CAJ | 학술논문

目的：探讨应用高压氧、针灸联合小剂量美多巴治疗对帕金森综合征（ Parkinson disease ， PD）患者生活质量的改善作用。方法选择PD患者140例，经患者及家属知情同意，将患者按照治疗方法分为A组（针灸＋美多巴组，20例）、B组（高压氧＋美多巴组，20例）、C组（高压氧＋针灸＋小剂量美多巴组，60例）、D组（小剂量美多巴组，40例），用生活质量评定量表（EQ-5D）、统一PD评定量表（ UPDRS）、Hoehn-Yahr（ H-Y）分级、PD睡眠量表（ PDSS）、汉密尔顿抑郁量表（ HAMD）、汉密尔顿焦虑量表（HAMA），评估PD患者运动、非运动症状改善及生活质量改善情况。结果（1）4组患者经短期治疗（治疗1个月）后UPDRSⅠ、UPDRSⅡ、UPDRSⅢA组t值分别为7．71，6．14，6．50；B组t值分别为6．87、6．09、6．66；C组t值分别为6．69、6．66、9．68；D组t值分别为7．79、6．07、6．41。 HAMA、HAMD、PDSS、EQ-5D评分较治疗前明显改善，差异有统计学意义（P＜0．05）。提示4种治疗方案短期内皆可改善患者运动和非运动症状，提高PD患者生活质量；C组在UPDRSⅢ、HAMA、HAMD、PDSS方面改善更显著，差异有统计学意义（P＜0．05）。（2）长期治疗（6个月）后C组患者UPDRSⅢ、HAMA、HAMD、PDSS评分与D组相比差异有统计学意义（P＜0．05）。（3）长期治疗（6个月）后，C组患者的生活质量呈上升趋势，与其他组比较差异有统计学意义（P＜0．05）。结论高压氧、针灸联合小剂量美多巴可提高PD患者生活质量。
목적：탐토응용고압양、침구연합소제량미다파치료대파금삼종합정（ Parkinson disease ， PD）환자생활질량적개선작용。방법선택PD환자140례，경환자급가속지정동의，장환자안조치료방법분위A조（침구＋미다파조，20례）、B조（고압양＋미다파조，20례）、C조（고압양＋침구＋소제량미다파조，60례）、D조（소제량미다파조，40례），용생활질량평정량표（EQ-5D）、통일PD평정량표（ UPDRS）、Hoehn-Yahr（ H-Y）분급、PD수면량표（ PDSS）、한밀이돈억욱량표（ HAMD）、한밀이돈초필량표（HAMA），평고PD환자운동、비운동증상개선급생활질량개선정황。결과（1）4조환자경단기치료（치료1개월）후UPDRSⅠ、UPDRSⅡ、UPDRSⅢA조t치분별위7．71，6．14，6．50；B조t치분별위6．87、6．09、6．66；C조t치분별위6．69、6．66、9．68；D조t치분별위7．79、6．07、6．41。 HAMA、HAMD、PDSS、EQ-5D평분교치료전명현개선，차이유통계학의의（P＜0．05）。제시4충치료방안단기내개가개선환자운동화비운동증상，제고PD환자생활질량；C조재UPDRSⅢ、HAMA、HAMD、PDSS방면개선경현저，차이유통계학의의（P＜0．05）。（2）장기치료（6개월）후C조환자UPDRSⅢ、HAMA、HAMD、PDSS평분여D조상비차이유통계학의의（P＜0．05）。（3）장기치료（6개월）후，C조환자적생활질량정상승추세，여기타조비교차이유통계학의의（P＜0．05）。결론고압양、침구연합소제량미다파가제고PD환자생활질량。
Objective To investigate the effects of hyperbaric oxygen ( HBO ) combined with acupuncture and low-dose L-dopa on the improvement of motor and non-motor symptoms and life quality of the patients with Parkinson's disease.Methods One hundred and forty PD patients were chosen for our study . With the knowledge and consent of the patients and their dependents , the patients were divided into 4 groups, by different treatment methods:group A (the acupuncture plus small-dose L-dopa group, n=20 cases), group B ( the HBO plus small-dose L-dopa group , n=20 cases ) , group C ( the HBO plus acupuncture and plus small-dose L-dopa group , n =60 cases ) , and group D ( the small-dose L-dopa group , n =40 cases ) . Improvement of motor and non-motor symptoms and their life quality of the patients were assessed by using the EQ-5D, Uniform Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr (H-Y) Rating Scale, Parkinson's Disease Sleep Scale ( PDSS) , Hamilton Anxiety Rating Scale ( HAMA) and Hamilton Depression Rating Scale (HAMD).Results (1)After one month of treatment, the scores of UPDRS I, UPDRS II and UPDRSⅢfor group A were respectively 7.71, 6.14 and 6.50, the scores for group B were respectively 6.87, 6.09 and 6.66, the scores for group C were respectively 6.69, 6.66 and 9.68, and the scores for group D were respectively 7.79, 6.07 and 6.41.The scores of HAMA, HAMD, PDSS and EQ-5D were significantly improved as compared with those before treatment (P<0.05), indicating that the 4 treatment profiles within a relatively short time could all improve the motor and non-motor symptoms and life quality of the PD patients The scores of UPDRSⅢ, HAMA, HAMD and PDSS for group C were more significantly improved (P<0.05).(2) After 6 months of prolonged treatment , statistical significance could be noted in the scores of UPDRS Ⅲ, HAMA, HAMD and PDSS in the patients of group C (P <0.05).(3) Following 6 months of prolonged treatment , the life quality of the patients in group C tended to improve , and statistical significance could also be noted, when comparisons were made with that of the other groups (P<0.05).Conclusions HBO combined with acupuncture and small-dose L-dopa could reduce the dosage of L-dopa, decrease adverse reactions and improve the life quality of patients with Parkinson's disease.