本文選題：帕金森病 + 輔酶Q10��； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：背景：帕金森病(Parkinson's disease, PD)是一種中老年人常見的、慢性進行性神經(jīng)系統(tǒng)變性疾病,各種運動及非運動癥狀嚴(yán)重降低了患者的生活質(zhì)量,也給家庭和社會帶來了極大的負(fù)擔(dān),隨著中國人口日益老齡化,PD的發(fā)病率逐年升高,因此,尋找有效的抗PD藥物以彌補當(dāng)前治療的不足,緩解疾病的進展,成為當(dāng)務(wù)之急。目前PD的主要治療方法仍為藥物治療,研究發(fā)現(xiàn)早期給予神經(jīng)保護劑可延緩病情進展,改善疾病預(yù)后。近年來研究提示,多種機制參與PD的發(fā)病過程,包括遺傳因素、氧化應(yīng)激、線粒體功能障礙、免疫功能異常及環(huán)境因素等。輔酶Q10(CoQlO),作為一種脂溶性抗氧化劑,價格低廉,可清除自由基,減少氧化應(yīng)激,目前在國內(nèi)外主要用于心力衰竭、心肌病、心肌炎和肝炎等疾病的治療,近期研究發(fā)現(xiàn),CoQ10在神經(jīng)系統(tǒng)的損傷與修復(fù)中也具有重要的保護和營養(yǎng)作用,國外臨床試驗也證實較大劑量CoQ10(300mg/d)在PD的治療上具有一定的積極意義,但目前國內(nèi)CoQ10的片劑為10mg,如此大劑量服用此藥給患者帶來了極大的負(fù)擔(dān)。因此,我們設(shè)計了本研究,觀察正常劑量CoQ10(60mg/d)對PD是否有神經(jīng)保護作用,以期為PD的神經(jīng)保護治療提供一種新的治療藥物。 目的：探討正常劑量CoQ10(60mg/d)對PD是否有神經(jīng)保護治療作用。 方法：本研究采用隨機、對照試驗,將40例PD患者分為CoQ10治療組(20例)和對照組(20例)。治療組除常規(guī)多巴絲肼片治療外加用CoQ1060mg/d,對照組維持常規(guī)多巴絲肼片治療,分別在治療前、治療3個月及6個月時進行臨床評價,評價指標(biāo)包括UPDRS(統(tǒng)一帕金森病評定量表)、ADL(日常生活能力表)、MMSE(簡易智力精神狀況檢查量表)、MoCA(蒙特利爾認(rèn)知評估量表)、HAD(醫(yī)院焦慮／抑郁量表)及PSQI(匹茲堡睡眠質(zhì)量指數(shù))評分。然后通過Graph Prism5.0對兩組患者數(shù)據(jù)進行統(tǒng)計學(xué)分析。 結(jié)果：CoQ10治療3個月后,治療組UPDRS-總、UPDRS-I、 UPDRS-II、 UPDRS-III、 UPDRS-IV、 H-Y分期、AD、 HAD A、 HAD D、 MoCA及MMSE評分較對照組均無顯著性差異(P＞0.05)；治療組PSQI評分較對照組有統(tǒng)計學(xué)差異(P＜0.05)。 CoQ10治療6個月后,治療組UPDRS-總、UPDRS-I、 UPDRS-II、 UPDRS-III、 UPDRS-IV、 H-Y分期、HAD D、 ADL及MMSE較對照組均稍有改善,但無顯著性差異(P＞0.05)；治療組MoCA、 HAD A和PSQI評分較對照組均有統(tǒng)計學(xué)差異(P＜0.05)。 結(jié)論：正常劑量CoQ10(60mg/d)治療3個月對PD的睡眠障礙有一定的改善；治療6個月對PD的認(rèn)知功能、焦慮情緒及睡眠障礙有改善作用,提示CoQ10對PD有一定神經(jīng)保護作用。
[Abstract]:Background: Parkinsonian disease (PDD) is a common and chronic progressive neurodegenerative disease in the elderly. All kinds of motor and non-motor symptoms have seriously reduced the quality of life of the patients and brought great burden to the family and society.With the aging of population in China, the incidence of PD is increasing year by year. Therefore, it is urgent to find effective anti-PD drugs to remedy the deficiency of current treatment and alleviate the progress of disease.At present, the main treatment of PD is drug therapy. It is found that early administration of neuroprotective agent can delay the progress of the disease and improve the prognosis of the disease.Recent studies suggest that many mechanisms are involved in the pathogenesis of PD, including genetic factors, oxidative stress, mitochondrial dysfunction, immune dysfunction and environmental factors.Coenzyme Q10, CoQlO, as a kind of fat soluble antioxidant, can scavenge free radicals and reduce oxidative stress. At present, it is mainly used in the treatment of heart failure, cardiomyopathy, myocarditis, hepatitis and other diseases at home and abroad.Recent studies have found that CoQ10 also plays an important protective and nutritional role in the injury and repair of the nervous system. Foreign clinical trials have also confirmed that a large dose of CoQ1010 300 mg / d has a certain positive significance in the treatment of PD.But at present the domestic CoQ10 tablet is 10 mg, such a large dose of this drug to patients with a great burden.Therefore, we designed this study to investigate the neuroprotective effect of normal dose of CoQ 10mg / d on PD, in order to provide a new therapeutic drug for the neuroprotective therapy of PD.Objective: to investigate whether the normal dose of CoQ 10 0 mg / d has neuroprotective effect on PD.Methods: 40 PD patients were randomly divided into CoQ10 treatment group (n = 20) and control group (n = 20).In the treatment group, in addition to conventional dobutazid tablets and CoQ 1060 mg / d, the control group was treated with conventional dobutazid tablets, and the clinical evaluation was performed at 3 months and 6 months before treatment, respectively.The evaluation indexes included ADL (Unified Parkinson's Disease rating scale) and PSQI (Pittsburgh Sleep quality Index), including MMSE (Mini-Mental Mental status scale), MoCA (Hospital anxiety / Depression scale) and PSQI (Pittsburgh Sleep quality Index).Then the two groups of patient data were statistically analyzed by Graph Prism5.0.Results after 3 months of treatment, there was no significant difference in the scores of UPDRS-I, UPDRS-II, UPDRS-III, UPDRS-IVH, H-Y staging, HAD A, HAD D, MoCA and MMSE in the treatment group compared with the control group (P > 0.05), and the PSQI score in the treatment group was significantly higher than that in the control group (P < 0.05).After 6 months of CoQ10 treatment, the levels of UPDRS-I, UPDRS-II, UPDRS-III, UPDRS-IV, H-Y staging of had D, ADL and MMSE in the treatment group were slightly improved as compared with those in the control group (P > 0.05), and the scores of MoCA, HAD A and PSQI in the treatment group were significantly higher than those in the control group (P < 0.05).Conclusion: normal dose of CoQ1010 60mg / d can improve the sleep disorder of PD for 3 months, and improve the cognitive function, anxiety and sleep disorder of PD for 6 months, suggesting that CoQ10 has a certain neuroprotective effect on PD.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R742.5

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本文編號：1756761