加用自拟滋阴解郁汤治疗帕金森病伴焦虑抑郁疗效观察

Adding Self-Prepared Ziyin Jieyu Decoction in the Treatment of Parkinson’s Disease with Anxiety and Depression

[目的]观察加用自拟滋阴解郁汤治疗帕金森病(PD)伴发焦虑抑郁的疗效。[方法]选取80例PD伴发焦虑抑郁患者作为研究对象,按随机数字表法分为对照组和观察组。对照组40例给予单纯西医常规治疗(口服多巴丝肼片和盐酸普拉克索缓释片),观察组40例在对照组基础上加服自拟滋阴解郁汤(熟地黄30 g,山茱萸20 g,夜交藤20 g,玄参20 g,天麻15 g,钩藤15 g,丹参15 g,石决明15 g,炒白芍15 g,枸杞子15 g,龟板15 g,煅牡蛎15 g,煅龙骨15 g,炙甘草6 g),每日1剂。治疗2个月后对比两组患者的统一帕金森病评定量表评分、焦虑和抑郁状态、神经递质水平和不良反应发生率。[结果]两组患者治疗后统一帕金森病评定量表第一至第四部分(UPDRS-Ⅰ、UPDRS-Ⅱ、UPDRS-Ⅲ、UPDRS-Ⅳ)的评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05或P<0.01);汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.01);血清神经营养因子3(NT-3)、5-羟色胺(5-HT)、多巴胺(DA)水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.01)。观察组不良反应发生率为2.50%(1/40),对照组为7.50%(3/40),两组不良反应发生率无显著性差异(P>0.05)。[结论]加用自拟滋阴解郁汤治疗PD伴焦虑抑郁患者,可改善统一帕金森病评定量表评分,调节神经递质水平和焦虑、抑郁状态,安全性高,值得临床推广。

[Objective]To observe the curative effect of self-prepared Ziyin Jieyu decoction on Parkinson’s dis⁃ease(PD)complicated with anxiety and depression.[Methods]A total of 80 PD patients with anxiety and depression were selected as the research objects,and divided into control group and observation group according to the random number table method.The 40 cases in the control group were given routine treatment by orally taking dopasrazide tab⁃lets and pramipexole hydrochloride sustained-release tablets,and the 40 cases in the observation group were given self-prepared Ziyin Jieyu decoction(Rehmanniae Radix 30 g,Corni Fructus 20 g,Caulis Polygoni Multiflori 20 g,Radix Scrophulariae 20 g,Gastrodiae Rhizoma 15 g,Uncaria 15 g,Salviae Miltiorrhizae Radix et Rhizoma 15 g,Cassia ob⁃tusifoliae Rhizoma 15 g,Radix Paeoniae Alba 15 g,Fructus Lycii 15 g,Tortoise shell 15 g,Calcined oyster 15 g,Cal⁃cined keel 15 g,Roasted licorice 6 g),one dose per day.After 2 months of treatment,the unified Parkinson’s disease rating scale score,anxiety and depression status,neurotransmitter levels and incidence of adverse reactions were com⁃pared between the two groups.[Results]After treatment,the scores of the first to fourth parts of the unified Parkinson’s disease rating scale(UPDRS-Ⅰ,UPDRS-Ⅱ,UPDRS-Ⅲ,UPDRS-Ⅳ)were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05 or P<0.01).The scores of hamilton anxi⁃ety scale(HAMA)and hamilton depression scale(HAMD)were lower than those before treatment(P<0.05),and the ob⁃servation group was lower than the control group(P<0.01).The levels of serum neurotrophic factor 3(NT-3),5-hy⁃droxytryptamine(5-HT),and dopamine(DA)were higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.01).The incidence of adverse reactions in the observation group was 2.50%(1/40),and that in the control group was 7.50%(3/40).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).[Conclusion]Adding self-prepared Ziyin Jieyu decoction can treat PD patients with anxiety and depression and improve the unified Parkinson’s disease rating scale score,adjust the level of neurotransmitters,anxiety and depression.Besides that,it is highly safe and worthy of clinical promotion.