摘要
目的分析补肾止颤方联合针刺在治疗帕金森病(Parkinson’s disease,PD)睡眠障碍中的疗效及其对血谷氨酸(glutamate,Glu)、胱抑素C(cystatin C,CysC)水平的影响。方法随机选取医院2019年6月—2021年6月收治的124例肝肾阴虚型PD合并睡眠障碍患者,随机数字表法将其均分为观察组与对照组,对照组接受常规西医治疗,观察组在此基础上联合应用补肾止颤方与针刺治疗,观察两组治疗后睡眠质量[帕金森病睡眠量表(Parkinson’s disease sleep scale,PDSS)、匹兹堡睡眠质量指数量表(Pittsburgh sleep qulality,PQSI)]、生活质量[39项帕金森生存质量量表(the 39-item Parkinson’s disease questionnaire,PDQ-39)]、中医临床疗效、治疗前后血浆Glu、血清CysC水平,日平均多巴丝肼用量以及不良反应。结果治疗后,两组PDSS量表得分均较其同组治疗前上升,PQSI量表得分均较其同组治疗前下降,差异具有统计学意义(P<0.05),且观察组治疗后PDSS量表得分高于对照组,PQSI量表得分低于对照组,差异具有统计学意义(P<0.05)。两组治疗后,PDQ-39量表中运动能力、日常生活、躯体不适、社交、社会支持、耻辱感、情感、认知等维度得分及量表总得分均较其治疗前下降,差异具有统计学意义(P<0.05),且观察组治疗后PDQ-39量表各维度得分及总得分均低于对照组,差异具有统计学意义(P<0.05)。观察组睡眠障碍中医临床治疗有效率高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组血浆Glu水平均较同组治疗前上升,血清CysC水平均较同组治疗前下降,差异具有统计学意义(P<0.05),且观察组治疗后血浆Glu水平高于对照组,血清CysC水平低于对照组,差异均具有统计学意义(P<0.05)。治疗后,对照组多巴丝肼日平均用量与治疗前比较,差异无统计学意义(P>0.05),观察组多巴丝肼日平均用量较同组治疗前下降,差异具有统计学意义(P<0.05),且明显低于对照组治疗后药物平均用量(P<0.05)。观察组治疗中恶心欲吐发生率低于对照组,差异具有统计学意义(P<0.05),两组流涎、便秘发生率比较,差异无统计学意义(P>0.05),此外,观察组针刺治疗后,有5例患者出现针刺部位过敏现象,经热敷等简单处理后均好转。结论在常规西药治疗基础上联合补肾止颤方与针刺能有效改善PD合并睡眠障碍患者相关临床症状,提高其生活质量,且治疗安全性高,值得临床推广。
Objective To analyze the effect of Bushen Zhichan Decoction(补肾止颤方)combined with acupuncture treating sleep disorders in Parkinson's disease(PD)and its influence on levels of serum glutamate(Glu)and cystatin C(CysC).Methods A sample of 124 patients with PD complicating sleep disorders of liver-kidney Yin deficiency syndrome in the hospital from June 2019 to June 2021 were enrolled and randomly divided into two groups by random number table methods.The control group re⁃ceived routine western medical treatment,based on this,observation group received Bushen Zhichan decoction combined with acu⁃puncture.Then various parameters were compared between two groups,including Parkinson's Disease Sleep Scale(PDSS)score,Pittsburgh Sleep Quality Index(PQSI)score,39-item Parkinson's disease Questionnaire(PDQ-39)score,traditional Chinese medicine(TCM)efficacy,levels of serum Glu and CysC,the daily average dosage of levodopa and benserazide hydrochloride tab⁃lets and adverse effects.Results After treatment,an increase in PDSS score and a decrease in PQSI score were observed in both groups,with statistical difference(P<0.05).Compared with the control group,the observation group had significantly higher PDSS score and lower PQSI score after treatment(P<0.05).After treatment,the scores of motor ability,daily life,physical dis⁃comfort,social contact,social support,stigma,emotion,cognition and other dimensions of PDQ-39 as well as the total score of PDQ-39 decreased in both groups(P<0.05).The scores of each dimension and PDQ-39 total score were significantly lower in the observation group than those in the control group(P<0.05).The TCM effective rate for sleep disorder in the observation group was higher than that in the control group(P<0.05).After treatment,the Glu level increased and serum CysC level de⁃creased in both groups(P<0.05).The observation group had significantly higher serum Glu level and lower serum CysC level compared with those of the control group after treatment,with statistical difference(P<0.05).The daily average dosage of levo⁃dopa and benserazide hydrochloride tablets yielded no significant changes in the control group before and after treatment(P>0.05),which was significantly decreased in the observation group after treatment(P<0.05).Moreover,the dosage of the obser⁃vation group was significantly lower than that of the control group after treatment(P<0.05).The incidence of nausea in the ob⁃servation group was lower than that in the control group(P<0.05),and no significant difference was found in the incidence rate of salivation and constipation between groups(P>0.05).In addition,5 patients in the observation group developed acupuncture site allergy after acupuncture treatment,which was alleviated after hot compress.Conclusion Application of Bushen Zhichan De⁃coction combined with acupuncture based on western medicine treatment in the treatment of PD complicating sleep disorders can effectively ameliorate the clinical symptoms and improve the quality of life with high safety,worthy of recommendation.
作者
宋曦
胡玉英
张志伟
SONG Xi;HU Yuying;ZHANG Zhiwei(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530022,Guangxi,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第2期71-75,共5页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(81960842)
广西高等学校高水平创新团队及卓越学者计划项目(桂教人才[2020]6号)
广西中医脑病临床研究中心项目(桂科AD20238028)
广西中医药大学“岐黄工程”高层次人才团队培育项目(2018003)
广西中医药大学第一附属医院学术团队建设项目(院字[2018]146号)。
关键词
帕金森
睡眠障碍
补肾止颤方
针刺
血谷氨酸
胱抑素C
Parkinson's disease
sleep disorders
Bushen Zhichan Decoction(补肾止颤方)
acupuncture
serum glutamate
cystatin C
