CAJ | 학술논문

目的：探讨喹硫平治疗帕金森病（PD）合并精神障碍的疗效及不良反应。方法收集PD合并精神障碍患者共78例。所有患者均伴有精神行为异常1个月以上，其中以阳性症状为主要表现者42例，以阴性症状为主要表现者36例。78例患者随机分为两组，治疗组40例，对照组38例。治疗组在调整抗帕金森药物的基础上加用喹硫平50～400mg/d，观察8周；对照组仅予以调整抗帕金森药物的治疗。治疗前后以统一帕金森病评定量表（UPDRS）评定运动功能；以阳性症状和阴性症状量表（PANSS）评定精神障碍程度及疗效；以副反应量表（TESS）评定不良反应。结果两组患者治疗后PANSS评分均比治疗前减少，以治疗组减少程度较大，两组差异有统计学意义（P＜0.01）；两组患者治疗后UPDRS评分均比治疗前减少，两组差异无统计学意义（P＞0.05）；治疗组不良反应少，未出现严重不良反应。结论喹硫平治疗PD合并精神障碍的疗效肯定，不良反应少，安全性强，值得临床应用和推广。
목적：탐토규류평치료파금삼병（PD）합병정신장애적료효급불량반응。방법수집PD합병정신장애환자공78례。소유환자균반유정신행위이상1개월이상，기중이양성증상위주요표현자42례，이음성증상위주요표현자36례。78례환자수궤분위량조，치료조40례，대조조38례。치료조재조정항파금삼약물적기출상가용규류평50～400mg/d，관찰8주；대조조부여이조정항파금삼약물적치료。치료전후이통일파금삼병평정량표（UPDRS）평정운동공능；이양성증상화음성증상량표（PANSS）평정정신장애정도급료효；이부반응량표（TESS）평정불량반응。결과량조환자치료후PANSS평분균비치료전감소，이치료조감소정도교대，량조차이유통계학의의（P＜0.01）；량조환자치료후UPDRS평분균비치료전감소，량조차이무통계학의의（P＞0.05）；치료조불량반응소，미출현엄중불량반응。결론규류평치료PD합병정신장애적료효긍정，불량반응소，안전성강，치득림상응용화추엄。
Objective To investigate the efficacy and adverse reactions of quetiapine in the treatment of Parkinson's disease(PD) complicated with mental disorder. Methods 78 patients with Parkinson's disease complicated with mental disorder were included. All of them had psychological and behavioral abnormality for more than one month,including 42 cases with positive symptom and 36 cases with negative symptom. 78 patients were randomly divided into two groups with 40 cases in the treatment group and 38 cases in the control group. The treatment group was given 50~400mg of Quetiapine per day as well as anti-Parkinson drugs and then was observed for 8 weeks while the control group only received anti-Parkinson drugs. Before and after the treatment,the unified parkinson's disease Rating Scale(UPDRS) was adopted for functional assessment,the positive and negative syndrome scale(PANSS) for the evaluation of mental disorder and efficacy and the treatment emergent symptom scale(TESS) for assessing the adverse reactions. Results After the treatment, the PANSS score decreased in both groups with greater drop in the treatment group. There was statistically significant difference in both groups(P < 0.01). The UPDRS score decreased in both groups after the treatment with no statistically significant difference(P>0.05). There were fewer adverse reactions in the treatment group and no severe adverse reactions occurred. Conclusion Quetiapine should be promoted clinically with reliable efficacy in Parkinson's disease complicated with mental disorder, fewer adverse reactions and good safety.