通督调神针刺联合帕罗西汀治疗帕金森病抑郁32例临床观察
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摘要
目的观察通督调神针刺联合帕罗西汀治疗帕金森病抑郁的临床疗效。方法将63例帕金森病抑郁患者随机分为对照组31例、治疗组32例。2组患者均接受帕金森病基础治疗,在此基础上对照组予帕罗西汀口服治疗;治疗组在对照组治疗方法的基础上予通督调神针刺治疗。治疗8周后比较2组的临床疗效,治疗前后的中医证候积分及汉密尔顿抑郁量表(HAMD)、帕金森病综合评分量表(UPDRS)评分。结果治疗8周后,2组的中医证候积分和HAMD评分、UPDRS评分均明显降低,与同组治疗前比较差异有统计学意义(P<0.05或P<0.01),且治疗组降低更明显,2组治疗后比较差异均有统计学意义(P<0.05或P<0.01);治疗组总有效率为87.5%,对照组为61.3%,2组比较差异有统计学意义(P<0.05)。结论通督调神针刺联合帕罗西汀治疗帕金森病抑郁疗效确切,可明显改善患者的抑郁症状及运动症状,值得临床推广应用。
Objective To observe the clinical efficacy of dredging governor vessel and regulating spirit acupuncture combined with paroxetine in the treatment of depression with Parkinson's disease. Methods Sixty-three patients of depression with Parkinson's disease were randomly divided into control group with 31 cases and treatment group with 32 cases. Both groups received basic treatment for Parkinson's disease. On this basis,the control group was given oral paroxetine,while the treatment group was given dredging governor vessel and regulating spirit acupuncture therapy. After treatment for 8 weeks,the clinical efficacy,TCM symptom integral and the scores of Hamilton's depression scale( HAMD) and the unified Parkinson's disease rating scale( UPDRS) of the 2 groups before and after treatment were compared. Results After treatment for 8 weeks,the TCM symptom integral,the scores of HAMD and UPDRS of the 2 groups all decreased significantly,there was statistically significant difference compared with the same group before treatment( P<0.05 or P<0.01). Moreover,the treatment group decreased more significantly,there was statistically significant difference between the two groups after treatment( P < 0. 05 or P<0.01).The total effective rate of the treatment group was 87.5%,that of the control group was 61.3%,there was statistically significant difference between the two groups( P<0.05). Conclusion It has definite therapeutic effect to use dredging governor vessel and regulating spirit acupuncture combined with paroxetine in the treatment of depression with Parkinson's disease,which markedly improves the depressive symptoms and motor symptoms of the patients.It deserves clinical promotion and application.
Objective To observe the clinical efficacy of dredging governor vessel and regulating spirit acupuncture combined with paroxetine in the treatment of depression with Parkinson's disease. Methods Sixty-three patients of depression with Parkinson's disease were randomly divided into control group with 31 cases and treatment group with 32 cases. Both groups received basic treatment for Parkinson's disease. On this basis,the control group was given oral paroxetine,while the treatment group was given dredging governor vessel and regulating spirit acupuncture therapy. After treatment for 8 weeks,the clinical efficacy,TCM symptom integral and the scores of Hamilton's depression scale( HAMD) and the unified Parkinson's disease rating scale( UPDRS) of the 2 groups before and after treatment were compared. Results After treatment for 8 weeks,the TCM symptom integral,the scores of HAMD and UPDRS of the 2 groups all decreased significantly,there was statistically significant difference compared with the same group before treatment( P<0.05 or P<0.01). Moreover,the treatment group decreased more significantly,there was statistically significant difference between the two groups after treatment( P < 0. 05 or P<0.01).The total effective rate of the treatment group was 87.5%,that of the control group was 61.3%,there was statistically significant difference between the two groups( P<0.05). Conclusion It has definite therapeutic effect to use dredging governor vessel and regulating spirit acupuncture combined with paroxetine in the treatment of depression with Parkinson's disease,which markedly improves the depressive symptoms and motor symptoms of the patients.It deserves clinical promotion and application.
引文
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[11]王冰,汤修敏.帕金森病统一评分量表信度和效度研究[J].山东医药,2009,49(28):88-89.
[12]郭隆润.舒肝解郁胶囊治疗轻中度抑郁症发作的临床疗效[J].临床合理用药杂志,2018(9):63-64.
