摘要
目的探讨柴胡加龙骨牡蛎汤加减对帕金森病(PD)肝肾阴虚证患者临床疗效及同源性磷酸酶张力蛋白诱导激酶1(phosphatase and tensin homolog-induced putative kinase 1,PINK1)/E3泛素连接酶(E3 ubiquitin ligase,Parkin)信号通路的影响。方法随机对照试验研究。选择2020年5月-2024年5月西安市中医医院脑病科120例PD患者作为观察对象,采用随机数字表法分为2组,每组60例。对照组口服多巴丝肼片,联合组在对照组基础上服用柴胡加龙骨牡蛎汤。2组均连续治疗2个月。采用ELISA法检测胶质细胞源性神经营养因子(GDNF)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)、碱性成纤维细胞生长因子2(FGF2)水平,采用实时荧光定量PCR法检测PINK1、Parkin、螯合体1(SQSTM1)mRNA水平,观察治疗期间的不良反应,评价临床疗效。结果联合组总有效率为95.00%(57/60)、对照组为83.33%(50/60),2组比较差异有统计学意义(χ^(2)=4.23,P=0.040)。联合组治疗后血清GDNF[(510.78±31.57)ng/L比(431.89±30.45)ng/L,t=13.93]、BDNF[(36.47±3.72)ng/L比(27.84±3.55)ng/L,t=13.00]、NGF[(57.24±4.17)ng/L比(50.72±4.11)ng/L,t=8.63]、FGF2[(26.21±3.71)ng/L比(21.63±3.54)ng/L,t=6.92]水平高于对照组(P<0.001)。联合组治疗后PINK1[(2.38±0.07)比(2.19±0.05),t=17.11]、Parkin[(1.89±0.03)比(1.74±0.05),t=19.93]、SQSTM1[(1.82±0.07)比(1.61±0.05),t=18.91]mRNA水平高于对照组(P<0.001)。治疗期间,联合组不良反应发生率为6.67%(4/60)、对照组为10.00%(6/60),2组比较差异无统计学意义(χ^(2)=0.44,P=0.509)。结论柴胡加龙骨牡蛎汤加减可提高PD肝肾阴虚证患者神经营养因子水平,调节PINK1/Parkin通路,保护神经元,改善线粒体自噬功能,提高临床疗效。
ObjectiveTo explore the clinical efficacy of modified Chaihu Jia Longgu Muli Decoction in patients with liver and kidney Yin deficiency syndrome of Parkinson's disease(PD)and the effects on phosphatase and tensin homolog-induced putative kinase 1(PINK1)/E3 ubiquitin ligase(Parkin)signaling pathway.MethodsA randomized controlled trial study was conducted.A total of 120 PD patients from the Department of Encephalopathy of Xi'an Hospital of Traditional Chinese Medicine from May 2020 to May 2024 were selected as the observation objects and divided into 2 groups through random number table method,with 60 cases in each group.The control group took dopashydrazine tablets orally,while the combined group took Chaihu Jia Longgu Muli Decoction on the basis of the control group.Two groups were treated continuously for 2 months.The levels of glial cell-derived neurotrophic factor(GDNF),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),and basic fibroblast growth factor 2(FGF2)were detected by ELISA.The expression levels of PINK1,Parkin and chelate 1(SQSTM1)mRNA were detected by real-time fluorescence quantitative PCR.The adverse reactions during the treatment were observed and recorded to evaluate the clinical efficacy.ResultsThe total effective rate was 95.00%(57/60)in the combined group and 83.33%(50/60)in the control group,with statistical significance(χ^(2)=4.23,P=0.040).After treatment,the levels of serum GDNF[(510.78±31.57)ng/L vs.(431.89±30.45)ng/L,t=13.93],BDNF[(36.47±3.72)ng/L vs.(27.84±3.55)ng/L,t=13.00],NGF[(57.24±4.17)ng/L vs.(50.72±4.11)ng/L,t=8.63]and FGF2[(26.21±3.71)ng/L vs.(21.63±3.54)ng/L,t=6.92]in the combined group were higher than those in the control group(P<0.001).After treatment,the mRNA expression levels of PINK1(2.38±0.07 vs.2.19±0.05,t=17.11),Parkin(1.89±0.03 vs.1.74±0.05,t=19.93),and SQSTM1(1.82±0.07 vs.1.61±0.05,t=18.91)in the combined group were higher than those in the control group(P<0.001).During the treatment period,the incidence of adverse reactions was 6.67%(4/60)in the combined group and 10.00%(6/60)in the control group,without statistical significance(χ^(2)=0.44,P=0.509).ConclusionModified Chaihu Jia Longgu Muli Decoction can increase the levels of neurotrophic factors in patients with PD of liver and kidney yin deficiency syndrome,regulate the PINK1/Parkin pathway,protect neurons,improve mitochondrial autophagy function,and enhance clinical efficacy.
作者
任庆萍
林海
王晨
杨春梅
王开娜
李敏
Ren Qingping;Lin Hai;Wang Chen;Yang Chunmei;Wang Kaina;Li Min(Department of Encephalopathy,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China)
出处
《国际中医中药杂志》
2025年第8期1066-1071,共6页
International Journal of Traditional Chinese Medicine
