目的 探討羅替高汀貼片聯(lián)合金剛烷胺治療帕金森病的臨床療效。方法 選取2019年11月—2021年12月巴彥淖爾市醫(yī)院門診及住院收治的124例帕金森病患者，以隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各62例。對(duì)照組口服鹽酸金剛烷胺片，0.1 g/次，2次/d。治療組在對(duì)照組基礎(chǔ)上使用羅替高汀貼片，每日同一時(shí)間將本品貼于皮膚上并保留24 h，起始劑量為2 mg/24 h，1次/d，每次更換貼片時(shí)貼于皮膚另一部位，避免14 d內(nèi)在同一部位重復(fù)使用；每周劑量增加2 mg/24 h直至有效劑量（不超過8 mg/24 h）。兩組療程均為12周。觀察兩組的臨床療效，比較治療前后兩組統(tǒng)一帕金森病評(píng)定量表（UPDRS）、心理社會(huì)適應(yīng)量表（PAS）、帕金森病睡眠量表-2（PDSS-2）、8項(xiàng)帕金森病調(diào)查表（PDQ-8）、帕金森病非運(yùn)動(dòng)癥狀量表（PD-NMSS）評(píng)分以及血清超氧化物歧化酶（SOD）、乙酰膽堿（Ach）、白細(xì)胞介素（IL）-6水平。結(jié)果 治療后，治療組有效率是93.55%，相較對(duì)照組的80.65%顯著提高（P＜0.05）。治療后，兩組UPDRS中Ⅰ、Ⅱ、Ⅲ、Ⅳ部分評(píng)分及量表總分較治療前均顯著降低（P＜0.05）；且以治療組降低更顯著（P＜0.05）。治療后，兩組PAS評(píng)分均顯著增加，而PDSS-2、PDQ-8、PD-NMSS評(píng)分則均顯著降低（P＜0.05）；均以治療組改善更顯著（P＜0.05）。治療后，兩組血清SOD水平較治療前均顯著上升，而血清Ach、IL-6水平較治療前均顯著降低（P＜0.05）；且治療后，治療組血清SOD水平顯著高于對(duì)照組，血清Ach、IL-6水平均顯著低于對(duì)照組（P＜0.05）。結(jié)論 羅替高汀貼片聯(lián)合金剛烷胺治療帕金森病可取得確切療效，能有效改善患者臨床癥狀、睡眠狀況及生活質(zhì)量，并可進(jìn)一步增強(qiáng)機(jī)體抗氧化能力、減輕炎性損傷以及抑制Ach功能亢進(jìn)，利于延緩病情進(jìn)展，且安全性好。

Objective To investigate the clinical efficacy of Rotigotine Patches combined with amantadine in treatment of Parkinson’s disease. Methods From November 2019 to December 2021, 124 patients with Parkinson’s disease admitted to the outpatient and inpatient departments of Bayannur Hospital were selected, and all patients were divided into control group and treatment group by random number table method, with 62 patients in each group. Patients in the control group were po administered with Amantadine Hydrochloride Tablets, 0.1 g/time, twice daily. Patients in the treatment group were given Rotigotine Patches on the basis of the control group, applied the product to the skin at the same time every day and keep it for 24 h, the initial dosage was 2 mg/24 h, once daily, and applied to another part of the skin when changing the patch each time, to avoid repeated use within 14 d of the same part. The weekly dosage was increase by 2 mg/24 h until the effective dosage (not more than 8 mg/24 h). The treatment course of both groups was 12 weeks. The clinical efficacy of the two groups was observed. The scores of the unified Parkinson’s Disease Rating Scale (UPDRS), the Psychosocial Adaptation Scale (PAS), the Parkinson’s Sleep Scale-2 (PDSS-2), the eight item Parkinson’s Disease Questionnaire (PDQ-8), the Parkinson's Disease Non motor Symptom Scale (PD-NMSS), and the levels of serum superoxide dismutase (SOD), acetylcholine (Ach), and interleukin-6 (IL-6) were compared between the two groups before and after treatment. Results After treatment, the effective rate of the treatment group was 93.55%, which was significantly higher than that of the control group (80.65%) (P < 0.05). After treatment, the scores of Ⅰ, Ⅱ, Ⅲ, and Ⅳ in UPDRS and the total scores of scales in both groups were significantly decreased compared with those before treatment (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). After treatment, PAS scores in both groups were significantly increased, while PDSS-2, PDQ-8 and PD-NMSS scores were significantly decreased (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the serum SOD level in both groups was significantly increased, while the serum Ach and IL-6 levels were significantly decreased (P < 0.05). After treatment, the serum SOD level in the treatment group was significantly higher than that in the control group, and the serum Ach and IL-6 levels were significantly lower than that in the control group (P < 0.05). Conclusion Rotigotine Patches combined with amantadine can achieve a definite effect in treatment of Parkinson’s disease, and can effectively improve the clinical symptoms, sleep status and quality of life of patients, and can further enhance the antioxidant capacity of the body, reduce inflammatory damage and inhibit the hyperactivity of Ach, which is conducive to delaying the progress of the disease with good safety.

R971

內(nèi)蒙古醫(yī)科大學(xué)聯(lián)合項(xiàng)目計(jì)劃（YKD2021LH100）