目的 探讨罗替高汀贴片联合金刚烷胺治疗帕金森病的临床疗效。方法 选取2019年11月—2021年12月巴彦淖尔市医院门诊及住院收治的124例帕金森病患者，以随机数字表法将所有患者分为对照组和治疗组，每组各62例。对照组口服盐酸金刚烷胺片，0.1 g/次，2次/d。治疗组在对照组基础上使用罗替高汀贴片，每日同一时间将本品贴于皮肤上并保留24 h，起始剂量为2 mg/24 h，1次/d，每次更换贴片时贴于皮肤另一部位，避免14 d内在同一部位重复使用；每周剂量增加2 mg/24 h直至有效剂量（不超过8 mg/24 h）。两组疗程均为12周。观察两组的临床疗效，比较治疗前后两组统一帕金森病评定量表（UPDRS）、心理社会适应量表（PAS）、帕金森病睡眠量表-2（PDSS-2）、8项帕金森病调查表（PDQ-8）、帕金森病非运动症状量表（PD-NMSS）评分以及血清超氧化物歧化酶（SOD）、乙酰胆碱（Ach）、白细胞介素（IL）-6水平。结果 治疗后，治疗组有效率是93.55%，相较对照组的80.65%显著提高（P＜0.05）。治疗后，两组UPDRS中Ⅰ、Ⅱ、Ⅲ、Ⅳ部分评分及量表总分较治疗前均显著降低（P＜0.05）；且以治疗组降低更显著（P＜0.05）。治疗后，两组PAS评分均显著增加，而PDSS-2、PDQ-8、PD-NMSS评分则均显著降低（P＜0.05）；均以治疗组改善更显著（P＜0.05）。治疗后，两组血清SOD水平较治疗前均显著上升，而血清Ach、IL-6水平较治疗前均显著降低（P＜0.05）；且治疗后，治疗组血清SOD水平显著高于对照组，血清Ach、IL-6水平均显著低于对照组（P＜0.05）。结论 罗替高汀贴片联合金刚烷胺治疗帕金森病可取得确切疗效，能有效改善患者临床症状、睡眠状况及生活质量，并可进一步增强机体抗氧化能力、减轻炎性损伤以及抑制Ach功能亢进，利于延缓病情进展，且安全性好。

Objective To investigate the clinical efficacy of Rotigotine Patches combined with amantadine in treatment of Parkinson’s disease. Methods From November 2019 to December 2021, 124 patients with Parkinson’s disease admitted to the outpatient and inpatient departments of Bayannur Hospital were selected, and all patients were divided into control group and treatment group by random number table method, with 62 patients in each group. Patients in the control group were po administered with Amantadine Hydrochloride Tablets, 0.1 g/time, twice daily. Patients in the treatment group were given Rotigotine Patches on the basis of the control group, applied the product to the skin at the same time every day and keep it for 24 h, the initial dosage was 2 mg/24 h, once daily, and applied to another part of the skin when changing the patch each time, to avoid repeated use within 14 d of the same part. The weekly dosage was increase by 2 mg/24 h until the effective dosage (not more than 8 mg/24 h). The treatment course of both groups was 12 weeks. The clinical efficacy of the two groups was observed. The scores of the unified Parkinson’s Disease Rating Scale (UPDRS), the Psychosocial Adaptation Scale (PAS), the Parkinson’s Sleep Scale-2 (PDSS-2), the eight item Parkinson’s Disease Questionnaire (PDQ-8), the Parkinson's Disease Non motor Symptom Scale (PD-NMSS), and the levels of serum superoxide dismutase (SOD), acetylcholine (Ach), and interleukin-6 (IL-6) were compared between the two groups before and after treatment. Results After treatment, the effective rate of the treatment group was 93.55%, which was significantly higher than that of the control group (80.65%) (P < 0.05). After treatment, the scores of Ⅰ, Ⅱ, Ⅲ, and Ⅳ in UPDRS and the total scores of scales in both groups were significantly decreased compared with those before treatment (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). After treatment, PAS scores in both groups were significantly increased, while PDSS-2, PDQ-8 and PD-NMSS scores were significantly decreased (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the serum SOD level in both groups was significantly increased, while the serum Ach and IL-6 levels were significantly decreased (P < 0.05). After treatment, the serum SOD level in the treatment group was significantly higher than that in the control group, and the serum Ach and IL-6 levels were significantly lower than that in the control group (P < 0.05). Conclusion Rotigotine Patches combined with amantadine can achieve a definite effect in treatment of Parkinson’s disease, and can effectively improve the clinical symptoms, sleep status and quality of life of patients, and can further enhance the antioxidant capacity of the body, reduce inflammatory damage and inhibit the hyperactivity of Ach, which is conducive to delaying the progress of the disease with good safety.

R971

内蒙古医科大学联合项目计划（YKD2021LH100）