度洛西汀治疗帕金森病患者疲劳的临床效果

Clinical effect of Duloxetine on fatigue in patients with Parkinson disease

目的 观察度洛西汀治疗帕金森病患者疲劳的临床效果。方法 选择2020年7月至2022年3月河北省张家口市第一医院神经内科就诊、随访的58例帕金森病疲劳患者,以随机数字表法将其分为干预1组和干预2组,各29例。干预1组采用帕金森药物治疗,干预2组在此基础上联合度洛西汀治疗。比较两组治疗前后疲劳评分、抑郁评分及血清5-羟色胺(5-HT)、去甲肾上腺素(NE)水平。结果 整体分析发现:组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。组内比较:两组各时间点FS-14评分及抑郁评分比较,差异有统计学意义(P<0.05);组间比较:治疗后干预2组各时间点FS-14评分及抑郁评分低于干预1组,差异有统计学意义(P<0.05)。干预2组疲劳控制疗效优于干预1组,差异有统计学意义(P<0.05)。组内比较:两组治疗后各个时间点5-HT、NE水平比较,差异有统计学意义(P<0.05);组间比较:治疗后,干预2组各时间点5-HT、NE水平高于干预1组,差异有统计学意义(P<0.05)。结论 在优化帕金森药物基础上,度洛西汀可以通过调节血清5-HT和NE的水平,提高疲劳控制效果,其改善疲劳的作用不依赖于改善抑郁症状。

Objective To observe the clinical effect of Duloxetine in treating Parkinson disease fatigue.Methods From July 2020 to March 2022,58 patients with Parkinson disease fatigue who were treated and followed up in the Department of Neurology of the First Hospital of Zhangjiakou they were divided into intervention group 1 and intervention group 2 by random number table method,with 29 patients in each group.Intervention group 1 was treated with parkinson’s drugs,and intervention group 2 was treated with Duloxetine on this basis.Fatigue scores,depression scores and serum levels of 5-hydroxytryptamine(5-HT)and norepinephrine(NE)before and after treatment were compared between the two groups.Results The overall analysis showed that there were significant differences between groups,time point comparison and interaction(P<0.05).Intra-group comparison:the FS-14 score and depression score between the two groups at each time point and the differences were statistically significant(P<0.05).Inter-group comparison:the FS-14 score and depression score of intervention group 2 were lower than those of intervention group 1 at each time point after treatment,and the differences were statistically significant(P<0.05).The fatigue control effect of intervention group 2 was better than that of intervention group 1,the difference was statistically significant(P<0.05).Intra-group comparison:the 5-HT and NE levels between the two groups at each time point and the differences were statistically significant(P<0.05).Inter-group comparison:After treatment,the levels of 5-HT and NE in intervention group 2 were higher than those in intervention group 1 at each time point,and the differences were statistically significant(P<0.05).Conclusion On the basis of optimizing Parkinson’s drug,Duloxetine can improve fatigue control effect by regulating serum 5-HT and NE levels,and its effect on fatigue improvement is not dependent on improving depressive symptoms.