2023 年第 12 期 第 18 卷

盐酸氨溴索联合多巴丝肼对老年早期帕金森病患者运动功能和自主神经的保护作用

Protective effect of ambroxol hydrochloride combined with levodopa and benserazide on motor function and autonomic nerves in patients with early Parkinson′s disease

作者：蒋颖梁健芬雷贻禄毛丹凤唐旭丽王林海张兴博

英文作者：Jiang Ying Liang Jianfen Lei Yilu Mao Danfeng Tang Xuli Wang Linhai Zhang Xingbo

单位：广西中医药大学第一附属医院老年病科，南宁530023

英文单位：Department of Geriatrics the First Affiliated Hospital of Guangxi University of Chinese Medicine Nanning 530023 China

关键词：帕金森病；盐酸氨溴索；多巴丝肼；自主神经功能

英文关键词：Parkinson′sdisease;Ambroxolhydrochloride;Levodopaandbenserazide;Autonomicnervousfunction

• 摘要：

• 目的  探究盐酸氨溴索联合多巴丝肼对老年早期帕金森病患者运动功能和自主神经的保护作用。方法  选取2020年11月至2022年4月于广西中医药大学第一附属医院就诊的老年早期帕金森病患者75例作为研究对象，采用随机数字表法将患者分为观察组（38例）和对照组（37例）。对照组给予多巴丝肼片口服治疗；观察组在对照组基础上给予盐酸氨溴索口服溶液口服治疗。比较2组治疗前后改良Webster症状评分量表、统一帕金森病评分量表（UPDRS）、帕金森病自主神经症状量表（SPOCA-AUT）评分。通过倾向性评分匹配（PSM）扩展束对观察组和对照组患者按1∶1进行匹配。结果  PSM后，观察组和对照组各纳入36例患者。治疗3个月，2组改良Webster症状评分量表评分均低于治疗前，且观察组低于对照组［（8.4±1.4）分比（15.3±1.4）分］（均P<0.001）。观察组总有效率高于对照组［91.7%（33/36）比69.4%（25/36）］（P=0.038）。治疗1、2、3个月，2组UPDRS各项评分均呈降低趋势（P<0.05），且治疗2、3个月观察组UPDRS各项评分均低于对照组（均P<0.05）。治疗3个月，2组SPOCA-AUT各项评分均低于治疗前，且观察组泌尿系统症状、体温调节功能症状、性功能症状评分均低于对照组（均P<0.05）。结论  盐酸氨溴索联合多巴丝肼能够改善老年早期帕金森病患者的运动功能，发挥自主神经保护作用。

• Objective To explore the protective effect of ambroxol hydrochloride combined with levodopa and benserazide on motor function and autonomic nerves in patients with early Parkinson′s disease. Methods Totally 75 patients with early Parkinson′s disease admitted to the First Affiliated Hospital of Guangxi University of Chinese Medicine from November 2020 to April 2022 were selected. Patients were divided into observation group (38 cases) and control group (37 cases) by the random number table method. The control group was treated with levodopa and benserazide orally, and the observation group was treated with ambroxol hydrochloride oral solution based on the control group. The scores of modified Webster scale, Unified Parkinson′s Disease Rating Scale (UPDRS) and Parkinson′s Disease Autonomic Symptom Scale (SPOCA-AUT) scores were compared between the two groups before and after treatment. Patients in the observation and control groups were matched 1∶1 by the propensity score matching (PSM) extended beam. Results  Following PSM, there were 36 cases in each observation group and control group. After 3 months of treatment, the score of modified Webster scale in both groups decreased, and the score in the observation group was lower than that in the control group［（8.4±1.4） vs （15.3±1.4）］（all P<0.001）. The total response rate in the observation group was higher than that in the control group［91.7%（33/36） vs 69.4%（25/36）］（P=0.038）. After 1, 2 and 3 months of treatment, all item scores of UPDRS in both groups trended downward, and the scores in the observation group 2 and 3 months after treatment were lower than those in the control group (all P<0.05). After 3 months of treatment, all item scores of SPOCA-AUT in both groups were lower than those before treatment, and the scores of urinary symptoms, thermoregulatory symptoms, sexual function symptoms in the observation group were lower than those in the control group (all P<0.05). Conclusion Ambroxol hydrochloride combined with levodopa and benserazide can improve the motor function of early elderly patients with Parkinson′s disease and play the role of autonomic nerve protection.