熟地平颤汤联合复方左旋多巴治疗震颤麻痹综合征临床研究  

Clinical Study on Treatment of Paralysis Agitans by Shudi Pingchan Decoction and Compound Levodopa

作　　者：刘玉涛[1] 许予明[1] 高远[1] 史长河[1] 杨靖[1] 王燕琳[1] LIU Yutao;XU Yuming;GAO Yuan;SHI Changhe;YANG Jing;WANG Yanlin(The First Affiliated Hospital of Zhengzhou University, Zhenzhou Henan China 45000)

机构地区：[1]郑州大学第一附属医院,河南郑州450000

出　　处：《中医学报》2018年第4期653-658,共6页Acta Chinese Medicine

基　　金：郑州市科技攻关计划项目(1219P-IGG4)

摘　　要：目的:观察熟地平颤汤联合复方左旋多巴治疗震颤麻痹综合征的临床疗效。方法:将92例震颤麻痹综合征患者按随机数字表法分为对照组和观察组,每组46例,对照组采用复方左旋多巴治疗,观察组在对照组治疗基础上加用熟地平颤汤治疗,方药组成:熟地黄15 g,枸杞子15 g,白芍15 g,桑寄生20 g,天麻15 g,莪术15 g,僵蚕10 g,天南星15 g,全蝎粉3 g。观察两组患者的临床疗效、治疗前后UPDRS评分、"开"或"关"时间、H-Y分级和不良反应情况。结果:观察组有效率为89.13%显著高于对照组69.57%,两组比较,差异有统计学意义(P<0.05)。观察组治疗前及治疗后不同时间点帕金森病综合评分量表(unified Parkinson sdiseaseratingscale,UPDRS)中UPDRSⅡ评价患者日常生活能力和UPDRSⅢ评价患者运动功能比较,差异均有统计学意义(P<0.05),而对照组治疗前后差异无统计学意义(P>0.05);且治疗后6个月观察组UPDRSⅡ评分明显较对照组低,差异有统计学意义(P<0.05);治疗后2个月、3个月及6个月观察组UPDRSⅢ评分显著低于对照组,差异有统计学意义(P<0.05)。观察组中40例和对照组中32例患者有明显"开""关"现象,观察组从治疗后2个月起"开"的时间明显较治疗前延长,"关"的时间缩短,经重复测量方差齐性分析治疗前后"开""关"时间比较,差异均有统计学意义(P<0.05);对照组治疗前及治疗后"开""关"时间均未见明显变化,差异无统计学意义(P>0.05)。治疗前两组患者H-Y分级比较,差异无统计学意义(P>0.05);观察组治疗前、治疗后H-Y分级比较,差异有统计学意义(P<0.01);对照组治疗前后H-Y分级比较,差异有统计学意义(P<0.01);治疗后观察组恢复至0~2.5级所占比例为84.78%,明显高于对照组的65.22%,差异有统计学意义(P<0.05)。治疗后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:熟地平颤汤联合复方左旋多巴治疗震颤麻痹综合征可提高临�Objective：To investigate the clinical effect of Shudi Pingchan decoction combined with Compound Levodopa in the treatment of paralysis agitans. Methods：92 patients with paralysis agitans were divided into the control group （n = 46） and the observation group（ n = 46）. The control group was treated with Compound Levodopa, while the observation group was treated with Shudi Pingchan decoction on the basis of the control group. The composition： Shudihuang （ Radix Rehmanniae Preparata） 15 g, Gouqizi （ Fructus Lycii） 15 g, Baishao （ Radix Paeoniae Alba） 15 g, Sangjisheng （ Loranthus Parasiticus ） 20 g, Tianma （ Gastrodia Elata） 15 g, Ezhu （ Curcuma Zedoaria ） 15 g, Jiangcan （ Stiff Silkworm ） 10 g, Tiannanxing （ Rhizoma Arisaematis ） 15 g, Quanxiefen （ Scorpion Powder） 3 g. Observed the clinical efficacy, unified parkinson disease rating scale （ UPDRS ） score,＂ on＂ or ＂ off＂ time, H-Y grading and adverse reactions between the two groups. Results：The effective rate of the observation group 89.13 % was significant-ly higher than that of the control group 69.57% （ P 〈 0.05 ）. There were statistically significant differences in UPDRS Ⅱ and UP- DRS m scores at different time points in the observation group before and after treatment （P 〈 0.05 ）, and the control group was not statistically significant differences before and after treatment （P 〉 0.05 ） ; After 6 months treatment, the total UPDRS score of the observation group was significantly lower than that of the control group （ P 〈 0.05 ） ; the scores of UPDRS llI in the observation group were significantly lower than those in the control group after 2 months＇ ,3 months＇ and 6 months＇ treatment（ P 〈 0.05 ） ;40 cases in the observation group and 32 patients in control group had obvious ＂on＂ and ＂ off＂ phenomenon, 2 months after treatment,＂ on＂ time in the observation group was significantly prolonged, and the ＂off＂ time is shortened. After repeated measures

关 键 词：震颤麻痹综合征 熟地平颤汤 复方左旋多巴 中医药疗法 中西医结合 

分 类 号：R259.425[医药卫生—中西医结合]