目的:探讨幽门螺杆菌(HP)根除治疗对帕金森病(PD)患者运动症状的影响及其安全性,为临床治疗提供参考。方法:选取2013年1月-2015年10月医院收治的PD患者120例,根据尿素呼吸试验(UBT)检测结果,将PD患者分为HP组(n=32)和非HP组(n=88),两组均进行抗PD的常规治疗,HP组在此基础上采用HP根除治疗(奥美拉唑+克拉霉素+阿莫西林),采用帕金森病评定量表(UPDRS)评估两组患者治疗前后的运动症状,并对治疗过程中的不良反应进行统计分析。结果:120例PD患者中,HP感染32例占26.67%,经HP根除治疗后,HP检测阴性者26人,成功根除率81.25%。组间比较,治疗前两组UPDRS Ⅳ评分有统计学差异(P〈0.05),而UPDRS Ⅲ评分、Hoehn-Yahr分级、"开"期和"关"期时间无统计学差异(P〉0.05);治疗后两组"开"期和"关"期时间存在统计学差异(P〈0.05),而UPDRS Ⅲ评分、UPDRS Ⅳ评分、Hoehn-Yahr分级无统计学差异(P〉0.05)。组内比较,治疗后,HP组UPDRS Ⅲ评分和UPDRS Ⅳ评分均较治疗前下降,差异有统计学意义(P〈0.05),且"开"期时间明显延长,"关"期时间明显缩短,差异均有统计学意义(P〈0.05),而非HP组治疗前后上述各项指标比较,差异均无统计学意义(P〉0.05)。HP根除组不良反应发生率与非HP组相比,差异无统计学意义(P〉0.05)。结论:HP感染与PD的发生有关,HP根除治疗能显著改善PD患者的运动症状,安全有效,值得临床推广使用。
Objective: To investigate the influence of Helicobacter pylori(HP)eradication therapy on motor symptoms in patients with Parkinson's disease(PD)and its safety so as to provide the reference for clinical treatment. Methods: A total of 120 patients diagnosed with PD in hospital from January 2013 to December 2015 were selected and divided into HP group(n=32)and non-HP group(n=88)according to the results of urea breath test(UBT), they were given anti-PD conventional treatment, base on which the HP group was added HP eradication therapy(omeprazole+clarithromycin+amoxicillin), the motor symptoms were evaluated by Unified Parkinson's Disease Rating Scale(UPDRS)in two groups before and after treatment, and the adverse reactions were analyzed by statistical methods in two groups during treatment. Results: Totally 32 patients occurred HP infection in 120 PD patients, accounting for 26.67%, after HP eradication treatment, 26 patients turned to HP negative, the successful eradication rate was 81.25%. Comparison between two groups, before treatment, the UPDRS Ⅳ score was statistically difference(P〈0.05), but the difference of UPDRS Ⅲ score,Hoehn-Yahr level, "on-time" and "off-time" had no statistically significant(P〈0.05); after treatment, the "on-time" and "off-time" was statistically difference(P〈0.05), but the difference of UPDRS Ⅲ score, UPDRS Ⅳ score, Hoehn-Yahr level had no statistically significant(P〈0.05). Comparison of intra-groups, after treatment, the UPDRS Ⅲ and UPDRS Ⅳ scores both decreased than before treatment(P〈0.05), and the "on-time" prolong and "off-time" shorten significance(P〈0.05), but above indexes in non-HP group had no significant change before and after treatment(P〈0.05). The incidence rate of adverse reactions in HP group had no significant difference than non-HP group(P〈0.05). Conclusion: HP infection relate with the incidence of PD, and the HP eradication therapy can sign