.The control group was treated with madopar,while the observation group was treated with pramipexole on basis of control group.All the patients were continuously treated for 12 weeks.The clinical efficacy after treatment,severity of autonomic nerve dysfunction[the scale outcomes in PD for autonomic symptoms(SCOPA-AUT)],motor function[Unified Parkinson's Disease Rating ScaleⅢ(UPDRSⅢ)],and levels of serum indexes(Hcy,UA)before and after treatment were compared between the two groups.The incidence of adverse reactions during treatment was recorded.Results After treatment,the total response rate of treatment in the observation group was significantly higher than that in control group(95.56%vs 77.78%,P<0.05).After treatment,scores of SCOPA-AUT and UPDRS in the observation group were(16.24±3.06)points and(24.58±1.76)points,significantly lower than(21.21±4.82)points,(29.31±1.86)points in the control group;level of serum Hcy was(11.05±1.12)μmol/L,signidficantly lower than(27.58±6.61)μmol/L in the control group;level of blood UA was(324.24±21.96)μmol/L,significantly higher than(260.11±31.85)μmol/L in the control group;the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group(13.33%vs 31.11%,P<0.05).Conclusion The madopar combined with pramipexole can effectively improve autonomic nerve dysfunction and motor function in PD patients,with significant clinical curative effect and high safety.