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多奈哌齐联合神经生长因子治疗帕金森病痴呆患者的临床疗效及其对脂联素和可溶性肿瘤坏死因子-α受体-1的影响

Clinical efficacy of donepezil combined with nerve growth factor in the treatment of patients with Parkinson's disease dementia and its impact on adiponectin and soluble tumor necrosis factor-alpha receptor-1.

作者信息

Hu Meiling, Ye Jiamei

机构信息

Meiling Hu, Department of Neurology, Taizhou First People's Hospital, Taizhou, Zhejiang Province 318020, P.R. China.

Jiamei Ye, Department of Neurology, Taizhou First People's Hospital, Taizhou, Zhejiang Province 318020, P.R. China.

出版信息

Pak J Med Sci. 2025 Feb;41(2):372-377. doi: 10.12669/pjms.41.2.11191.

Abstract

OBJECTIVE

To explore clinical efficacy of donepezil combined with nerve growth factor (NGF) in the treatment of Parkinson's disease dementia (PDD) and its potential impact on serum levels of adiponectin (APN) and soluble tumor necrosis factor receptor-1 (sTNFR-1).

METHODS

Clinical data of 140 patients with PDD treated in Taizhou First People's Hospital from March 2021 to December 2023 were retrospectively analyzed. Patients were grouped based on the treatment received. Patients who received donepezil alone (n=68) comprised the Donepezil group, and patients who were treated with a combination of donepezil and NGF (n=72) were assigned into the Donepezil & NGF group. Treatment effects, symptom improvement before and after the treatment, APN and sTNFR-1 levels, and incidence of adverse reactions were compared between two groups.

RESULTS

The overall efficacy of the combination therapy was higher than that of donepezil regimen alone (<0.05). After treatment, symptom improvement in the Donepezil & NGF group was significantly better than that in the Donepezil group (<0.05). Post-treatment serum levels of APN in the Donepezil & NGF group were significantly higher than that of Donepezil group, while the level of sTNFR-1 was significantly lower (<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (>0.05).

CONCLUSION

Combined regimen of donepezil and NGF is more effective than donepezil monotherapy in improving cognitive function, neurological function, and severity of the condition of patients with PDD, and is associated with the suppression of the inflammatory response without a significant increase in the incidence of adverse reactions. The study provides a basis for the clinical application of the combined regimen, but it still needs to be confirmed by more basic and clinical research.

摘要

目的

探讨多奈哌齐联合神经生长因子(NGF)治疗帕金森病痴呆(PDD)的临床疗效及其对血清脂联素(APN)和可溶性肿瘤坏死因子受体-1(sTNFR-1)水平的潜在影响。

方法

回顾性分析2021年3月至2023年12月在泰州市第一人民医院治疗的140例PDD患者的临床资料。根据接受的治疗方法对患者进行分组。单纯接受多奈哌齐治疗的患者(n = 68)组成多奈哌齐组,接受多奈哌齐与NGF联合治疗的患者(n = 72)被分配到多奈哌齐+NGF组。比较两组的治疗效果、治疗前后症状改善情况、APN和sTNFR-1水平以及不良反应发生率。

结果

联合治疗的总体疗效高于单纯多奈哌齐治疗方案(P<0.05)。治疗后,多奈哌齐+NGF组的症状改善明显优于多奈哌齐组(P<0.05)。多奈哌齐+NGF组治疗后血清APN水平显著高于多奈哌齐组,而sTNFR-1水平显著降低(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。

结论

多奈哌齐与NGF联合方案在改善PDD患者的认知功能、神经功能和病情严重程度方面比多奈哌齐单药治疗更有效,且与炎症反应的抑制相关,不良反应发生率无显著增加。该研究为联合方案的临床应用提供了依据,但仍需更多基础和临床研究加以证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12d7/11803811/ea272bc99250/PJMS-41-372-g001.jpg

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