| BackgroudParkinson disease(PD) is a progressive neurodegenerative disorder with cardinal motor features of tremor,bradykinesia,and rigidity.As the rapidity of population aging process,PD has brought the whole world,especially China,heavier burden in the economic and social development.Retrospecting of the treatment status of chinese medicine and western medicine,there is no effective method for preventing its progressing.L-madopa occupy the drug treatment nowadays.However,as the disease progresses,the duration of effect gradually becomes shorter and patients become aware of a missed or delayed dose as their parkinsonian symptoms and signs reemerge.Dopaminergic therapies are eventually complicated by motor fluctuations,including off time in most patients.These motor complications can impair quality of life and cause significant disability.Neuroprotective therapies has been increasingly addressed,but concerned with its fancy price and the unsatisfied result of clinical and experimental evaluation,this kind of treatment will take a long way for popularization.In chinese medicine,PD belongs to the tremor disease and rigidity disease.We conclude that kidney deficiency and blood stasis is an important pathogenesis of PD by reviewing the Chinese medical works.Plenty of experiments in vitro and clinical study have been proved that chinese medicine that reinforcing kidney and activating blood can reduce oxidative stress injury,scavenge free radicals,inhibit LOP reaction,increase dopamine level in brain,raise antioxidation ability as to anti-apoptosis in different degree.Emphasising chinese medicine of neuroprotective therapies in early metaphase PD patients,and establishing a definite clinical effect evaluation system is an important research aspect.ObjectiveTo observe the efficacy and security of chinese medicine for reinforcing kidney and activating blood circulation combined with western medicine in treating patients with PD.Try to establish and optimize a better integrated Traditional Chinese and Western Medicine therapy that is effective and safe for early metaphase PD patients.Discuss the TCM curative effect in reducing side effect inducing by anti-parkinsonism drug.Methods60 patiants were selected according to the British PD Diagnostic Criteria and inclusion criteria.The patients were divided into treatment group(30 cases)and control group(30 cases)by random number table and were treated with original therapeutic scheme,which madopa dose was ranged from 375mg/d to 1000mg/d.While those in the treatment group were additionally treated with the Chinese herbs(composed of Fuzi,Heshouwu,Shanyurou,Gouqizi,Danshen, Shichangpu,Shengdi,Baishao,Tianma,Wugong and etc.) The Chinese herbs were provided by the pharmaceutical preparation section of the hospitall steeped in 1500ml water simmered down to 300ml decoction,taken orally on an empty stomach separately in the morning and evening.1 dosage daily.3 mouths were regarded as one course of treatment.(The effect was evaluated once a mouth with the Unified Parkinson Disease Rating Scale,Hoehn and Yahr Scale, Parkinson's Disease Questionnaire and Parkinson Disease Sleep Scale.10-mile turned back test and one-minute bimanual timed motor test were also involved. The baseline score was assessed before treatment and compared with the scores evaluated at the end of treatment.Safety index included adverse reaction, blood pressure,pulse,laboratory examination and ECG.ResultsAfter a 3-mouth treatment,in the treatment group,4 cases were ineffective, 16 cases were slightly progressive,9 cases were progessive,1 cases was marked effective.The total progress rate was 86.67%.While in the control group, 10 cases were ineffective,15cases were slightly progressive,5 cases were progessive,no case was marked effective.The total progress rate was 66.67%. The difference of efficacy between two group had statistical significance(P＜0.05).When evaluated by UPDRS score,both two groups had statistical significance compared before and after treatment in Activities Of Daily Living part and Motor Examination part(P＜0.05),while in Complications Of Therapy part there was no significant difference(P＞0.05).When comparing Hoehn and Yabr Scale,there was also no difference significant compared before and after treatment or between two groups(P＞0.05).In treatment group,the patients of Hoehn and Yahr Scale 1～1.5 degree and 2～2.5 degree,whose UPDRS scores had significant difference compared before and after treatment.(P＜0.01),the UPDRS score after treatment compared between patients of Hoehn-Yahr 2～2.5 degree in two groups had statistical significance(P＜0.05).Both time of 10-mile turned back test and one-minute bimanual timed motor test were reduced in two groups after given treatment,and the difference in treatment group had statistical significance(P＜0.05).Both reducing of Turning Time in two groups had statistical significance(P＜0.05).Scores of both Parkinson Disease Sleep Scale and Parkinson's Disease Questionnaire had statistical significance compared before and after treatment in two groups(P＜0.01). Scores of Parkinson Disease Sleep Scale after treatment compared between two groups had statistical significance(P＜0.05).While scores of Parkinson's Disease Questionnaire between two groups had no statistical significance(P＜0.05).The dose of madopa compared before and after treatment in two groups bad no statistical significance(P＞0.05).Compared the dose of madopa after treatment between groups,There was also no statistical significance.(P＞0.05).ConclusionThe chinese medicine treatment of reinforcing kidney and activating blood circulation,intergrated with western medicine can prove both the motor function and activities of PD patients,and the curative effect was better than western medicine treatment group. |
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