| 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.Methods24 patiants were selected according to the British PD Diagnostic Criteria and inclusion criteria. The patients were divided into treatment group (12 cases) and control group(12 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 electuaries made from the Chinese herbs (composed of Shanyurou, Gouqizi, Roucongrong, Danshen, Shichangpu, Wugong and etc.) The electuaries were provided by Shenzhen sanjiu modern chinerse medicin ltd., taken orally on an empty stomach separately in the morning and evening.2 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,3 cases were ineffective, 6 cases were slightly progressive,1 cases were progessive,2 cases was marked effective. The total progress rate was 75.00%. While in the control group, 2 cases were ineffective,5 cases were slightly progressive,1 cases were progessive,4 case was marked effective. The total progress rate was 83.33%. The difference of efficacy between two group had no statistical significance (P >0.05). When evaluated by UPDRS, there existed statistical significance compared the integrals before and after treatment of Motor Examination part and the overall UPDRS (P<0.05) within both treatment and control groups, while the differences had no statistical significances(P>0.05) on the integrals before and after treatment on the Daily life part, Motor Examination part, Complications and the overall UPDRS between the two groups. Comparing the times of one-minute bimanual timed motor test on both hands in the treatment group before and after the treatment, there existed statistical significances on the differences(P<0.05), while it came to the contrary between both groups that there had no statistical significances on the differences. Meanwhile, The time of 10-mile turned back test had not significantly changed before and after treatment within or between two groups, and the differences had no statistical significances(P>0.05). Otherwise, the score of Complications'part within and between groups had not changed significantly before and after the 3-month treatment (P>0.05). Scores on Sensory Function part, intelligent and emotional part in Parkinson's Disease Questionnaire had statistical significance compared before and after treatment within the treatment group(P <0.05), which were opposite within the control group (P>0.05). Scores of both Parkinson Disease Sleep Scale and Parkinson's Disease Questionnaire had no statistical significance compared before and after treatment between two groups (P>0.05). When comparing Hoehn and Yahr Scale, there was also no difference significant compared before and after treatment or between two groups (P>0.05).ConclusionThe chinese medicine treatment of reinforcing kidney and activating blood circulation, intergrated with western medicine can probably prove both the motor function, active coordination and some aspects(sensory function, intelligent and emotional function etc.) on life quality of PD patients in 3-month treatment. However, the curative effect was not significant compared with the western medicine treatment group. |
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