恩他卡朋治疗帕金森病的疗效及对患者抗氧化应激反应的影响

摘要

目的 探讨左旋多巴联合恩他卡朋治疗帕金森病(PD)的临床疗效及对患者抗氧化应激反应的影响.方法 选取本院在2015年11月至2017年3月收治的PD患者84例,按照随机数字表法分为观察组和对照组,各42例,对照组给予左旋多巴口服治疗,观察组在此基础上联合恩他卡朋口服治疗,12w 1个疗程;观察两组患者临床疗效、统一PD评定定量表(UPDRS)、日常生活能力表(ADL)、非运动症状评价表(NMSS)评分及抗氧化应激反应的影响.结果 ①观察组临床总有效率95.24%,对照组临床总有效率为80.95%,差异有统计学意义(χ2=4.086,P=0.043);②治疗后2组患者UPDRS、ADL、NMSS评分明显低于治疗前,且观察组UPDRS、ADL、NMSS评分明显低于对照组,差异有统计学意义(P<0.05);治疗后2组患者UPDRS-I评分比较差异无统计学意义(P>0.05),观察组UPDRS-II、UPDRS-III评分明显低于对照组,差异有统计学意义(P<0.05);③治疗后观察组IL-1β、IL-6、丙二醛(MDA)水平低于对照组,超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH-PX)水平高于对照组,差异有统计学意义(P<0.05);④治疗期间观察组不良反应发生率为11.90%,对照组不良反应发生率为30.95%,差异有统计学意义(χ2=4.525,P=0.033).结论 左旋多巴联合恩他卡朋治疗PD临床疗效显著,可明显提高患者运动功能和日常生活能力,改善患者清除自由基的能力,延缓氧化应激的进展,且不良反应少,有临床应用价值.%Objective To investigate the clinical efficacy of levodopa combined with entacapone in the treatment of Parkinson's disease(PD)and its effect on antioxidant stress in patients. Method 184 patients with PD admitted in hospital from November 2015 to March 2017 were divided into experimental group and control group according to the random number table, 42 cases each group. The control group was treated with levodopa oral therapy, the experimental group was treated with entacapone oral treatment on this basis treatment of the control group; and 12 weeks was a course of treatment. The clinical efficacy, UPDRS, ADL, NMSS score and the effects on oxidative stress were observed between the two groups. Results ① The total effective rate of the experimental group was 95.24%, and the total effective rate of the control group was 80.95%; the difference between the two groups was statistically significant (χ2=4.086, P=0.043);② After treatment, the unifired PD rating scale(UPDRS), activites of daily(ADL) and motor symptoms scale(NMSS)score of the two groups were significantly lower than those before treatment, and the UPDRS, ADL and NMSS score of the observation group were significantly lower than those of the control group, the difference was statistically significant (P<0.05). There was no significant difference in UPDRS-I score between the two groups after treatment (P>0.05). The scores of UPDRS-II and UPDRS-III in the experimental group were lower than those in the control group, the difference was statistically significant (P<0.05); ③After treatment, the levels of IL-1β, IL-6 and malondialdehyde(MDA)in the experimental group were lower than those in the control group, and the levels of superoxide dismulase(SOD), glutathione(GSH)and gluathione peroxidase(GSH-PX)of the experimental group were higher than those of the control group, the difference was statistically significant (P<0.05);④The incidence of adverse reactions of the experimental group was 11.90%, the incidence of adverse reactions of the control group was 30.95%; and the difference was statistically significant (χ2=4.525, P=0.033). Conclusion The clinical efficacy of levodopa combined with entacapone in the treatment of PD is significant, it can significantly improve motor function and ability of daily life, improve the ability to scavenge free radicals of patients, delay the progress of oxidative stress, and less adverse reactions; it is worthy of clinical promotion.