不同运动障碍分型的帕金森病伴抑郁患者的联合治疗比较  

Efficacy of combination therapy in depressive patients with Parkinson's disease manifesting as different types of dyskinesia

作　　者：李珂[1] 洪丽[1] Li Ke;Hong Li(Department of Neurology,Puyang Anyang District Hospital,Anyang 455000,Henan,China)

机构地区：[1]濮阳市安阳地区医院神经内科,河南安阳455000

出　　处：《广州医科大学学报》2021年第5期83-87,共5页Academic Journal of Guangzhou Medical University

摘　　要：目的:不同运动障碍分型的帕金森病伴抑郁患者的联合治疗比较。方法:本院收治的帕金森伴抑郁患者,根据国际统一帕金森病评分量表分为两组,震颤组和姿势不稳异常步态组。采用随机对照法将每组患者再分两组,对照组和治疗组。对照组给予多巴丝肼片(0.125 g,1天1次)。治疗组为在给予多巴丝肼的基础上,给予文拉法辛缓释胶囊(75 mg,1天1次随饭服用)。药物治疗8周。比较4组的国际统一帕金森病评分、抑郁评分、生活质量评分及不良反应。结果:复方左旋多巴对TD型运动障碍更有效(P<0.05)。文拉法辛能改善两组PD患者的抑郁评分,但TD组的改善更明显(P<0.05)。复方左旋多巴联合文拉法辛能改善PD患者的运动功能障碍,TD型患者改善程度更明显(P<0.05)。复方左旋多巴联合文拉法辛能提高PD患者的生活质量,TD型患者改善程度更明显(P<0.05)。4组患者均无严重不良反应。结论:复方左旋多巴对不同运动障碍分型的PD患者疗效存在差异。复方左旋多巴和文拉法辛联合治疗能明显改善震颤型运动障碍,提升震颤型帕金森伴抑郁患者的生活质量,且安全性高。Objective:To compare the efficacy of combination therapy in depressive patients with Parkinson's disease manifesting as different types of dyskinesia.Methods:Depressive patients with Parkinson's disease(PD)admitted to our hospital were divided into two groups according to the Unified Parkinsons Disease Rating Scale(UPDRS):the tremor-dominant(TD)group and the postural instability gait difficulty(PIGD)group.A randomized control approach was used to further divide each of the two groups into two smaller groups(the control and the treatment groups).The control group was given oral Levodopa/Benserazide Hydrochloride(compound levodopa,0.125g,thrice daily),while the treatment group was given sustained-release Venlafaxine capsules(75 mg,taken once daily with meals)in addition to the therapy given in the control group.The course of medications lasted for eight weeks.The scores of UPDRS,Self-rating depression scale(SDS)and Parkinson's Disease Questionnaire-39(PDQ-39),as well as adverse reactions,were compared across the four groups.Results:Compound levodopa was more effective for TD dyskinesia(P<0.05).Venlafaxine can improve the depression in PD patients with TD or PIGD dyskinesia,but the improvement was greater for TD(P<0.05).Compound levodopa plus Venlafaxine improved the dyskinesia in PD patients,and the improvement was greater for TD dyskinesia(P<0.05).Compound levodopa plus venlafaxine improved the quality of life in PD patients,and the improvement was greater in patients with TD dyskinesia(P<0.05).There were no severe adverse reactions in the four groups of patients.Conclusion:Compound levodopa results in varying effects in PD patients with different types of dyskinesia.Combination therapy with compound levodopa and venlafaxine can significantly improve the tremor-dominant dyskinesia and quality of life in depressive patients with PD manifesting as this type of dyskinesia,and is with good safety profile.

关 键 词：帕金森病 文拉法辛 运动障碍 抑郁 

分 类 号：R741.05[医药卫生—神经病学与精神病学]