大定风珠加减联合西药治疗伴发疼痛的帕金森患者疗效及作用机制

目的:探讨大定风珠加减联合西药治疗伴发疼痛的肝肾阴虚型帕金森(PD)患者的疗效及其作用机制。方法:选择伴发疼痛症状的肝肾阴虚型帕金森患者96例,随机分为对照组和观察组,各42例,均给予多巴丝肼片治疗,对照组给予复方海蛇胶囊治疗,观察组给予大定风珠加减治疗,连续治疗4周。比较2组患者的临床疗效、运动症状、生活质量、情感状态、精神状态及认知状况、腓总神经的传导速度(MCV),潜伏期(LP),波幅(Amp),血浆同型半胱氨酸(Hcy)及氧化应激相关指标及重组人帕金森病蛋白7(PARK7)和神经营养因子-3(NT-3)水平的变化。结果:观察组治疗总有效率明显高于对照组(P0.05)。治疗后,观察组患者运动症状明显优于本组治疗前及对照组(P0.05)。观察组的视觉模拟评分法(VAS),帕金森患者的生活质量问卷(PDQ-39)及帕金森氏病综合评分量表(UPDRS)评分均明显低于本组治疗前及对照组(P0.05)。观察组Hcy和氧化应激指标水平明显低于治疗前及对照组(P0.05)。观察组抗氧化指标水平,Amp及MCV水平明显高于本组治疗前及对照组(P0.05),而LP水平明显低于本组治疗前及对照组(P0.05)。治疗后,观察组血清PARK7明显低于治疗前及对照组,NT-3水平明显高于本组治疗前及对照组(P0.05)。结论:大定风珠加减联合西药治疗伴发疼痛的帕金森病患者可明显改善患者的疼痛症状,修复神经功能,提高生活质量,其机制可能与抑制患者过度的氧化应激状态有关。

Effect of Modified Da Dingfengzhu Therapy Combined with Western Medicine and Its Mechanism in Patients with Parkinson's Disease with Pain

Objective: To investigate the efficacy and mechanism of modified Da Dingfengzhu therapy combined with western medicine in the treatment of patients with Yin deficiency in liver and kidney type Parkinson''s disease (PD) with pain. Method: The 96 patients with Yin deficiency in liver and kidney type PD with pain were randomly divided into control group and experimental group, 48 cases in each group. All patients were given with dopasil hydrazine tablets treatment. On the basis of the treatment, the control group also received compound sea cucumber capsule, while the experimental group received modified Da Dingfengzhu therapy for 4 weeks. The clinical efficacy, motor symptoms, quality of life, emotional status, mental status and cognitive status, the plasma homocysteine (Hcy) and oxidative stress related indicators, motor nerve conduction velocity (MCV), latency (LP) and amplitude (Amp) of the common peroneal nerve, the levels of recombinant human Parkinson''s disease protein 7 (PARK7) and neurotrophic factor-3 (NT-3) before and after treatment were compared between two groups. Result: The total effective rate of the experimental group was significantly higher than that of control group (P<0.05). After treatment, the motor symptoms in experimental group were significantly better than those before treatment and control group (P<0.05). The visual analogue scale (VAS) score, 39-item PD Questionnaire (PDQ-39) and unified PD rating scale (UPDRS) scores in the experimental group were significantly lower than those before treatment and control group (P<0.05). The levels of Hcy and oxidative stress in experimental group were significantly lower than those before treatment and those in control group (P<0.05). The levels of antioxidant, Amp and MCV in the experimental group were significantly higher while the LP level was significantly lower than those in control group and those before treatment (P<0.05). After treatment, the level of serum PARK7 in the experimental group was significantly lower and the level of NT-3 was significantly higher than that before treatment and that in control group (P<0.05). Conclusion: Modified Da Dingfengzhu therapy combined with western medicine can significantly improve the pain, repair nerve function, and improve the quality of life for patients in the treatment of PD with pain, and its mechanism may be related with the inhibition of excessive oxidative stress in patients.