Constipation alleviation and the efficacy improvement of levodopa and benserazide in Parkinson patients with early intestinal flora intervention
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摘要: 目的 探讨早期肠道菌群干预对帕金森病（PD）患者肠道便秘症状及多巴丝肼疗效的影响，为临床治疗提供参考。 方法 纳入2015月1月至2017年10月我院神经内科初次诊断的PD患者114例，随机分为肠道菌群干预组（n=57）与对照组（n=57），两组均予多巴丝肼片常规初始治疗，干预组在此基础上加用三联活菌制剂调理肠道菌群，采用便秘患者生活质量量表（PAC-QOL）等评估患者便秘症状及满意度，采用统一帕金森病评定量表（UPDRS-Ⅲ）等评估两组患者治疗前后的运动症状及心理状态。 结果 1干预组较治疗前及较对照组的PAC-QOL，Bristol粪便性状量表（BSFS）评分改善显著，差异有统计学意义（P<0.05）；2两组患者较治疗前UPDRS-Ⅲ运动评分均有改善，差异有统计学意义（P<0.05），干预组较对照组4周时UPDRS-Ⅲ评分有下降，差异有统计学意义（P<0.05）；3干预组较对照组治疗后医院焦虑量表（HAD-A）、医院抑郁量表（HAD-D）、匹兹堡睡眠质量指数（PSQI）评分均有下降，差异有统计学意义（P<0.05）。 结论 早期肠道菌群干预能有效改善PD患者的便秘症状及焦虑睡眠等心理状态，可能有早期增强多巴丝肼制剂对运动症状的疗效，但远期影响仍有待研究。Abstract: Objective To investigate the effect of early intestinal flora intervention on the symptoms and the efficacy of Levodopa and Benserazide in Parkinson's disease (PD), provide a reference for clinical treatment. Methods 114 patients diagnosed as PD for the first time in our department of neurology from January 2015 to October 2017 were randomly divided into intervention group (n=57) and control group (n=57). Both groups received Levodopa and Benserazide, A triple live bacterial preparation was given to the intervention group only to regulate the intestinal flora. Patient-Assessment of Constipation Quality of Life (PAC-QOL) was used to assess the constipation symptoms and patient's satisfaction. The Unified Parkinson's Disease Rating Scale (UPDRS Ⅲ) was used to evaluate the motor symptoms and psychological status for the patients in both groups before and after treatments. Results 1 The PAC-QOL and BSFS scores in intervention group were improved significantly compared to those before treatment (P<0.05); 2 After the treatments, the UPDRS Ⅲ scores in both groups were improved significantly (P<0.05). The UPDRS Ⅲ score in the intervention group was significantly lower than that in the control group at 4 weeks (P<0.05). 3 Compared with the control group, the HAD-A, HAD-D and PSQI Score were decreased in the intervention group. (P<0.05). Conclusion Early intestinal flora intervention effectively alleviated constipation symptom and improved therapeutic effects of Levodopa and Benserazide preparation. However, the long-term effect remains to be studied.
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[1] BRAAK H, DE VOS R A I, BOHL J, et al. Gastric α-synuclein immunoreactive inclusions in Meissner's and Auerbach's plexuses in cases staged for Parkinson's disease-related brain pathology[J]. Neurosci Lett, 2006, 396(1):67-72. [2] 中华医学会神经病学分会运动障碍及帕金森病学组.帕金森病的诊断[J].中华神经科杂志,2006,(6):408-409. [3] BERG D, POSTUMA RB, ADLER CH, et al. MDS research criteria for prodromal Parkinson's disease[J]. Mov Disord, 2015, 30(12):1600-1611. [4] ZHANG TM, YU SY, GUO P, et al. Nonmotor symptoms in patients with Parkinson disease:A cross-sectional observational study[J]. Medicine (Baltimore), 2016, 95(50):e5400. [5] ABBOTT RD, PETROVITCH H, WHITE LR, et al. Frequency of bowel movements and the future risk of Parkinson's disease[J]. Neurology, 2001, 57(3):456-462. [6] PETROVITCH H, ABBOTT RD, ROSS GW, et al. Bowel movement frequency in late-life and substantia nigra neuron density at death[J]. Mov Disord, 2009, 24(3):371-376. [7] KESHAVARZIAN A, GREEN SJ, ENGEN PA, et al. Colonic bacterial composition in Parkinson's disease[J]. Mov Disord, 2015, 30(10):1351-1360. [8] FANG X. Potential role of gut microbiota and tissue barriers in Parkinson's disease and amyotrophic lateral sclerosis[J]. Int J Neurosci, 2016, 126(9):771-776. [9] NIELSEN HH, QIU J, FRⅡS S, et al. Treatment for Helicobacter pylori infection and risk of Parkinson's disease in Denmark[J]. Eur J Neurol, 2012, 19(6):864-869. [10] DEVOS D, LEBOUVIER T, LARDEUX B, et al. Colonic inflammation in Parkinson's disease[J]. Neurobiol Dis, 2013, 50:42-48. [11] FASAN A, BOVE F, GABRIELLI MA, et al. The role of small intestinal bacterial overgrowth in Parkinson's disease[J].Mov Disord,2013,28(9):1241-1249. [12] HOLMQVIST S, CHUTNA O, BOUSSET L, et al. Direct evidence of Parkinson pathology spread from the gastrointestinal tract to the brain in rats[J]. Acta Neuropathol, 2014, 128(6):805-820. [13] 王文建,郑跃杰.肠道菌群与中枢神经系统相互作用及相关疾病[J].中国微生态学杂志,2016,28(2):240-245. [14] ANIL ANANTHASWAMY.Faecal transplant eases symptoms of Parkinson's disease[J].New Scientist,209:8-9. [15] BARICHELLA M, PACCHETTI C, BOLLIRI C, et al. Probiotics and prebiotic fiber for constipation associated with Parkinson disease:an RCT[J]. Neurology, 2016, 87(12):1274-1280. -
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