针灸治疗中晚期帕金森病便秘的临床疗效及对患者用药依从性的影响

Clinical efficacy of acupuncture and moxibustion in treatment of constipation in patients with middle-and advanced-stage Parkinson’s disease and effect on medication compliance

目的观察针灸治疗中晚期帕金森病便秘的临床疗效及对患者用药依从性的影响。方法将72例中晚期帕金森病便秘患者随机分为治疗组和对照组,每组36例。两组均给予帕金森病基础治疗措施,对照组加服麻仁软胶囊,治疗组加用针灸疗法。两组疗程均为28天,观察临床疗效,比较统一帕金森病评定量表(UPDRS)第Ⅱ及第Ⅲ部分评分、便秘症状积分、用药依从性的变化情况。结果①治疗组总有效率为72.2%,对照组总有效率为44.4%,治疗组临床疗效优于对照组(P<0.05)。②治疗前后组内比较,两组便秘症状均较治疗前改善(P<0.05);组间治疗后比较,治疗组便秘症状改善情况优于对照组(P<0.05)。③治疗前后组内比较,治疗组UPDRS第Ⅱ部分评分较治疗前减少(P<0.05);组间治疗后比较,治疗组UPDRS中第Ⅱ部分评分少于对照组(P<0.05)。④治疗前后组内比较,两组用药依从性均较治疗前提高(P<0.05);组间治疗后比较,治疗组用药依从性优于对照组(P<0.05)。结论针灸治疗中晚期帕金森病便秘疗效满意,可有效缓解患者的便秘症状,改善日常生活活动情况,提高用药依从性。

Objective To observe the clinical efficacy of acupuncture and moxibustion in the treatment of constipation in patients with middle-and advanced-stage Parkinson’s disease(PD) and the effect on medication compliance. Methods 72 middle-and advanced-stage PD patients with constipation were randomly assigned into treatment group and control group, 36 patients in each group. Routine treatment for PD was given to patients in both groups, and in addition, patients in the control group took Maren Soft Capsules and those in the treatment group were treated with acupuncture and moxibustion. The treatment course was 28 days in both groups. The clinical efficacy was observed and changes in the score on unified Parkinson’s disease rating scale(UPDRS) II and III, constipation score and medication compliance were compared. Results ①The overall effective rate was 72.2% and 44.4% in the treatment and control groups respectively, and the clinical efficacy in the treatment group was superior to that in the control group(P<0.05). ②Constipation improved significantly in both groups after treatment compared to that before treatment(P<0.05);and it showed significantly greater improvement in the treatment group than in the control group after treatment(P<0.05). ③The UPDRS II score decreased in both groups after treatment compared to that before treatment(P<0.05), and it was lower in the treatment group than in the control group after treatment(P<0.05). ④Medication compliance improved significantly in both groups after treatment compared to that before treatment(P<0.05), and it was significantly better in the treatment group than in the control group after treatment(P<0.05). Conclusion Acupuncture and moxibustion show satisfactory efficacy in the treatment of constipation in patients with middle-and advanced-stage Parkinson’s disease. They can effectively relieve constipation and improve the patients’ daily activities and medication compliance.