生酮饮食干预对帕金森病患者运动症状及非运动症状的影响  

Effects of ketogenic diet intervention on motor symptoms and non-motor symptoms in patients with Parkinson's disease

作　　者：李智慧 罗羡慕 张倩[3] 王轶楠 迟春玲[1] LI Zhi-hui;LUO Xian-mu;ZHANG Qian;WANG Yi-nan;CHI Chun-ling(Department of Neurology,The Fourth Afiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Neurology,Mianyang 404 Hospital,Mianyang 621000,China;Department of Neurology,Xinjiang Production&Construction Corps Hospital,Urumqi 830000,China)

机构地区：[1]哈尔滨医科大学附属第四医院神经内科,黑龙江哈尔滨150001 [2]绵阳四〇四医院神经内科,四川绵阳621000 [3]新疆生产建设兵团医院神经内科,新疆乌鲁木齐830000

出　　处：《哈尔滨医科大学学报》2024年第6期607-612,共6页Journal of Harbin Medical University

基　　金：黑龙江省卫生健康委科研课题(20220303071059)。

摘　　要：目的 探讨生酮饮食(ketogenic diet, KD)干预对帕金森病(Parkinson’s disease, PD)患者运动症状及非运动症状的影响。方法 收集2021年1月~3月哈尔滨医科大学附属第四医院帕金森门诊符合入组标准的27例PD患者为研究对象,进行12周生酮饮食干预,比较PD患者生酮饮食干预前后运动症状及非运动症状的变化。结果 生酮饮食干预后PD患者运动症状明显改善,MDS-UPDRSⅢ评分显著下降(P<0.001),其中震颤改善最明显(P<0.01);运动迟缓和姿势步态异常亦有改善(P<0.05);而肌强直无明显改善(P>0.05)。生酮后PD患者非运动症状相关量表MDS-UPDRSⅠ(P=0.0 001)、Ⅱ(P<0.0 001)、PACSYM(P=0.0 024)、ESS(P=0.0 024)、HAMA(P=0.0 007)、HAMD(P<0.0 001)、RBD-HK(P=0.0 016)的评分显著下降,MMSE(P=0.0 039)和MoCA-B(P=0.0 004)评分显著升高,显示生酮饮食干预后PD患者便秘、日间嗜睡、焦虑、抑郁和认知障碍等非运动症状明显改善。PDSS(-4.44±10.94,P=0.0 763)和HRS(1.31±4.76,P=0.1 821)评分生酮前后无统计学意义。结论 生酮饮食干预能够改善PD患者运动症状中的震颤、运动迟缓、姿势步态异常以及非运动症状中的便秘、日间嗜睡、焦虑、抑郁、认知障碍等,提高生活质量。Objective To explore the effects of the ketogenic diet(ketogenic diet,KD)inter-vention on the motor symptoms and non-motor symptoms of patients with Parkinson's Disease(Parkinson's disease,PD).Methods From January to March 2021,27 PD patients from our hospital's Parkinson's outpatient clinic were collected as research subjects for KD.KD in-tervention was carried out for 12 weeks to compare the changes of motor symptoms and non-mo-tor symptoms in PD patients before and after KD.Results After the KD intervention,the mo-tor symptoms of PD patients were significantly improved,with a significant decrease in MDS-UPDRSⅢscores(P<0.001),among which tremor improved the most(P<0.01);bradyki-nesia and postural gait abnormalities were also improved(P<0.05);while rigidity showed no significant improvement(P>0.05).After KD,the scores of MDS-UPDRSⅠ(P<0.0001)&Ⅱ(P<0.0001),PACSYM(P=0.0024),ESS(P=0.0024),HAMA(P=0.0007),HAMD(P<0.0001),RBDQ-HK(P=0.0016)decreased in group A,while the scores of MMSE(P=0.0039)and MoCA-B(P=0.0004)increased.The changes of these scales showed that KD significantly improved the non-motor symptoms such as constipa-tion,daytime sleepiness,anxiety,depression and cognitive impairment in patients with PD.There was no significant difference in the changes of PDSS(-4.44±10.94,P=0.0763)and HRS(1.31±4.76,P=0.1821).Conclusion The KD intervention can improve the motor symptoms of tremor,bradykinesia,postural and gait abnormalities,as well as the non-motor symptoms of constipation,daytime sleepiness,anxiety,depression,cognitive impairment in PD patients,and improve the quality of life.

关 键 词：生酮饮食 帕金森病 运动症状 非运动症状 

分 类 号：R742.5[医药卫生—神经病学与精神病学]