养心定悸胶囊治疗帕金森病合并抑郁患者的临床疗效及对PI3K、AKT、mTOR蛋白水平的影响

Effect of Yangxin Dingji Capsule on Patients with Parkinson′s Disease and Depression Based on PI3K/AKT/mTOR Signaling Pathway

目的基于磷脂酰肌醇-3-激酶/蛋白激酶B/雷帕霉素靶体蛋白(PI3K/AKT/mTOR)信号通路探讨养心定悸胶囊对帕金森病(Parkinson′s disease,PD)合并抑郁患者的疗效。方法选取2018年1月—2021年1月期间河北中医学院第二附属医院收治的PD合并抑郁患者102例,随机分为对照组和研究组,每组各51例。对照组接受常规西药治疗,研究组在对照组基础上加用养心定悸胶囊。治疗12周后,观察比较两组患者临床疗效,治疗前后统一帕金森病评分量表(Unified Parkinson′s Disease Rating Scale,UPDRS)评分、帕金森病自主神经症状量表(SPOCA-AUT)评分、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分及血清PI3K、AKT、mTOR蛋白水平情况。结果治疗后研究组总有效率92.16%(47/51)较对照组76.47%(39/51)明显升高,差异有统计学意义(P<0.05)。治疗后两组患者各项UPDRS评分及总分均低于治疗前,差异有统计学意义(P<0.05);且研究组各项UPDRS评分及总分低于对照组,差异有统计学意义(P<0.05)。治疗后研究组消化、心血管系统、体温调节、瞳孔调节评分及SCOPA-AUT总分均低于治疗前,差异有统计学意义(P<0.05);且研究组消化、心血管系统、体温调节、瞳孔调节评分及SCOPA-AUT总分均低于对照组,差异有统计学意义(P<0.05)。治疗后研究组HAMD评分低于治疗前,差异有统计学意义(P<0.05);且研究组HAMD评分低于对照组,差异有统计学意义(P<0.05)。治疗后研究组PI3K、AKT、mTOR蛋白表达水平均低于对照组,差异均有统计学意义(P<0.05)。结论养心定悸胶囊对PD合并抑郁患者具有较好的疗效,可缓解病情发展,改善非运动症状,并能减轻抑郁情绪,可能是通过影响PI3K/AKT/mTOR信号通路而发挥作用。

Objective To investigate the effect of Yangxin Dingji Capsule on patients with Parkinson′s disease(PD)and depression based on phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(PI3 K/AKT/mTOR)signaling pathway.Methods A total of 102 patients PD and depression admitted to the Second Affiliated Hospital of Hebei University of Traditional Chinese Medicine from January 2018 to January 2021 were randomly divided into a control group and a research group,with 51 patients in each group.The control group was treated with routine western medicine,and the research group was additionally treated with Yangxin Dingji Capsule on the basis of the control group.Patients in both groups received continuous treatment for 12 weeks.The clinical efficacy,Unified Parkinson′s Disease Rating Scale(UPDRS),Scales for Outcomes in Parkinson′s Disease-Autonomic Dysfunction(SPOCA-AUT),Hamilton Rating Scale for Depression(HAMD),and serum PI3 K,AKT,and mTOR protein levels of the two groups were compared.Results The total effective rate was 92.16%(47/51)in the research group,which was higher than 76.47%(39/51)in the control group(P<0.05).After treatment,the UPDRS scores and total scores of the two groups were lower than those before treatment(P<0.05).In addition,the UPDRS scores and total scores of the research group were lower than those of the control group(P<0.05).After treatment,the digestive system,cardiovascular system,thermoregulation,pupillary regulation,and the total score of SCOPA-AUT in the research group were decreased(P<0.05),which were also lower than those in the control group(P<0.05).After treatment,the expression levels of PI3 K,AKT,and mTOR proteins in the research group were lower than those in the control group(P<0.05).Conclusion Yangxin Dingji Capsule has a good effect on patients with PD and depression,which alleviates the progression of the disease,improves non-motor symptoms,and reduces depression.The mechanism may be related toits effect onthe PI3 K/AKT/mTOR signaling pathway.