Clinical Research On Parkinson's Disease With Treatment Of Strengthening Kidney And Activating Circulation

[Objective]To study the optimized scheme for treatment of Parkinson's disease(PD)with combined Traditional Chinese and Western medicine, which is supported by National Ministry of Science and Technology "Eleventh Five-Year" project. We adopted motor signs, symptoms in TCM, quality of Life, levels of DA in brain, muscular tension, usage of Madopar to observe the effects of Strengthening Kidney and Activating Circulation (SKAC).[Method]①A multi-center, randomized, placebo-controlled, double-blind clinical study was undertaken. Totally 120 PD patients were randomly divided into treatment group and placebo group, both groups based on Madopar treatment. All patients were treated for 9 months, including 6 months'follow-up period. The above-mentioned assessment scale, and symptoms in TCM, security indicators for drug adverse effects were measured at each time point:before treatment, treatment after 1,2,3,6,9 month. Among which,60 patients were enrolled in measurement of EFG and Myotonometer at the meantime.②We established the multiple linear regression mode to analyze the effects of "sex", "age", "duration", "H-Y" and "Madopar" on "UPDRSⅡ", "UPDRS III", "10m x 2 time", "Ji-Shi-Test(JST)" and "Sleep" after analysis of repeated measurement data in the study.【Result】①arameters such as UPDRSIII score,10m×2 test and JST were ameliorated in treatment group at each time point. UPDRSIII score and time of getting up showed significant statistical difference in following-up period(P< 0.01).The times of left and right hands showed no statistical significant difference between groups(P>0.05);The scores of UPDRSⅡ, PDSS, and some aspects of PDQ-39 showed statistical significant in both treatment and following-up periods(P<0.05). Symptoms in TCM were improved markedly (effective power 85.50%).②The treatment group showed a higher efficacy than the placebo group in increasing the levels of DA not only in treatment period (P<0.05), DA level in the placebo group was slightly increased, but no statistical difference was found between groups (P>0.05);The treatment group showed a higher efficacy in relieving motor function obstacle, from the aspects of both biceps brachii and quadriceps femoris (P<0.05), especially in biceps brachii (P<0.01).③The symptoms of poor appetite, sleep disorders were significant statistical difference(P<0.01). With the extension of treatment time, the scores of dyskinesia and motor fluctuation was reduced(P<0.05).The usage of Madopar in treatment group were decreased, especially in patients with H-Y 2-3,but placebo group were increased; Treatment complications scores (Sweating,Constipation, Urination disorder) were reduced after 9 months,compared with placebo group(P <0.01).④"H-Y" showed significant effects on "UPDRSⅡ", "UPDRSⅢ", "getting up time" (P<0.01), "Madopar" and "H-Y" had effects on "10m×2 time" (P <0.05), "Madopar" on "sleep" (P<0.05), "age" on "JST-left" (P<0.01) and "age", "duration" on "JST-right" (P<0.05).【Conclusion】①SKAC treatment can improve motor signs and symptoms in TCM of PD patients significantly(effective power 85.50%).The curative effects were more permanent and stable. From the aspects of Ability of Daily Life, Sleep Initiation &Maintenance Disorders and Psychophysiologic Disorders, quality of life of PD patients improved markedly in treatment group. ②Levels of DA in brain and static muscular tension were significantly improved with the effects of the SKAC treatment.③Usage of Madopar and score of treatment complications in treatment group were decreased. SKAC treatment can decrease the side-effects of Madopar and put off the development of PD. The longer treatment time, the more significant effects of "Attenuation and Synergia" for SKAC.④There is a correlation between "H-Y", "Madopar" and clinical evaluation indexes for PD treatment:"UPDRSⅡ", "UPDRSIII"," 10m×2 time" and "Sleep".