卡左雙多巴控釋片對(duì)帕金森病合并睡眠障礙患者精神行為癥狀、認(rèn)知障礙及日常生活能力的影響

劉華釗　鐘建新　梁彥珊　溫清艷　陳克強(qiáng)

【摘要】 目的：探討卡左雙多巴控釋片對(duì)帕金森病合并睡眠障礙患者精神行為癥狀、認(rèn)知障礙及日常生活能力的影響。方法：選取本院2017年2月-2019年1月帕金森病合并睡眠障礙患者72例，按隨機(jī)數(shù)字表法分為接受多巴絲肼組（多巴絲肼膠囊治療）與卡左雙多巴組（卡左雙多巴控釋片治療），每組36例。比較兩組精神行為癥狀、認(rèn)知能力、日常生活能力、帕金森病癥狀、睡眠情況及不良反應(yīng)發(fā)生情況。結(jié)果：治療4周內(nèi)，兩組簡(jiǎn)明精神狀態(tài)檢查量表（MMSE）、蒙特利爾認(rèn)知評(píng)估量表（MoCA）及日常生活活動(dòng)能力量表（ADL）評(píng)分均呈升高趨勢(shì)（P<0.05）。治療3、4周后，卡左雙多巴組MMSE評(píng)分均高于多巴絲肼組（P<0.05）。入組時(shí)、治療1、2、3、4周后，兩組MoCA評(píng)分比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。治療3、4周后，卡左雙多巴組ADL評(píng)分均高于多巴絲肼組（P<0.05）。治療4周后，卡左雙多巴組帕金森病評(píng)分量表（UPDRS）及匹茲堡睡眠質(zhì)量指數(shù)（PSQI）評(píng)分均低于多巴絲肼組（P<0.05）。兩組不良反應(yīng)發(fā)生率比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：卡左雙多巴控釋片可明顯改善帕金森病合并睡眠障礙患者的精神行為癥狀及日常生活能力，減輕帕金森病病情并提升睡眠質(zhì)量。

【關(guān)鍵詞】 卡左雙多巴控釋片 帕金森病 睡眠障礙

Effects of Carbidopa and Levodopa CR Tablets on Psychomotor Symptom， Cognitive Impairment and Daily Living Ability in Patients with Parkinsons Disease Complicated with Sleep Disorders/LIU Huazhao， ZHONG Jianxin， LIANG Yanshan， WEN Qingyan， CHEN Keqiang. //Medical Innovation of China， 2020， 17（09）： 0-072

[Abstract] Objective： To investigate the effects of Carbidopa and Levodopa CR Tablets on psychosomatic symptoms， cognitive impairment and daily living ability of patients with Parkinsons disease complicated with sleep disorder. Method： A total of 72 patients with Parkinsons disease complicated with sleep disorder in our hospital from February 2017 to January 2019 were selected， and they were divided into Levodopa and Benserazide group （Levodopa and Benserazide Capsule treatment） and the Carbidopa and Levodopa group （Carbidopa and Levodopa CR Tablets treatment） according to the random number table， 36 cases in each group. Psychosomatic symptoms， cognitive ability， daily living ability， Parkinsons disease symptom， sleep and adverse reactions were compared between the two groups. Result： Within 4 weeks of treatment， the scores of mini-mental state examination （MMSE）， Montreal cognitive assessment scale （MoCA） and activity of daily life scale （ADL） showed an increasing trend （P<0.05）. After 3 and 4 weeks of treatment， the MMSE score of the Carbidopa and Levodopa group were higher than those of the Levodopa and Benserazide group （P<0.05）. At enrolled， after 1， 2， 3， 4 weeks of treatment， there were no significant differences in MoCA scores between the two groups （P>0.05）. After 3 and 4 weeks of treatment， the ADL scores of the Carbidopa and Levodopa group were higher than those of the Levodopa and Benserazide group （P<0.05）. After 4 weeks of treatment， the scores of unified Parkinsons disease rating scale （UPDRS） and Pittsburgh sleep quality index （PSQI） in the Carbidopa and Levodopa group were lower than those in the Levodopa and Benserazide group （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion： Carbidopa and Levodopa CR Tablets can significantly improve the psychomotor symptoms and daily living ability of patients with Parkinsons disease and sleep disorders， reduces Parkinsons disease symptom and improves sleep quality.

[Key words] Carbidopa and Levodopa CR Tablets Parkinsons disease Sleep disorders

First-authors address： Jiangmen Central Hospital， Jiangmen 529000， China

doi：10.3969/j.issn.1674-4985.2020.09.017

帕金森病是以動(dòng)作遲緩及靜止震顫為主要臨床表現(xiàn)的神經(jīng)系統(tǒng)疾病，本病以中腦黑質(zhì)多巴胺神經(jīng)元變形、壞死為主要病理改變，好發(fā)于老年人群[1-2]。睡眠障礙作為帕金森病最為常見(jiàn)的并發(fā)癥，可使患者出現(xiàn)失眠、異態(tài)睡眠及日間瞌睡等多種臨床表現(xiàn)，不僅對(duì)患者睡眠造成嚴(yán)重的影響，同時(shí)也對(duì)患者預(yù)后造成一定的影響[3-5]。目前雖然臨床已經(jīng)有多種藥物可應(yīng)用于帕金森病合并睡眠障礙的治療，但其治療效果存在一定的差異[6-8]。本研究將卡左雙多巴控釋片應(yīng)用于帕金森病合并睡眠障礙的治療中，對(duì)其臨床治療效果進(jìn)行初步評(píng)價(jià)，現(xiàn)報(bào)道如下。……