丁苯酞联合脑蛋白水解物治疗中晚期帕金森病的临床研究

Effect of butylphthalide combined with brain protein hydrolysate in the treatment of advanced Parkinson s disease

目的:探讨丁苯酞联合脑蛋白水解物治疗中晚期帕金森病(PD)的临床疗效。方法:选取120例中晚期PD患者为研究对象,按照治疗方案不同分为观察组和对照组,每组各60例。对照组给予脑蛋白水解物治疗;观察组在对照组基础上给予丁苯酞治疗,疗程均为6周。比较两组患者疗效、精神活动、情感障碍、日常生活能力及运动功能[帕金森病评定量表(UPDRS)评分]、免疫功能指标(外周血Th17、Treg百分比及Th17/Treg比值)、血清氧化应激指标[丙二醛(MDA)、8-羟基脱氧鸟苷(8-OHdG)、谷胱甘肽过氧化物酶(GSH-Px)]水平及不良反应发生情况。结果:观察组总有效率高于对照组(95.00%vs.81.67%,P<0.05)。治疗后,两组患者UPDRS中各部分(Ⅰ、Ⅱ、Ⅲ)评分均降低(P<0.05),且观察组低于对照组(P<0.05);外周血Treg百分比及血清GSH-Px、超氧化物歧化酶(SOD)水平均升高(P<0.05),且观察组高于对照组(P<0.05);外周血Th17百分比和Th17/Treg比值及血清MDA、8-OHdG水平均降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丁苯酞与脑蛋白水解物联用能有效调节中晚期PD患者外周血Th17/Treg免疫平衡,减轻体内氧化应激状态,疗效确切,且安全性较好。

Objective:To investigate the clinical efficacy of butylphthalide combined with brain protein hydrolysate in the treatment of advanced Parkinson s disease(PD).Methods:120 patients with advanced PD were divided into observation group and control group according to the treatment plan,with 60 cases in each group.The control group was treated with brain protein hydrolysate,while the observation group was treated with butylphthalide and brain protein hydrolysate,and the course of treatment was 6 weeks.The curative effect,mental activity,emotional disorder,daily living ability and motor function[Unified Parkinson s Disease Rating Scale,(UPDRS score)],immune function indicators(peripheral blood Th17,Treg percentage and Th17/Treg ratio),serum oxidative stress indicators[malondialdehyde(MDA),8-hydroxydeoxyguanosine(8-OHdG),glutathione peroxidase(GSH Px)]and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(95.00%vs.81.67%,P<0.05).After treatment,the scores of all parts of UPDRS(Ⅰ,Ⅱ,Ⅲ)in the two groups were lower than those before treatment(P<0.05),and the decrease was more significant in the observation group(P<0.05).After treatment,the percentage of peripheral blood Treg and the levels of GSH-Px and superoxide dismutase(SOD)in the two groups were increased compared with those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).The percentage of peripheral blood Th17 and Th17/Treg ratio,and the concentrations of serum MDA and 8-OHdG were decreased compared with those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination of butylphthalide and brain protein hydrolysate can effectively regulate Th17/Treg immune balance in peripheral blood of patients with advanced PD and reduce oxidative stress in vivo,with definite efficacy and good safety.