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辅酶Q10对帕金森病的临床疗效分析

发布时间:2018-04-16 01:38

  本文选题:帕金森病 + 辅酶Q10 ; 参考:《山东大学》2014年硕士论文


【摘要】:背景:帕金森病(Parkinson's disease, PD)是一种中老年人常见的、慢性进行性神经系统变性疾病,各种运动及非运动症状严重降低了患者的生活质量,也给家庭和社会带来了极大的负担,随着中国人口日益老龄化,PD的发病率逐年升高,因此,寻找有效的抗PD药物以弥补当前治疗的不足,缓解疾病的进展,成为当务之急。目前PD的主要治疗方法仍为药物治疗,研究发现早期给予神经保护剂可延缓病情进展,改善疾病预后。近年来研究提示,多种机制参与PD的发病过程,包括遗传因素、氧化应激、线粒体功能障碍、免疫功能异常及环境因素等。辅酶Q10(CoQlO),作为一种脂溶性抗氧化剂,价格低廉,可清除自由基,减少氧化应激,目前在国内外主要用于心力衰竭、心肌病、心肌炎和肝炎等疾病的治疗,近期研究发现,CoQ10在神经系统的损伤与修复中也具有重要的保护和营养作用,国外临床试验也证实较大剂量CoQ10(300mg/d)在PD的治疗上具有一定的积极意义,但目前国内CoQ10的片剂为10mg,如此大剂量服用此药给患者带来了极大的负担。因此,我们设计了本研究,观察正常剂量CoQ10(60mg/d)对PD是否有神经保护作用,以期为PD的神经保护治疗提供一种新的治疗药物。 目的:探讨正常剂量CoQ10(60mg/d)对PD是否有神经保护治疗作用。 方法:本研究采用随机、对照试验,将40例PD患者分为CoQ10治疗组(20例)和对照组(20例)。治疗组除常规多巴丝肼片治疗外加用CoQ1060mg/d,对照组维持常规多巴丝肼片治疗,分别在治疗前、治疗3个月及6个月时进行临床评价,评价指标包括UPDRS(统一帕金森病评定量表)、ADL(日常生活能力表)、MMSE(简易智力精神状况检查量表)、MoCA(蒙特利尔认知评估量表)、HAD(医院焦虑/抑郁量表)及PSQI(匹兹堡睡眠质量指数)评分。然后通过Graph Prism5.0对两组患者数据进行统计学分析。 结果:CoQ10治疗3个月后,治疗组UPDRS-总、UPDRS-I、 UPDRS-II、 UPDRS-III、 UPDRS-IV、 H-Y分期、AD、 HAD A、 HAD D、 MoCA及MMSE评分较对照组均无显著性差异(P>0.05);治疗组PSQI评分较对照组有统计学差异(P<0.05)。 CoQ10治疗6个月后,治疗组UPDRS-总、UPDRS-I、 UPDRS-II、 UPDRS-III、 UPDRS-IV、 H-Y分期、HAD D、 ADL及MMSE较对照组均稍有改善,但无显著性差异(P>0.05);治疗组MoCA、 HAD A和PSQI评分较对照组均有统计学差异(P<0.05)。 结论:正常剂量CoQ10(60mg/d)治疗3个月对PD的睡眠障碍有一定的改善;治疗6个月对PD的认知功能、焦虑情绪及睡眠障碍有改善作用,提示CoQ10对PD有一定神经保护作用。
[Abstract]:Background: Parkinsonian disease (PDD) is a common and chronic progressive neurodegenerative disease in the elderly. All kinds of motor and non-motor symptoms have seriously reduced the quality of life of the patients and brought great burden to the family and society.With the aging of population in China, the incidence of PD is increasing year by year. Therefore, it is urgent to find effective anti-PD drugs to remedy the deficiency of current treatment and alleviate the progress of disease.At present, the main treatment of PD is drug therapy. It is found that early administration of neuroprotective agent can delay the progress of the disease and improve the prognosis of the disease.Recent studies suggest that many mechanisms are involved in the pathogenesis of PD, including genetic factors, oxidative stress, mitochondrial dysfunction, immune dysfunction and environmental factors.Coenzyme Q10, CoQlO, as a kind of fat soluble antioxidant, can scavenge free radicals and reduce oxidative stress. At present, it is mainly used in the treatment of heart failure, cardiomyopathy, myocarditis, hepatitis and other diseases at home and abroad.Recent studies have found that CoQ10 also plays an important protective and nutritional role in the injury and repair of the nervous system. Foreign clinical trials have also confirmed that a large dose of CoQ1010 300 mg / d has a certain positive significance in the treatment of PD.But at present the domestic CoQ10 tablet is 10 mg, such a large dose of this drug to patients with a great burden.Therefore, we designed this study to investigate the neuroprotective effect of normal dose of CoQ 10mg / d on PD, in order to provide a new therapeutic drug for the neuroprotective therapy of PD.Objective: to investigate whether the normal dose of CoQ 10 0 mg / d has neuroprotective effect on PD.Methods: 40 PD patients were randomly divided into CoQ10 treatment group (n = 20) and control group (n = 20).In the treatment group, in addition to conventional dobutazid tablets and CoQ 1060 mg / d, the control group was treated with conventional dobutazid tablets, and the clinical evaluation was performed at 3 months and 6 months before treatment, respectively.The evaluation indexes included ADL (Unified Parkinson's Disease rating scale) and PSQI (Pittsburgh Sleep quality Index), including MMSE (Mini-Mental Mental status scale), MoCA (Hospital anxiety / Depression scale) and PSQI (Pittsburgh Sleep quality Index).Then the two groups of patient data were statistically analyzed by Graph Prism5.0.Results after 3 months of treatment, there was no significant difference in the scores of UPDRS-I, UPDRS-II, UPDRS-III, UPDRS-IVH, H-Y staging, HAD A, HAD D, MoCA and MMSE in the treatment group compared with the control group (P > 0.05), and the PSQI score in the treatment group was significantly higher than that in the control group (P < 0.05).After 6 months of CoQ10 treatment, the levels of UPDRS-I, UPDRS-II, UPDRS-III, UPDRS-IV, H-Y staging of had D, ADL and MMSE in the treatment group were slightly improved as compared with those in the control group (P > 0.05), and the scores of MoCA, HAD A and PSQI in the treatment group were significantly higher than those in the control group (P < 0.05).Conclusion: normal dose of CoQ1010 60mg / d can improve the sleep disorder of PD for 3 months, and improve the cognitive function, anxiety and sleep disorder of PD for 6 months, suggesting that CoQ10 has a certain neuroprotective effect on PD.
【学位授予单位】:山东大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R742.5

【参考文献】

相关期刊论文 前3条

1 李熙东;张萍;闵连秋;隋汝波;赵春玉;;辅酶Q_(10)对帕金森病大鼠黑质细胞损伤的保护作用[J];辽宁医学院学报;2009年03期

2 张克忠;张廉;袁永胜;万琪;;帕金森病患者非运动症状的临床特征分析[J];川北医学院学报;2012年04期

3 高俊华;闫兆芬;孙莉;刘卓;黄曦妍;张巍;;帕金森病患者非运动症状的临床研究[J];中国全科医学;2010年23期



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