复元胶囊联合盐酸美金刚片对帕金森痴呆患者认知功能和血清α-突触核蛋白、同型半胱氨酸的影响  

Effect of Fuyuan capsule combined with memantine hydrochloride on cognitive function and serumα-synuclein,homocysteinein patients with Parkinson's disease-dementia

作　　者：郭洋 李洪梅 史红星 王晓琴 郭晓 GUO Yang;LI Hongmei;SHI Hongxing;WANG Xiaoqin;GUO Xiao(Department of Pharmacy,Hengshui Hospital of Traditional Chinese Medicine,Hengshui,Hebei 053000;Department of Encephalopathy,Hengshui Hospital of Traditional Chinese Medicine,Hengshui,Hebei 053000;Department of Surgery,Hengshui Hospital of Traditional Chinese Medicine,Hengshui,Hebei 053000)

机构地区：[1]河北省衡水市中医医院药剂科,河北衡水053000 [2]河北省衡水市中医医院脑病科,河北衡水053000 [3]河北省衡水市中医医院外科,河北衡水053000

出　　处：《河北中医》2024年第9期1460-1465,1471,共7页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2020年度中医药类科研计划项目(编号:2020530)。

摘　　要：目的观察复元胶囊联合盐酸美金刚片对帕金森痴呆(PDD)患者认知功能和血清α-突触核蛋白(α-syn)、同型半胱氨酸(Hcy)的影响。方法将82例PDD患者按照随机数字表法分为2组,均予基础治疗。对照组41例予盐酸美金刚片口服,治疗组41例在对照组治疗基础上加复元胶囊口服,2组均持续治疗3个月。比较2组临床疗效;比较2组治疗前后蒙特利尔认知评估表(MoCA)评分、帕金森病评定量表(UPDRS)评分、简易精神状态量表(MMSE)评分变化;比较2组治疗前后氧化应激指标[(谷胱甘肽过氧化酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)]、炎症指标[(肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-17、IL-1β)]变化;比较2组治疗前后血清α-突触核蛋白(α-syn)、同型半胱氨酸(Hcy)变化;比较2组不良反应发生率。结果治疗组总有效率90.24%(37/41),对照组总有效率73.17%(30/41),治疗组临床疗效优于对照组(P<0.05)。2组治疗后MoCA评分、MMSE评分均较本组治疗前升高(P<0.05),UPDRS评分较本组治疗前降低(P<0.05);治疗后治疗组MoCA评分、MMSE评分均高于对照组(P<0.05),UPDRS评分低于对照组(P<0.05)。2组治疗后GSH-Px、SOD均较本组治疗前升高(P<0.05),MDA较本组治疗前降低(P<0.05);治疗后治疗组GSH-Px、SOD均高于对照组(P<0.05),MDA低于对照组(P<0.05)。2组治疗后TNF-ɑ、IL-17、IL-1β均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后α-syn、Hcy均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论复元胶囊联合盐酸美金刚片治疗PDD疗效显著,可能通过减轻氧化应激损伤和炎症反应,下调血清ɑ-syn、Hcy水平等途径来改善患者认知功能和临床症状。Objective To investigate the effect of Fuyuan capsule combined with memantine hydrochloride on cognitive function and serumα-synuclein(ɑ-syn),homocysteine(Hcy)in patients with Parkinson's disease-dementia(PDD).Methods Eighty-two patients with PDD were randomized 1∶1 to memantine hydrochloride(control group)or Fuyuan capsule+memantine hydrochloride(treatment group)for 3 months.The clinical efficacy,scores of Montreal Cognitive Assessment Scale(MoCA),Unified Parkinson's Disease Rating Scale(UPDRS)and Mini-Mental State Examination(MMSE),oxidative stress index(glutathione peroxidase[GSH-Px],superoxide dismutase[SOD],Malonaldehyde[MDA]),and inflammatory index(tumor necrosis factor-ɑ[TNF-ɑ],interleukin[IL]-17,IL-1β),serumɑ-syn,as well asHcy levels were calculated.The incidence of adverse reactions was assessed.Results The total effective ratein the treatment group was better than that in the control group(90.24%[37/41]vs 73.17%[30/41],P<0.05).Significantly higher MoCA and MMSE scores,and lower UPDRS score were detected in the both groups than those before reatment(P<0.05),the improvements were more pronounced in the treatment group relative the control group(P<0.05).Significantly increased GSH-Px and SOD,and decreased MDA were found in the both groups than those before reatment(P<0.05),the treatment group was superior to the control group for the levels of GSH-Px,SOD,and SOD(P<0.05).TNF-ɑ,IL-17 and IL-1β,as well asɑ-syn and Hcy in the both groups were significantly lower than those before treatment(P<0.05),with statistically significant difference between the treatment group and the control group(P<0.05).There was no statistical significance in the incidence of adverse reactions(P>0.05).Conclusion Fuyuan capsule combined with memantine hydrochloride has significant therapeutic effect in the treatment of PDD,which may improve the cognitive function and clinical symptoms of patients by reducing oxidative stress damage and inflammatory response,and down-regulating serum syn and Hcy levels.

关 键 词：痴呆 帕金森病 并发症 中西医结合疗法 

分 类 号：R277.705.8[医药卫生—中医学]