摘要
目的观察氟哌啶醇联合普拉克索治疗帕金森病伴精神障碍的临床效果及经济性。方法选取2017年6月—2020年5月武汉市汉口医院收治的帕金森病伴精神障碍老年患者86例,依照随机分组对照原则分为观察组和对照组,各43例。对照组予单纯盐酸普拉克索片治疗,观察组在对照组基础上加用奥氮平片治疗,2组均持续治疗3个月。比较2组治疗效果,治疗前后39项帕金森病调查问卷(PDQ⁃39)评分、简易精神状态量表(MMSE)评分、帕金森病统一评分量表Ⅲ(UPDRS⁃Ⅲ)评分、帕金森病非运动症状调查问卷(NMSQ)评分变化,不良反应及医疗费用情况。结果观察组患者治疗总有效率为88.37%,高于对照组的69.77%(χ^(2)=4.497,P=0.034);治疗3个月后,2组PDQ⁃39、MMSE、UPDRS⁃Ⅲ评分及NMSQ诸项评分均较治疗前降低,且观察组PDQ⁃39、MMSE、UPDRS⁃Ⅲ评分及NMSQ评分中胃肠道消化功能、自主神经症状、神经精神类症状、睡眠障碍评分降低的程度大于对照组(P均<0.01);观察组不良反应总发生率为11.63%,低于对照组的37.21%(χ^(2)=7.623,P=0.006);观察组住院费用明显低于对照组,医疗总费用明显高于对照组(P均<0.01)。结论氟哌啶醇联合普拉克索治疗帕金森病伴精神障碍的临床效果突出且安全性高,但考虑到此联合用药的医疗费用高于单一用药,临床需根据患者实际情况的制定具体方案。
Objective To observe the clinical effect and economy of haloperidol combined with pramipexole in the treatment of Parkinson′s disease with mental disorder.Methods Eighty⁃six elderly patients with Parkinson′s disease with mental disorders treated in Wuhan Hankou Hospital from June 2017 to may 2020 were selected.According to the principle of random grouping and control,they were divided into observation group and control group,with 43 cases in each group.The control group was treated with pramipexole hydrochloride tablets only,and the observation group was treated with olanzapine tablets on the basis of the control group.Both groups were treated for 3 months.The treatment effects of the two groups were compared.The scores of 39 items of Parkinson′s disease questionnaire(PDQ⁃39),Mini mental state examination(MMSE),Unified Parkinson′s disease rating scale⁃Ⅲ(UPDRS⁃Ⅲ),Parkinson′s disease non motor symptoms questionnaire(NMSQ)before and after treatment were compared,as well as the occurrence of adverse reactions and medical expenses.Results The total effective rate of the observation group was 88.37%,higher than 69.77%of the control group(χ^(2)=4.497,P=0.034).After 3 months of treatment,the scores of PDQ⁃39,MMSE,UPDRS⁃Ⅲand NMSQ in the two groups were lower than those before treatment.The scores of PDQ⁃39,MMSE and UPDRS⁃Ⅲ,as well as the scores of gastrointestinal digestive function,autonomic nerve symptoms,neuropsychiatric symptoms and sleep disorders in the observation group were significantly lower than those in the control group(all P<0.01).The total incidence of adverse reactions in the observation group was 11.63%,lower than 37.21%in the control group(χ^(2)=7.623,P=0.006).The hospitalization cost of the observation group was significantly lower than that of the control group,and the total medical cost was significantly higher than that of the control group(all P<0.01).Conclusion Haloperidol combined with pramipexole has prominent clinical effect and high safety in the treatment of Parkinson′s disease with mental disorder.However,considering that the medical cost of combined medication is higher than that of single medication,the clinical needs to formulate a specific scheme according to the actual situation of patients.
作者
吴娴
WU Xian(Wuhan Hankou Hospital,Hubei Province,Wuhan 430010,China)
出处
《临床合理用药杂志》
2022年第26期12-15,19,共5页
Chinese Journal of Clinical Rational Drug Use
