目的 探究多奈哌齊聯(lián)合雷沙吉蘭治療帕金森病患者的臨床效果。方法 選取2021年3月—2023年2月沭陽中醫(yī)院收治的120例帕金森病患者，按照隨機(jī)數(shù)字表法將患者分為對照組和治療組，每組各60例。兩組患者均進(jìn)行多巴替代等常規(guī)治療。對照組睡前溫水吞服甲磺酸雷沙吉蘭片，1 mg/次，1次/d。治療組在對照組基礎(chǔ)上晚飯后溫水吞服鹽酸多奈哌齊片5 mg/次，1次/d。兩組均連續(xù)治療2個月。觀察兩組臨床療效，比較兩組統(tǒng)一帕金森病評定量表（UPDRS）評分、蒙特利爾認(rèn)知評估量表（MoCA）評分、簡明精神狀態(tài)量表（MMSE）評分、神經(jīng)精神問卷（NPI）評分及血清相關(guān)因子的變化。結(jié)果 治療后，治療組患者治療總有效率是93.33%，顯著高于對照組的80.00%，具有統(tǒng)計學(xué)差異（P＜0.05）。治療后，兩組UPDRS、NPI評分下降，而MoCA、MMSE評分上升（P＜0.05），且治療后治療組患者UPDRS、NPI評分低于對照組，MoCA、MMSE評分高于對照組，具有統(tǒng)計學(xué)差異（P＜0.05）。治療后，兩組多巴胺（DA）、5-羥色胺（5-HT）水平均顯著上升（P＜0.05）；且治療后，治療組DA、5-HT水平高于對照組，具有統(tǒng)計學(xué)差異（P＜0.05）。治療后，兩組血清總抗氧化能力（TAOC）、晚期糖基化終產(chǎn)物（AGEs）水平均下降（P＜0.05）；且治療后治療組TAOC、AGEs水平低于對照組，具有統(tǒng)計學(xué)差異（P＜0.05）。結(jié)論 多奈哌齊聯(lián)合雷沙吉蘭對帕金森病患者進(jìn)行治療能夠有效減輕患者臨床癥狀，改善患者精神狀態(tài)及認(rèn)知功能，調(diào)節(jié)患者神經(jīng)遞質(zhì)水平，改善患者腦血管調(diào)節(jié)功能及血流動力學(xué)。

Objective To investigate the therapeutic efficacy of donepezil combined with rasagiline in treatment of Parkinson’s disease. Methods A total of 120 patients with Parkinson’s disease admitted to Shuyang Hospital of Traditional Chinese Medicine from March 2021 to February 2023 were selected and divided into control group and treatment group according to random number table method, with 60 cases in each group. Both groups of patients received conventional treatments such as dopa replacement. Patients in control group swallowed Rasagiline Mesylate Tablets with warm water before going to bed, 1 mg/time, once daily. Patients in treatment group were po administered with Donepezil Hydrochloride Tablets on the basis of control group, 5 mg/time, once daily. Both groups were treated continuously for 2 months. The clinical efficacy of two groups was observed, and the changes of UPDRS score, MoCA score, MMSE score, NPI score, and serological related factors in two groups were compared. Results After treatment, the total effective rate of treatment in treatment group was 93.33%, significantly higher than 80.00% in control group, with a statistical difference (P < 0.05). After treatment, the UPDRS and NPI scores of both groups decreased, but the MoCA and MMSE scores increased (P < 0.05). After treatment, the UPDRS and NPI scores of treatment group were lower than those of control group, but the MoCA and MMSE scores were higher than those of control group, with statistically significant differences (P < 0.05). After treatment, the levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) in both groups increased significantly (P < 0.05). Moreover, after treatment, the levels of DA and 5-HT in treatment group were higher than those in control group, with a statistically significant difference (P < 0.05). After treatment, the levels of total serum antioxidant capacity (TAOC) and advanced glycation end products (AGEs) in both groups decreased (P < 0.05). After treatment, the levels of TAOC and AGEs in treatment group were lower than those in control group, and the difference was statistically significant (P < 0.05). Conclusion Donepezil combined with rasagiline in treatment of Parkinson’s disease can effectively alleviate the clinical symptoms of patients, and can improve their mental state and cognitive function, regulate the levels of neurotransmitters, and also can improve the cerebrovascular regulatory function and hemodynamics of patients.

R971

江蘇省重點研發(fā)計劃（社會發(fā)展）項目（BE2021630）