河南中医学院2009届硕士研究生学位论文 熄风定颤丸联合西药治疗 帕金森病临床研究 中国·郑州 2009年4月30日研究生姓名: 封 臻 导 师: 马云枝 教 授 指导组成员: 孟 毅 副教授 李 虹 副教授 武继涛 副教授 学科、专业: 中西医结合临床 所属院、系: 第一临床医学院 硕士学位论文原创性声明 本人所呈交的硕士学位论文,是在导师马云枝教授的指导下,独立进行科学研究工作所取得的成果。除文中已特别加以注明引用的内容外,论文中不包含任何其他个人或集体已经发表或撰写过的研究成果。对本文的研究做出重要贡献的个人和集体,均已在文中以明确方式标明并致谢。本人完全意识到本声明的法律结果由本人承担。 特此声明。 论文作者(签名): 年 月 日 硕士学位论文使用授权声明 本人已完全了解河南中医学院有关保留、使用硕士学位论文的相关规定,同意学校保留或向国家有关部门、机构送交本学位论文的复印件和电子版,允许论文被查阅或借阅。本人授权河南中医学院可以将本论文的全部或部分内容编入有关数据库进行检索,可以采用影印、缩印或其他复制手段保存、汇编本论文(注:保密论文在解密后适用本授权声明)。 特此声明。 论文作者(签名): 导师(签名): 年 月 日 年 月 日 - 1 - 目 录 摘要 ······························································································································· 1 前言 ································································································································ 4 对象与方法 ··················································································································· 6 1 观察对象 ··················································································································· 6 2 病例选择标准 ··········································································································· 6 3 分组治疗方法 ············································································································ 8 4 观察项目及指标 ······································································································· 8 5 疗效判定依据 ··············································································································· 9 6 统计学处理 ··············································································································· 9 结果 ····························································································································· 10 1 临床疗效 ·················································································································· 10 2 UPDRS 评分及中医证候积分比较 ··········································································· 11 3 SF-36 量表评分比较 ································································································· 13 4 UPDRS Ⅳ部分毒副作用量表评分 ··········································································· 13 5 美多巴用量比较 ······································································································· 14 理论探讨 ······················································································································ 15 1 祖国医学对帕金森病的认识历史沿革 ···································································· 15 2 现代医学对帕金森病的研究 ··················································································· 16 3 临床分型证治研究 ··································································································· 16 4 中西医结合治疗的依据和研究现状 ········································································ 17 5 中期帕金森病的治疗 ······························································································· 18 6 导师学术思想探讨 ···································································································· 18 6.1 肝肾阴虚为帕金森病的基本病机之一 ·································································· 18 6.2 培补肝肾、熄风定颤为治疗帕金森病的重要治法 ··············································· 19 6.3 立足于中西医结合思想 ························································································· 19 7 熄风定颤丸组方特点、中药溯源及现代药理研究 ················································· 19 7.1 熄风定颤丸组方特点 ···························································································· 19 7.2 中药溯源及现代药理研究 ····················································································· 20 8 研究结果分析 ··········································································································· 21 结论 ······························································································································ 23 致谢 ······························································································································ 24 参考文献 ······················································································································ 25 - 2 - 附录 1:颤证中医评分量表 ························································································ 28附录 2:统一帕金森病评定量表 ················································································ 31 附录 3:SF-36 量表 ····································································································· 37 附录 4:熄风定颤丸治疗中期帕金森病方案优化研究病例报告表··························· 40附录 5:文献综述 ······································································································· 52 附录 6:硕士期间发表论文及科研情况 ····································································· 59 摘要 - 1 - 摘 要 目的:本课题从临床方面进行研究,设计“中期中西药联用减毒增效”治疗方案,采用临床随机、平行对照、开放性试验方法,观察熄风定颤丸联合西药治疗中期帕金森病的疗效及安全性,探索方案的可行性。 方法:本课题以中期帕金森病肝肾阴虚型患者为研究对象,选取符合标准病例60例做为研究对象,采用随机方法将其分为治疗组和对照组各30例,治疗组口服熄风定颤丸和美多巴及泰舒达、对照组口服美多巴和泰舒达,两组疗程均为 3个月。评定两组患者治疗前后统一帕金森病评定量表(UPDRS)积分、颤证中医证候积分、 SF-36 量表积分、毒副作用评分及西药用量。 结果:临床疗效评定:治疗组临床痊愈 0 例、显效10例、有效18例、无效 2例,总有效率93.33%;对照组临床痊愈 0 例、显效 7 例、有效14例、无效 9 例,总有效率70.00%;经卡方检验,两组差别具有显著意义( P ﹤ 0.05 ), 治疗组临床疗...