摘要
目的探究吡贝地尔缓释片辅治老年帕金森病合并糖尿病对炎性指标及神经功能的改善情况。方法回顾性分析2015年1月至2016年12月中国人民解放军北部战区总医院收治的126例老年帕金森病合并糖尿病患者的临床资料,根据治疗方案的不同将患者分为两组:对照组(n=62)和研究组(n=64)。对照组患者采用多巴丝肼片治疗,研究组患者采用多巴丝肼片联合吡贝地尔缓释片治疗。对比两组患者治疗前后血清炎性指标肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)与白细胞介素-18(IL-18)的改善情况。观察记录两组患者的神经功能改善情况,包括肢体感觉症状、自主神经症状以及HY分级等。结果研究组与对照组患者治疗后血清炎性因子TNF-α、IL-6与IL-18的表达水平均较治疗前有明显改善(P<0.05),而相比于对照组,研究组患者的改善更为显著(t=3.362,2.129,6.257,P<0.05);治疗后研究组患者的肢体疼痛、肢体寒凉、肢体痉挛和不安腿综合征等症状的发生率均有明显降低(χ^2=4.354,5.680、5.395,4.614,P<0.05),而对照组患者的发生率降低并不显著(χ^2=1.442,2.185,2.563,1.846,P>0.05);治疗后研究组患者HY分级1、2级的数量较治疗前明显增多,3、4级的数量明显降低(Z=2.887,P<0.05);而对照组患者治疗前后的HY分级的变化情况差异无统计学意义(Z=1.225,P>0.05);治疗后研究组患者的口干、便秘、尿频尿急、出汗等自主神经异常症状的发生率均有明显降低(χ^2=5.236,7.127,30.676,30.040,P<0.05),而对照组患者的口干、便秘发生率降低并不显著(χ^2=1.679,3.345,P>0.05),尿频尿急、出汗的发生率明显降低(χ^2=15.629,23.522,P<0.05)。结论吡贝地尔缓释片联合多巴丝肼片治疗老年帕金森病合并糖尿病,可以明显改善患者的血清炎性指标水平和肢体感觉症状、运动症状、自主神经症状等神经功能,具有一定的临床价值。
Objective To explore the improvement of inflammatory factors and neurological function in patients with senile Parkinson’s disease and diabetes mellitus assistantly treated with piribedil SR.Methods The clinical data of 126 senile Parkinson’s disease with diabetes mellitus patients admitted to General Hospital of the PLA Northern Theater Command from January 2015 to December 2016 were retrospectively analyzed.The patients were divided into the control group(n=62)and the study group(n=64)according to their treatment plan.The patients in the control group were treated with doxycycline,while the patients in the study group were treated with doxycycline and piribedil SR.The improvement of serum inflammatory factors TNF-α,IL-6 and IL-18 before and after treatment was compared between the two groups.The improvement of neurological function in the two groups was observed and recorded,including limb sensory symptoms,autonomic symptoms and HY grade.Results The expression levels of serum inflammatory cytokines TNF-α,IL-6 and IL-18 in the study group and control group were both significantly improved after treatment(P<0.05).Compared with the control group,the improvement in the study group was more significant(t=3.362,2.129,6.257,P<0.05).After treatment,the incidence of limb pain,limb cold,limb spasm and restless leg syndrome were significantly reduced in the study group(χ^2=4.354,5.680,5.395,4.614,P<0.05),but not significantly reduced in the control group(χ^2=1.442,2.185,2.563,1.846,P>0.05).After treatment,the HY grade 1 and 2 patients in the study group increased significantly,while the HY grade3 and 4 patients decreased significantly(Z=2.887,P<0.05).However,there was no significant difference in the change of HY grade before and after treatment in the control group(Z=1.225,P>0.05).After treatment,the incidence of autonomic symptoms such as dry mouth,constipation,urinary frequency and urgency,and sweating was significantly reduced in the study group(χ^2=5.236,7.127,30.676,30.040,P <0.05).However,the incidence of dry mouth and constipation was not significantly reduced in the control group(χ^2=1.679,3.345,P>0.05),and the urinary frequency and urgency and sweating was also significantly reduced(χ^2=15.629,23.522,P<0.05).Conclusion Piribedil SR assisted doxycycline in the treatment of senile Parkinson’s disease with diabetes mellitus can significantly improve the level of serum inflammatory factors and the nerve function such as limb sensory symptoms,motor symptoms,autonomic nervous symptoms,etc.,which has a certain clinical value.
作者
李琳
孙冬萌
蒋智林
LI Lin;SUN Dong-meng;JIANG Zhi-lin(Department of Neurology,General Hospital of the PLA Northern Theater Command,Shenyang Liaoning 110003,China)
出处
《临床和实验医学杂志》
2020年第6期622-626,共5页
Journal of Clinical and Experimental Medicine
基金
辽宁省2017年自然科学基金计划立项项目(编号:2017020852)。
关键词
帕金森病
糖尿病
吡贝地尔缓释片
炎性因子
神经功能
Parkinson’s disease
Diabetes mellitus
Piribedil SR
Inflammatory factors
Neurological function
