感夜平颤方治疗早中期帕金森病伴快速眼动睡眠行为障碍患者睡眠及血压昼夜节律紊乱的临床研究OA
Ganye Pingchan Decoction(感夜平颤方)for Patients with Early-Moderate Parkinson's Disease Complicated with Rapid Eye Movement Sleep Behavior Disorder on Sleep and Blood Pressure Circadian Rhythm Disorders:A Randomized Controlled Trial
目的 探讨感夜平颤方治疗早中期帕金森病(PD)伴快速眼动睡眠行为障碍(RBD)患者睡眠及血压昼夜节律紊乱的临床疗效.方法 将80例早中期PD伴RBD患者随机分为治疗组与对照组各40例.对照组采用西药常规治疗联合感夜平颤方安慰剂,治疗组采用西药常规治疗联合感夜平颤方.两组疗程均为12周.分别于治疗前后检测两组患者帕金森病综合评定量表(UPDRS)、香港中文大学快速眼动睡眠期行为障碍量表(RBDQ-HK)、帕金森病睡眠量表(PDSS)、多导睡眠图(PSG)、唾液褪黑素分泌节律及24小时动态血压参数变化情况.结果 与本组治疗前相比,治疗后两组患者RBDQ-HK和UPDRS评分均降低,治疗组PDSS评分升高,对照组PDSS评分降低;治疗组患者的睡眠效率提高,微觉醒次数和微觉醒指数降低;两组患者的N3期占比均提高,快速动眼睡眠(REM)活动度、REM强度和REM密度均降低;两组患者褪黑素分泌中位数均提高,治疗组褪黑素分泌振幅提高;治疗组夜间收缩压下降率(Δn-SBP)提高,且非杓型血压节律患者比例增加(P＜0.05).治疗后治疗组UPDRS、RBDQ-HK评分、微觉醒次数、微觉醒指数均低于对照组,日间平均收缩压(d-SBP)、Δn-SBP高于对照组(P＜0.05).结论 感夜平颤方能够调节早中期PD伴RBD患者睡眠及血压昼夜节律,提高睡眠效率、减少睡眠碎片化,调节褪黑素昼夜分泌节律,提高夜间收缩压下降率,且安全性良好.
Objective To investigate the clinical effectiveness of Ganye Pingchan Decoction(感夜平颤方)for patients with early-moderate Parkinson's disease(PD)complicated with rapid eye movement sleep behavior disorder(RBD)on sleep and blood pressure circadian rhythm disorders.Methods A total of 80 patients with early-moderate PD patients with RBD were randomly assigned to either a treatment group or a control group,with 40 patients in each group.The control group received conventional western medicine plus placebo of Ganye Pingchan Decoction,while the treatment group received conventional western medicine combined with Ganye Pingchan Decoction.The course of treatment for both groups was 12 weeks.Changes in the Unified Parkinson's Disease Rating Scale(UPDRS),Hong Kong Rapid Eye Movement Sleep Behavior Disorder Questionnaire(RBDQ-HK),Parkinson's Disease Sleep Scale(PDSS),polysomnography(PSG),salivary melatonin(SM)secretion rhythms,and 24-hour ambulatory blood pressure before and after treatment were measured in both groups.Results Compared with the baseline data within group,the scores of RBDQ-HK and UPDRS decreased in both groups after treatment;the PDSSscore increased in the treatment group but decreased in the control group;in the treatment group,sleep efficiency was improved,and the number and index of microarousals reduced;the proportion of N3 sleep stage increased,while rapid eye movement(REM)activity,REM intensity and REM density decreased in both groups;the median SM secretion level increased in both groups,and the amplitude of SM secretion elevated in the treatment group;in the treatment group,the noctur-nal systolic blood pressure decline rate(n-SBP)increased,and the proportion of patients with non-dipper blood pres-sure rhythm raised(P＜0.05).After treatment,the scores of UPDRS and RBDQ-HK,as well as the number and index of microarousals in the treatment group were significantly lower than those in the control group;the daytime mean systolic blood pressure(d-SBP)and Δ n-SBP in the treatment group were higher than those in the control group(P＜0.05).Conclusion Ganye Pingchan Decoction can effectively regulate sleep and blood pressure circadian rhythms in patients with early-moderate PD complicated with RBD.It can improve sleep efficiency,reduce sleep frag-mentation,regulate the circadian rhythm of SM secretion,increase the nocturnal systolic blood pressure decline rate,with good safety.
吴攸;叶青;袁灿兴;许黎敏;杨柏灿;杨熠文
上海中医药大学附属龙华医院,上海市徐汇区宛平南路725号,200032上海中医药大学附属龙华医院,上海市徐汇区宛平南路725号,200032上海中医药大学附属龙华医院,上海市徐汇区宛平南路725号,200032上海中医药大学附属龙华医院,上海市徐汇区宛平南路725号,200032上海中医药大学中药学院上海中医药大学中药学院
帕金森病快速眼动睡眠行为障碍睡眠节律血压节律感夜平颤方
Parkinson's diseaserapid eye movement sleep behavior disordersleep rhythmblood pressure rhythmGanye Pingchan Decoction(感夜平颤方)
《中医杂志》 2026 (3)
283-290,8
上海市卫生健康委员会科研项目(20224Y0167)国家自然科学基金(82204642)
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