加减地黄饮子对老年帕金森病便秘的疗效观察  

Observation of curative effect of modified Dihuang decoction on constipation in elderly patients with Parkinson's disease

作　　者：惠振[1] 张臻年[1] 张秀琳 王苏雷[1] 张静思 Hui Zhen;Zhang Zhennian;Zhang Xiulin;Wang Sulei;Zhang Jingsi(Department of Encephalopathy,Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing,Jiangsu,210001,P.R.China;Department of Internal Medicine-Neurology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200021,P.R.China)

机构地区：[1]南京中医药大学附属南京中医院脑病科,江苏南京210022 [2]上海中医药大学附属曙光医院神经内科,上海200021

出　　处：《老年医学与保健》2021年第2期317-320,共4页Geriatrics & Health Care

基　　金：南京市卫生科技发展专项资金项目计划(YKK18134);南京中医药大学“江苏高校护理学优势学科建设工程资助项目”(2019YSHL098);南京市“十三五”名中医(刘孔江)工作室建设项目(LKJ-2017-NJ);南京市“十三五”名中医(王敬卿)工作室建设项目(WJQ-2019-NJ);江苏中医药局“中医脑病学”重点学科培育项目(NBPY201704)。

摘　　要：目的观察加减地黄饮子对老年帕金森病患者便秘的疗效。方法选择2018年12月-2020年12月在南京中医药大学附属南京市中医院收治的136例帕金森病便秘患者,采用随机数字表法将其分为观察组(n=68)与对照组(n=68),对照组患者应用美多芭和酚酞片治疗,观察组在对照组的基础上给予加减地黄饮子治疗,2组疗程均为28 d。比较2组便秘疗效、不良反应,及治疗前后的慢性便秘症状严重程度评分量表(CSS)评分和便秘患者生存质量量表(PAC-QOL)评分及帕金森病39项问卷评分(PDQ39)、肛门直肠动力学指标。结果观察组便秘治疗有效率显著高于对照组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05);治疗前,2组肛管静息压、CSS评分、PDQ39评分、直肠初次排便感觉阈、PAC-QOL评分与肛管最大收缩压差异无统计学意义(P>0.05);治疗后,2组肛管最大收缩压及肛管静息压相较于同组治疗前显著升高(P<0.05),直肠初次排便感觉阈及CSS、PDQ39、PAC-QOL评分较同组治疗前显著下降(P<0.05),而观察组肛管最大收缩压及肛管静息压升高程度大于对照组(P<0.05),观察组直肠初次排便感觉阈及CSS、PDQ39与PAC-QOL评分下降程度大于对照组(P<0.05)。结论加减地黄饮子治疗老年帕金森病便秘的疗效显著,可改善患者便秘症状、肛门直肠动力学及生活质量,安全可靠,值得推广。Objective To observe the curative effect of modified Dihuang decoction on constipation in elderly patients with Parkinson’s disease.Methods 136 constipation patients with Parkinson’s disease treated in Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine from December 2018 to December 2020 were selected and randomly divided into observation group(n=68) and control group(n=68).The control group was treated with madopar and phenolphthalein tablets,and the observation group was treated with modified Dihuang decoction on the basis of the control group.The course of treatment in both groups was 28 days.The curative effect and adverse reactions,symptom severity scale(CSS),the life quality of scale(PAC-QOL) score of constipation patients,39 item Parkinson’s Disease Questionnaire(PDQ39) score and anorectal dynamic indexes were compared between the two groups before and after treatment.Results The effective rate of constipation treatment in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P> 0.05).Before treatment,there were no significant differences in anal canal resting pressure,CSS score,PDQ39 score,rectal first defecation sensation threshold,PAC-QOL score,and maximum anal canal systolic pressure between the two groups(P>0.05).After treatment,the maximum anal canal systolic pressure and anal canal resting pressure of the two groups were significantly higher than those of the same group before treatment(P<0.05),the rectal first defecation sensation threshold and CSS,PDQ39,PAC-QOL scores of the two groups were significantly lower than those of the same group before treatment(P<0.05),and the improvement degree of the above indexes of the observation group was greater than that of the control group(P<0.05).Conclusion Modified Dihuang decoction has significant effect on constipation in elderly patients with Parkinson’s dise

关 键 词：老年 帕金森病 便秘 加减地黄饮子 临床疗效 

分 类 号：R742.5[医药卫生—神经病学与精神病学]