[13]吴玉,潘小平,杨淞然,等.帕金森病抑郁的发生率及相关因素分析[J].实用医学杂志,2015,31(16):2717-2720.
[14]王环宇.抑郁障碍对帕金森病患者生活质量的影响[J].中国现代神经疾病杂志,2016,16(9):633-635.
[15]林晓光,张雪玲,刘卫国,等.帕金森神经病理性疾病的临床分析[J].现代中西医结合杂志,2015,35(18):1985-1987.
[16]饶明月,刘欣.帕金森病伴发抑郁的研究进展[J].临床医药文献电子杂志,2017,4(30):5921-5922.
[17]钱佳佳.帕罗西汀对帕金森病抑郁患者用药依从性及疗效的影响[J].临床用药研究,2017,2(10):85-86.
[18]杨庆渝.帕罗西汀与舒肝解郁胶囊治疗帕金森病伴抑郁的对比研究[J].中国实用医药,2016,11(25):160-161.
[19]畅洪昇,段晓华,梁吉春,等.中医郁证学说源流探析[J].北京中医药大学学报,2011,8(10):653-658.
[20]李桂平,杜元灏,颜红,等.调神疏肝针法治疗抑郁症的临床疗效观察[J].天津中医药,2004(5):382-385.
[2]GROVER S,SOMAIYA M,KUMAR S,et al.Psychiatrie aspects of Parkinson’s disease[J]. J Neurosci Rural Pract,2015,6(1):65-76.
[3]董兴鲁,文玉敏,曲淼.帕金森病伴发抑郁的流行病学和治疗研究进展[J].现代中医临床,2015,22(1):56-60.
[4]文平,周宜.中西医结合治疗抑郁症优势探讨[J].山东中医杂志,2015,34(12):903-906.
[5]中华医学会神经病学分会神经心理学和行为神经病学组.帕金森病抑郁、焦虑及精神病性障碍的诊断标准及治疗指南[J].中华神经科杂志,2013,46(1):56-60.
[6]中华全国中医学会老年医学会.中医老年颤证诊断和疗效评定标准[J].北京中医学院学报,1992,15(4):39-41.
[7]国家中医药管理局.中医病症诊断疗效标准[M].北京:中国医药科技出版社,2012:33.
[8]中华医学会神经病学分会帕金森病及运动障碍组.中国帕金森病治疗指南(第3版)[J].中华神经科杂志,2014,17(6):428-433.
[9]高树中,杨骏.针灸治疗学[M].北京:中国中医药出版社,2012:99-120.
[10]梁普莹,崔立谦,吴卓华,等.帕金森病伴发抑郁患者的功能失调性态度和自动思维的特点[J].广东医学,2015,36(18):2833-2835.
[11]王冰,汤修敏.帕金森病统一评分量表信度和效度研究[J].山东医药,2009,49(28):88-89.
[12]郭隆润.舒肝解郁胶囊治疗轻中度抑郁症发作的临床疗效[J].临床合理用药杂志,2018(9):63-64.
[13]吴玉,潘小平,杨淞然,等.帕金森病抑郁的发生率及相关因素分析[J].实用医学杂志,2015,31(16):2717-2720.
[14]王环宇.抑郁障碍对帕金森病患者生活质量的影响[J].中国现代神经疾病杂志,2016,16(9):633-635.
[15]林晓光,张雪玲,刘卫国,等.帕金森神经病理性疾病的临床分析[J].现代中西医结合杂志,2015,35(18):1985-1987.
[16]饶明月,刘欣.帕金森病伴发抑郁的研究进展[J].临床医药文献电子杂志,2017,4(30):5921-5922.
[17]钱佳佳.帕罗西汀对帕金森病抑郁患者用药依从性及疗效的影响[J].临床用药研究,2017,2(10):85-86.
[18]杨庆渝.帕罗西汀与舒肝解郁胶囊治疗帕金森病伴抑郁的对比研究[J].中国实用医药,2016,11(25):160-161.
[19]畅洪昇,段晓华,梁吉春,等.中医郁证学说源流探析[J].北京中医药大学学报,2011,8(10):653-658.
[20]李桂平,杜元灏,颜红,等.调神疏肝针法治疗抑郁症的临床疗效观察[J].天津中医药,2004(5):382-385.
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