目的 观察司来吉兰联合普拉克索治疗帕金森病伴抑郁的临床疗效。方法 选取2014年1月—12月天津市宝坻区人民医院神经内科收治的帕金森病伴发抑郁患者106例,随机分为对照组和治疗组,每组各53例。对照组患者口服盐酸普拉克索片,1片/次,3次/d。治疗组在对照组基础上每日清晨餐后30 min口服盐酸司来吉兰片,第1～3天1片/次,1次/d,如无不良反应,从第4天开始口服2片/次,1次/d。两组均连续治疗8周。观察两组患者的临床疗效,同时比较汉密尔顿抑郁量表(HAMD)评分的变化,并采用统一帕金森评定量表(UPDRS)对患者日常生活能力及运动能力进行评分。结果 治疗后,对照组和治疗组的总有效率分别为64.15%、83.02%,两组比较差异具有统计学意义(P <0.05)。治疗4、8周后,两组HAMD评分、日常生活能力评分、运动能力评分均较显著降低,同组治疗前后比较差异具有统计学意义(P <0.05);且治疗组的下降程度优于对照组,两组比较差异具有统计学意义(P <0.05)。结论 司来吉兰联合普拉克索治疗帕金森病伴抑郁具有较好的临床疗效,可降低HAMD评分和UPDRS评分,临床疗效安全可靠,具有一定的临床应用价值。

Objective To observe the effect of selegiline combined with pramipexole in treatment of Parkinson's disease with depression. Methods Patients (106 cases) with Parkinson's disease with depression in Department of Neurology of Tianjin Baodi Hospital from January 2014 to December 2014 were randomly divided into control and treatment groups, and each group had 53 cases. The patients in the control group were po administered with Pramipexole Dihydrochloride Tablets, 1 tablet/time, three times daily. The patients in the treatment group were po Selegiline Hydrochloride Tablets 30 min after breakfast, 1 tablet for 1 — 3 d, once daily, and if there was no adverse reaction, 2 tablets/time, once daily from the fourth day. Two groups were treated for eight weeks. After treatment, the efficacy was evaluated, and the changes of HAMD score in two groups were compared. At the same time, the unified Parkinson's disease rating scale (UPDRS) was carried out to evaluate the daily life ability and movement ability of two groups. Results After treatment, the efficacies in the control and treatment groups were 64.15% and 83.02%, respectively, and there was difference between two groups (P < 0.05). After four and eight weeks of treatment, HAMD scores, daily life ability score and sports ability scores in two groups were significantly lower, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusions Selegiline combined with pramipexole has good clinical efficacy in treatment of Parkinson's disease with depression, and can reduce HAMD score and UPDRS score, while its clinical curative effect is safe and reliable, which has certain clinical application value.