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目的探讨左旋多巴联合地昔帕明改善帕金森病(PD)患者的抑郁症状及生活质量的效果。方法将伴有严重抑郁的帕金森病患者108例随机分为治疗组(51例)和对照组(57例),治疗组服用地昔帕明和左旋多巴,对照组服用安慰剂及左旋多巴,于治疗14d和30d后分别利用蒙哥马利抑郁量表(MADRS)和帕金森氏症生活品质问卷(PDQ-39)对两组患者抑郁症状和生活质量进行评估。结果在治疗前及治疗14d后,两组的MADRS和PDQ39评分差异均无统计学意义(P>0.05),但在治疗1个月后,治疗组的MADRS评分(33.33±4.07)及PDQ39评分(36.20±6.15)均显著低于对照组的(38.21±7.12)分和(42.53±9.61)分,差异有统计学意义(P<0.05);地昔帕明对轻、中度抑郁患者的治疗效果优于重度抑郁组P<0.05)。结论左旋多巴联合地昔帕明能在短期内有效改善PD患者的抑郁症状和生活质量,地昔帕明对轻、中度抑郁患者有较好的疗效。
Objective To investigate the effect of levodopa and desipramine on depressive symptoms and quality of life in patients with Parkinson’s disease (PD). Methods One hundred and eighty patients with severe depression accompanied with Parkinson’s disease were randomly divided into treatment group (n = 51) and control group (n = 57). Patients in the treatment group received desipramine and levodopa. Patients in the control group received placebo and levodopa , Depression symptoms and quality of life were evaluated in both groups on the 14th and 30th day after treatment by using the Montgomery Depression Scale (MADRS) and Parkinson’s Disease Quality of Life Questionnaire (PDQ-39) respectively. Results Before treatment and after 14 days of treatment, there was no significant difference in MADRS and PDQ39 scores between the two groups (P> 0.05), but after one month treatment, MADRS score (33.33 ± 4.07) and PDQ39 score 36.20 ± 6.15) were significantly lower than the control group (38.21 ± 7.12) and (42.53 ± 9.61) points, the difference was statistically significant (P <0.05); desipramine treatment of patients with mild to moderate depression Superior to severe depression group P <0.05). Conclusions Levodopa combined with desipramine can effectively reduce the depressive symptoms and quality of life in patients with PD in a short term. Desipramine has a good effect on patients with mild and moderate depression.