目的 探讨天麻醒脑胶囊联合多巴丝肼治疗帕金森病的临床疗效。方法 纳入2021年8月—2024年8月沧州市人民医院收治的帕金森病患者82例，按随机数字表法分为对照组和治疗组，每组各41例。对照组口服多巴丝肼片，首次62.5 mg/次，3次/d，据症状控制情况，每周可递增剂量125 mg，直至最大剂量750 mg/d。治疗组以对照组用药为基础，口服天麻醒脑胶囊，2粒/次，3次/d。两组患者疗程12周。观察两组患者临床疗效，比较治疗前后两组患者统一帕金森病评定量表（UPDRS）、症状自评量表（SCL-90）和36项健康调查简表（SF-36）评分，眼球平稳追踪运动增益值（SPEM G），及血清谷胱甘肽过氧化物酶（GSH-Px）、丙二醛（MDA）、5-羟色胺（5-HT）和β-内啡肽（β-EP）水平。结果 治疗后，治疗组总有效率为92.68%，较对照组患者的75.61%明显升高（P＜0.05）。治疗后，两组M1、M2、M3、M4模块评分和量表总分及SCL-90评分较治疗前均降低，而SF-36评分增加（P＜0.05），且治疗组评分改善优于对照组（P＜0.05）。治疗后，两组患者左侧SPEM G、右侧SPEM G比治疗前明显增加，而非对称性降低（P＜0.05），且治疗组SPEM G变化幅度比对照组更显著（P＜0.05）。治疗后，两组血清GSH-Px、5-HT和β-EP水平均显著上升，而血清MDA水平下降（P＜0.05），且治疗组血清因子水平明显好于对照组（P＜0.05）。结论 天麻醒脑胶囊联合多巴丝肼治疗帕金森病，能有效减轻患者临床症状，缓解神经元氧化损害，调节神经递质平衡及内源镇痛系统活性，进一步促进患者身心状态和神经功能改善。

Objective To explore the clinical efficacy of Tianma Xingnao Capsules combined with levodopa and benserazide in treatment of Parkinson's disease. Methods Patients (82 cases) with Parkinson's disease in Cangzhou People's Hospital from August 2021 to August 2024 were divided into control and treatment group according to the random number table method, and each group had 41 cases. Patients in the control group were po administered with Levodopa and Benserazide Hydrochloride Tablets, 62.5 mg/time for the first time, three times daily, the dose was increased by 125 mg every week until the maximum dose was 750 mg/d depending on the control of symptoms. Patients in the treatment group were po administered with Tianma Xingnao Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, and the scores of UPDRS, SCL-90 and SF-36, SPEM G, the levels of serum GSH-Px, MDA, 5-HT and β-EP in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 92.68%, which was significantly higher than 75.61% in the control group (P < 0.05). After treatment, the scores of M1, M2, M3, M4 modules, total scale scores and SCL-90 scores in two groups were decreased compared with before treatment, while the SF-36 score was increased (P < 0.05), and the improvement in the score of treatment group was better than that of control group group (P < 0.05). After treatment, the left tracking G and right tracking G were significantly increased in two groups compared with before treatment, while the asymmetry was decreased (P < 0.05), and the change in SPEM G in the treatment group was more significant than that in the control group (P < 0.05). After treatment, serum GSH-Px, 5-HT, and β-EP levels were significantly increased in two groups, while serum MDA levels were decreased (P < 0.05), and the serum factor levels in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The application of Tianma Xingnao Capsules combined with levodopa and benserazide in treatment of Parkinson's disease can effectively alleviate clinical symptoms, alleviate neuronal oxidative damage, regulate neurotransmitter balance and endogenous analgesic system activity, and further promote the improvement of patients' physical and mental status and neurological function.

R971

沧州市重点研发计划指导项目（222106086）