目的 探讨盐酸苯海索片联合盐酸司来吉兰片治疗帕金森病的临床疗效。方法 选取2017年5月-2018年11月在郑州大学第五附属医院诊治的帕金森病患者82例，根据用药的差别分为对照组（41例）和治疗组（41例）。对照组口服盐酸司来吉兰片，5 mg/次，若控制不佳可增至10 mg/次；治疗组在对照组的基础上口服盐酸苯海索片，开始1~2 mg/d，然后每3~5天增加2 mg，至疗效最好而又不出现副反应为止，最大剂量10 mg/d，分3~4次服用。两组患者均经12周治疗。观察两组患者临床疗效，同时比较治疗前后两组患者MoCA、MMSE、SPOCA-AUT、UPDRS和PDQ-39评分，以及血清白细胞介素-1β（IL-1β）、YKL40、胱抑素C（Cys-C）、可溶性肿瘤坏死因子受体-1（sTNFR-1）、脂联素（APN）、尿酸（UA）、一氧化氮合酶（NOS）、超氧化物歧化酶（SOD）、对氧磷脂酶1（PON1）和循环谷胱甘肽过氧化物酶（CGP）水平。结果 治疗后，对照组临床有效率为80.49%，显著低于治疗组的97.56%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者MoCA评分显著升高（P<0.05），MMSE、SPOCA-AUT、UPDRS和PDQ-39评分均显著降低（P<0.05），且治疗组患者这些评分改善程度更明显（P<0.05）。治疗后，两组患者血清IL-1β、YKL40、Cys-C、sTNFR-1水平均明显下降（P<0.05），APN、UA水平显著升高（P<0.05），且治疗组患者这些血清学指标改善更明显（P<0.05）。治疗后，两组患者血清NOS、SOD、PON1、CGP水平均显著升高（P<0.05），且治疗组比对照组升高更明显（P<0.05）。结论 盐酸苯海索片联合盐酸司来吉兰片治疗帕金森病效果显著，可有效促进患者认知功能、神经功能、运动功能及生活质量的改善。

Objective To investigate the clinical efficacy of benzhexol combined with selegiline in treatment of Parkinson's disease. Methods Patients (82 cases) with Parkinson's disease in the Fifth Affiliated Hospital of Zhengzhou University from May 2017 to November 2018 were divided into control (41 cases) and treatment (41 cases) groups based on different treatments. Patients in the control group were po administered with Selegiline Hydrochloride Tablets, 5 mg/time, if the condition was not well controlled, dosage could be increased to 10 mg/time. Patients in the treatment group were po administered with Benzhexol Hydrochloride Tablets on the basis of the control group, the initial dose was 1-2 mg/d, then increased 2 mg every 3-5 d until the best effect without side effects, and the maximum daily dose was 10 mg, 3-4 times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the MoCA, MMSE, SPOCA-AUT, UPDRS and PDQ-39 scores, and the serum levels of IL-1β, YKL40, Cys-C, sTNFR-1, APN UA, NOS, SOD, PON1, and CGP in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.49%, which was significantly lower than 97.56% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the MoCA scores in two groups were significantly increased (P<0.05), but the MMSE, SPOCA-AUT, UPDRS and PDQ-39 scores were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of IL-1β, YKL40, Cys-C, sTNFR-1 in two groups were significantly decreased (P<0.05), but the APN and UA levels were significantly increased (P<0.05), and these serological indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the NOS, SOD, PON1, and CGP levels in two groups were significantly increased (P<0.05), and which in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Benzhexol combined with selegiline have remarkable effect in treatment of Parkinson's disease, can effectively promote cognitive, neurological, motor function and quality of life.

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