普拉克索治疗帕金森病非运动症状疗效的Meta分析

发布时间：2018-05-08 14:48

本文选题：普拉克索 + 帕金森病　；参考：《吉林大学》2016年硕士论文

【摘要】：目的:本研究通过对普拉克索治疗帕金森病的随机对照试验进行Meta分析,评价普拉克索治疗帕金森病非运动症状的有效性及安全性,为其临床应用提供有效的循证医学证据。方法:计算机检索1997年1月到2016年1月期间发表的关于普拉克索治疗帕金森病非运动症状的文献,根据制定的纳入及排除标准筛选出符合标准的质量较高的文献,阅读全文后提取有效数据,应用Revman5.3软件对其进行Meta分析,计算相对危险度(OR)值、均数差(MD)、标准差(SD)及95%可信区间(95%CI),行Z检验。本研究认为P0.05为具有统计学意义。结果:共纳入文献13篇,总样本量1862例,其中普拉克索组924人,对照组938人。分别对UPDRS总分、UPDRSI部分、HAMD及HAMA评分相对基线变化幅度及UPDRSI部分评分改善病例数进行Meta分析,结果显示普拉克索组与对照组比较UPDRS总分、UPDRSI评分、HAMD及HAMA评分明显降低,UPDRS第一部分评分改善病例数明显增多,且差异具有统计学意义(P0.05)。其结果表明普拉克索对于PD的整体疗效确切,可减轻非运动症状中的精神、行为、情绪症状,缓解PD伴发的抑郁、焦虑状态。对不良反应的Meta分析结果显示:普拉克索组同对照组比较在用药过程中出现的头晕、头痛、失眠、恶心、便秘、低血压等不良反应发生率差异无统计学意义(P0.05),尚不能说明上述不良反应由普拉克索引起。普拉克索组幻觉、运动障碍发生率高于对照组,差异有统计学意义(P0.05)。结论:普拉克索治疗PD总体疗效确切,可降低UPDRSI部分评分,改善非运动症状中的精神、行为、情绪症状,对PD伴抑郁、焦虑状态亦有疗效,但同时,药物应用过程中幻觉、运动障碍发生率相对较高。如何安全有效地应用普拉克索尚需要更多的高质量的循证医学证据进一步指导。
[Abstract]:Objective: to evaluate the efficacy and safety of Praxol in the treatment of Parkinson's disease by Meta analysis in a randomized controlled trial to provide evidence for its clinical application. Methods: the literature published from January 1997 to January 2016 on the treatment of nonmotor symptoms of Parkinson's disease was searched by computer. According to the inclusion and exclusion criteria, the literature of high quality was selected. After reading the full text, the valid data were extracted, the Meta analysis was carried out by Revman5.3 software, and the values of relative risk, mean difference, standard deviation and 95% confidence interval were calculated, and the Z test was carried out. This study believes that P0.05 is statistically significant. Results: totally 13 articles were included, the total sample size was 1862 cases, including 924 cases in Praxol group and 938 cases in control group. The changes of Hamd and HAMA scores relative to baseline and the number of cases with improved UPDRSI score were analyzed by Meta. The results showed that compared with the control group, the total score of UPDRS, the score of HAMA and the score of Hamd and HAMA were significantly decreased in the Praquisol group compared with the control group. The number of patients with improved score of the first part of UPDRS was significantly increased, and the difference was statistically significant (P 0.05). The results showed that Platexol was effective in the treatment of PD, and could relieve the mental, behavioral and emotional symptoms associated with PD and relieve the depression and anxiety associated with PD. The results of Meta analysis of adverse reactions showed that dizziness, headache, insomnia, nausea, constipation occurred in the Praxol group as compared with the control group. There was no significant difference in the incidence of adverse reactions such as hypotension (P 0.05), which could not be explained by the Prac index. The incidence of hallucination and dyskinesia in the Praxol group was higher than that in the control group (P 0.05). Conclusion: Platexol is effective in the treatment of PD, which can decrease the UPDRSI score, improve the mental, behavioral and emotional symptoms of non-motor symptoms, and also have therapeutic effect on PD with depression and anxiety, but at the same time, the hallucinations in the course of drug use. The incidence of motor disorders is relatively high. More and more high-quality evidence-based medical evidence is needed to guide the safe and effective application of Plateson.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R742.5

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