文拉法辛联合美多芭治疗对帕金森病伴抑郁患者心理状态及运动功能的影响

The Effect of Venlafaxine Combined with Levodopa on the Psychological State and Motor Function of Parkinson's Disease Patients with Depression

【目的】探讨文拉法辛联合美多芭治疗对帕金森病伴抑郁患者心理状态及运动功能的影响。【方法】98例帕金森病伴抑郁患者随机分为观察组和对照组,每组49例。对照组口服美多芭治疗,观察组另给予盐酸文拉法辛缓释胶囊治疗。治疗前和治疗8周后,比较两组患者的心理状态[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD-24)]、运动功能[帕金森病评定量表第三部分(UPDRSⅢ)、起立行走测试(TUGT)、Berg平衡量表(BBS)]、炎症因子[白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]、生活质量[帕金森病症生活品质问卷(PDQ-39)和WHO生活质量评价量表(QOL)]及不良反应发生率。【结果】两组患者治疗后HAMA、HAMD-24评分较治疗前显著降低(P<0.05),且观察组上述评分均低于对照组(P<0.05)。两组治疗后UPDRSⅢ、TUGT较治疗前降低,BBS评分较治疗前升高(P<0.05),且观察组各项指标优于对照组(P<0.05)。两组治疗后IL-2、TNF-α、CRP较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。两组治疗后PDQ-39评分较治疗前降低,QOL评分较治疗前升高(P<0.05),且观察组各项评分优于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】文拉法辛联合美多芭能有效改善帕金森病伴抑郁患者的抑郁状态,增强其运动功能,提高生活质量,值得临床推广应用。

【Objective】To explore the effect of venlafaxine combined with levodopa treatment on the psychological state and motor function of patients with Parkinson's disease accompanied by depression.【Methods】Ninety-eight Parkinson's disease patients with depression were randomly divided into the observation group and the control group,with 49 patients in each group.The control group received oral levodopa treatment,while the observation group additionally received venlafaxine hydrochloride extended-release capsules.Before the treatment and after 8 weeks of treatment,the psychological state[Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD-24)],motor function[PartⅢof the Unified Parkinson's Disease Rating Scale(UPDRSⅢ),Timed Up and Go Test(TUGT),Berg Balance Scale(BBS)],inflammatory factors[serum interleukin-2(IL-2),tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)],quality of life[Parkinson's Disease Questionnaire(PDQ-39),WHO Quality of Life-BREF(QOL)]were compared between the two groups,as well as the incidence of adverse reactions.【Results】After treatment,scores of HAMA and HAMD-24 in both groups were significantly lower than before treatment(P<0.05),with the observation group scoring lower than the control group(P<0.05).UPDRSⅢand TUGT scores decreased,while BBS scores increased post-treatment compared to pre-treatment(P<0.05),with the observation group performing better than the control group(P<0.05).IL-2,TNF-α,and CRP levels decreased after treatment in both groups(P<0.05),with lower levels in the observation group(P<0.05).PDQ-39 scores decreased and QOL scores increased post-treatment compared to pre-treatment in both groups(P<0.05),with the observation group performing better(P<0.05).The overall incidence of adverse reactions was similar between the groups(P>0.05).【Conclusion】Venlafaxine combined with levodopa can effectively improve the depressive state,enhance motor function,and improve the quality of life of patients with Parkinson's disease and depression,warranting further clinical application.