目的 探究多奈哌齐联合雷沙吉兰治疗帕金森病患者的临床效果。方法 选取2021年3月—2023年2月沭阳中医院收治的120例帕金森病患者，按照随机数字表法将患者分为对照组和治疗组，每组各60例。两组患者均进行多巴替代等常规治疗。对照组睡前温水吞服甲磺酸雷沙吉兰片，1 mg/次，1次/d。治疗组在对照组基础上晚饭后温水吞服盐酸多奈哌齐片5 mg/次，1次/d。两组均连续治疗2个月。观察两组临床疗效，比较两组统一帕金森病评定量表（UPDRS）评分、蒙特利尔认知评估量表（MoCA）评分、简明精神状态量表（MMSE）评分、神经精神问卷（NPI）评分及血清相关因子的变化。结果 治疗后，治疗组患者治疗总有效率是93.33%，显著高于对照组的80.00%，具有统计学差异（P＜0.05）。治疗后，两组UPDRS、NPI评分下降，而MoCA、MMSE评分上升（P＜0.05），且治疗后治疗组患者UPDRS、NPI评分低于对照组，MoCA、MMSE评分高于对照组，具有统计学差异（P＜0.05）。治疗后，两组多巴胺（DA）、5-羟色胺（5-HT）水平均显著上升（P＜0.05）；且治疗后，治疗组DA、5-HT水平高于对照组，具有统计学差异（P＜0.05）。治疗后，两组血清总抗氧化能力（TAOC）、晚期糖基化终产物（AGEs）水平均下降（P＜0.05）；且治疗后治疗组TAOC、AGEs水平低于对照组，具有统计学差异（P＜0.05）。结论 多奈哌齐联合雷沙吉兰对帕金森病患者进行治疗能够有效减轻患者临床症状，改善患者精神状态及认知功能，调节患者神经递质水平，改善患者脑血管调节功能及血流动力学。

Objective To investigate the therapeutic efficacy of donepezil combined with rasagiline in treatment of Parkinson’s disease. Methods A total of 120 patients with Parkinson’s disease admitted to Shuyang Hospital of Traditional Chinese Medicine from March 2021 to February 2023 were selected and divided into control group and treatment group according to random number table method, with 60 cases in each group. Both groups of patients received conventional treatments such as dopa replacement. Patients in control group swallowed Rasagiline Mesylate Tablets with warm water before going to bed, 1 mg/time, once daily. Patients in treatment group were po administered with Donepezil Hydrochloride Tablets on the basis of control group, 5 mg/time, once daily. Both groups were treated continuously for 2 months. The clinical efficacy of two groups was observed, and the changes of UPDRS score, MoCA score, MMSE score, NPI score, and serological related factors in two groups were compared. Results After treatment, the total effective rate of treatment in treatment group was 93.33%, significantly higher than 80.00% in control group, with a statistical difference (P < 0.05). After treatment, the UPDRS and NPI scores of both groups decreased, but the MoCA and MMSE scores increased (P < 0.05). After treatment, the UPDRS and NPI scores of treatment group were lower than those of control group, but the MoCA and MMSE scores were higher than those of control group, with statistically significant differences (P < 0.05). After treatment, the levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) in both groups increased significantly (P < 0.05). Moreover, after treatment, the levels of DA and 5-HT in treatment group were higher than those in control group, with a statistically significant difference (P < 0.05). After treatment, the levels of total serum antioxidant capacity (TAOC) and advanced glycation end products (AGEs) in both groups decreased (P < 0.05). After treatment, the levels of TAOC and AGEs in treatment group were lower than those in control group, and the difference was statistically significant (P < 0.05). Conclusion Donepezil combined with rasagiline in treatment of Parkinson’s disease can effectively alleviate the clinical symptoms of patients, and can improve their mental state and cognitive function, regulate the levels of neurotransmitters, and also can improve the cerebrovascular regulatory function and hemodynamics of patients.

R971

江苏省重点研发计划（社会发展）项目（BE2021630）