目的 觀察司來吉蘭聯(lián)合普拉克索治療帕金森病伴抑郁的臨床療效。方法 選取2014年1月—12月天津市寶坻區(qū)人民醫(yī)院神經(jīng)內(nèi)科收治的帕金森病伴發(fā)抑郁患者106例,隨機分為對照組和治療組,每組各53例。對照組患者口服鹽酸普拉克索片,1片/次,3次/d。治療組在對照組基礎(chǔ)上每日清晨餐后30 min口服鹽酸司來吉蘭片,第1～3天1片/次,1次/d,如無不良反應(yīng),從第4天開始口服2片/次,1次/d。兩組均連續(xù)治療8周。觀察兩組患者的臨床療效,同時比較漢密爾頓抑郁量表(HAMD)評分的變化,并采用統(tǒng)一帕金森評定量表(UPDRS)對患者日常生活能力及運動能力進行評分。結(jié)果 治療后,對照組和治療組的總有效率分別為64.15%、83.02%,兩組比較差異具有統(tǒng)計學(xué)意義(P <0.05)。治療4、8周后,兩組HAMD評分、日常生活能力評分、運動能力評分均較顯著降低,同組治療前后比較差異具有統(tǒng)計學(xué)意義(P <0.05);且治療組的下降程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P <0.05)。結(jié)論 司來吉蘭聯(lián)合普拉克索治療帕金森病伴抑郁具有較好的臨床療效,可降低HAMD評分和UPDRS評分,臨床療效安全可靠,具有一定的臨床應(yīng)用價值。

Objective To observe the effect of selegiline combined with pramipexole in treatment of Parkinson's disease with depression. Methods Patients (106 cases) with Parkinson's disease with depression in Department of Neurology of Tianjin Baodi Hospital from January 2014 to December 2014 were randomly divided into control and treatment groups, and each group had 53 cases. The patients in the control group were po administered with Pramipexole Dihydrochloride Tablets, 1 tablet/time, three times daily. The patients in the treatment group were po Selegiline Hydrochloride Tablets 30 min after breakfast, 1 tablet for 1 — 3 d, once daily, and if there was no adverse reaction, 2 tablets/time, once daily from the fourth day. Two groups were treated for eight weeks. After treatment, the efficacy was evaluated, and the changes of HAMD score in two groups were compared. At the same time, the unified Parkinson's disease rating scale (UPDRS) was carried out to evaluate the daily life ability and movement ability of two groups. Results After treatment, the efficacies in the control and treatment groups were 64.15% and 83.02%, respectively, and there was difference between two groups (P < 0.05). After four and eight weeks of treatment, HAMD scores, daily life ability score and sports ability scores in two groups were significantly lower, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusions Selegiline combined with pramipexole has good clinical efficacy in treatment of Parkinson's disease with depression, and can reduce HAMD score and UPDRS score, while its clinical curative effect is safe and reliable, which has certain clinical application value.