Clinical Study On Invigorating Spleen And Beplenishing Kidney Recipe And Paroxetine For Patients Undergoing Parkinson With Anxiety And Depression (Syndrome Of Deficiency Of Spleen And Kidney)

Objective:PD with anxiety and depression, a kind of common psychosomaticdisease in neurology department, whose morbidity reaches40%~50%, is oneof the non motor symptoms to which patients with PD attach great importance.In the past, people focus mainly on the impairment of motor function in thetreatment such as Resting tremor and Myotonia and Bradykinesia andabnormal gait and posture, ignoring the existence of PD with anxiety anddepression. As a matter of fact, dysthymic disorder has a great influence onpatient with PD’s life quality. In recent years, along with the change ofmedical model, many domestic and foreign doctors and scholars began tostudy dysthymic disorders of patients with PD, and achieved fruitful results.Research found that PD patients with anxiety and depression result fromgenetic, environmental and social factors. The Pathogenesis is concernedabout the nervous system decoration, endocrine disorders, immune responsemechanism, nerve poison damage and social psychological reaction. While thespecific one is still not clear. The diagnosis mainly depends on the clinicalsymptoms of patient as well as doctors’ experience. So far, there is noobjective index can clearly support the diagnosis. Anti anxiety depressiontreatment as well as anti Parkinson’s disease treatment is applied to the patient.Drugs such as dopamine replacement therapy, dopamine receptor agonist,newer anti depression fluoxetine and mirtazapine, whose effects are good butexists a certain degree of side effects and withdrawal rebound phenomenon.Traditional Chinese medicine believes that this disease combines "tremorsyndrome" with "melancholia" and the causality is not clear. The main pathological changes lie in the liver, kidney and have something to do withspleen and the main pathological factor is liver wind. The treatment followsthese methods including nourishment of kidney and liver to promote essenceand blood circulation, which have a manifesting effect. Although the researchon PD with anxiety and depression reported in recent years at home andabroad have increased, but they are still relatively lacking and not sufficient toguide the clinical work. The study deal with invigorating spleen andreplenishing kidney recipe and paroxetine for patients undergoing Parkinsonwith anxiety and depression（syndrome of deficiency of spleen and kidney）and research and elaborate in terms of the treat in order to explore a newapproach to the treatment of this disease.Method:The study conducts a randomized controlled clinical trial, in which70patients undergoing Parkinson with anxiety and depression who visit HebeiChinese medicine hospital on2012.9to2013.12participate and employRandom number table to divide the patients into2groups, that is,experimental group and control group,35patients in each group. The twogroups were given anti Parkinson drug treatment; two groups are comparablein sex, age, severity of disease. The experimental group was treated withinvigorating spleen and replenishing kidney recipe, twice a time andParoxetine,20mg after breakfast, once a day. While the control group onlytake Paroxietine,20mg after breakfast, once a day.8weeks is a period oftreatment. After4weeks and8weeks, unified Parkinson disease rating scale(UPDRS), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale(HAMA) will be graded. Furthermore, the treatment efficiency, the changes ofUPDRS, HAMD, HAMA scores, the efficiency and side effect incidence willbe calculated through reduction rate.Results:1The study shows that both the experimental group and the controlgroup’s unified Parkinson disease rating scale (UPDRS), Hamilton DepressionScale (HAMD) and Hamilton Anxiety Scale (HAMA)scores were decreased, the difference was statistically significant (P<0.05);2The experimental group calculates the effective rate according toUPDRS, HAMD and HAMA score reduction rate (score reduction rate>30%)and the effective rate is higher than that of the control group. therefore, thedifference was statistically significant (P<0.05);3The different methods between the experimental group and the controlgroup exists interaction at different time after the treatment. therefore, thedifference was statistically significant (P<0.05); that is to say, the unifiedParkinson disease rating scale (UPDRS), Hamilton Depression Scale (HAMD)and Hamilton Anxiety Scale (HAMA)scores between experimental group andthe control group at4weeks or8weeks after treatment decline differently.The score of integrated traditional Chinese and Western medicine group issignificantly higher than the pure western medicine group.4The scale score of the experimental group after4weeks declines quitesimilar to that of control group after8weeks. Therefore, it’s of no statisticalsignificance (P>0.05). so integrated traditional Chinese and Western medicinein the treatment to cure PD with anxiety and depression is better than Westernmedicine5Before and after the treatment, patients in the two groups showed noobvious abnormality at blood and urine routine, liver and kidney function andelectrocardiogram. it is observed that the experimental group showed nosignificant side effects, while6patients (17.1%) in the control group appeareddiscomfort such as dizziness, nausea, loss of appetite, insomnia andexcitement.Conclusion:Application of invigorating spleen and replenishing kidney recipe andparoxetine for patients undergoing Parkinson with anxiety and depression(syndrome of deficiency of spleen and kidney) is of great efficiency, especiallyin the alleviation of anxiety and depression and the improvement of lifequality and the reduction of side effects. The recipe can reduce anti Parkinson drug dosage and has a effect and lasting effect on patients with PD.