The purpose of this study was to investigate the efficacy and safety of citicoline combined with Donepezil hydrochloride in patients with Parkinson’s disease.
Research introduction
Parkinson’s disease (PD) is a chronic, progressive disease of the central nervous system that primarily affects middle-aged and older people patients.
The typical symptoms include motor symptoms such as muscle rigidity, decreased movement, resting tremor, and non-motor symptoms such as mental symptoms, cognitive disorders, and inability to take care of themselves.
These symptoms not only seriously affect the quality of life of patients, but also bring a heavy burden to the families of patients.
Finding effective treatments to improve patients’ symptoms and improve their quality of life has always been a focus of the medical community.
By comparing the efficacy of Donepezil hydrochloride alone and citicoline combined with Donepezil hydrochloride, the improvement of mental state, cognitive ability and life ability of patients with combined use of Donepezil hydrochloride was evaluated, and its safety was analyzed.
Abstract
The purpose of this study was to investigate the efficacy and safety of citicoline combined with Donepezil hydrochloride in the treatment of Parkinson’s disease (PD).
A total of 115 PD patients were randomly divided into control group (57 cases) and observation group (58 cases).
The control group was treated with Donepezil hydrochloride, while the observation group was treated with citicoline on the basis of Donepezil hydrochloride. The treatment period was 3 months.
At 3 months after treatment, the scores of the observation group were significantly higher than those of the control group on the Simple Mental State Examination Scale (MMSE), the Montreal Cognitive Assessment Scale (MoCA) and the Activities of Daily Living Scale (ADL), indicating that the mental state, cognitive ability and living ability of the observation group were significantly improved.
The total effective rate of the observation group was 94.83%, which was significantly higher than that of the control group (75.44%), which further proved the superiority of the combination of drugs.
In terms of safety, the incidence of adverse reactions in the observation group was 8.62%, compared with 7.02% in the control group, the difference was not statistically significant, indicating that the combination of drugs did not increase the risk of adverse reactions.
Part 1 Research background
Parkinson’s disease is a complex neurological disease, and its pathogenesis has not been fully defined.
At present, it is generally believed that the onset of PD is related to many factors such as genetic factors, environmental factors and patient age.
The degeneration and death of dopaminergic neurons in the midbrain substantia nigra is the main pathological change of PD, which leads to hyperactivity of cholinergic system in striatum, and then causes symptoms such as muscle rigidity and quiescent tremor.
PD patients are also often accompanied by cognitive dysfunction and psychiatric symptoms, which seriously affect the quality of life of patients.
Donepezil hydrochloride is an acetylcholinase inhibitor often used to treat mild to moderate Alzheimer’s disease.
It improves the cognitive function of patients by inhibiting the activity of acetylcholinesterase and increasing the concentration of acetylcholine in the synaptic gap.
Donepezil hydrochloride alone is not effective in treating Parkinson’s disease, and patients still face severe cognitive impairment and psychiatric symptoms.
Citicoline is a nucleic acid derivative that can promote the metabolism of brain cells and improve brain function.
It can activate brain metabolism, assist the synthesis of lecithin, promote the respiration of brain cells, improve blood circulation in the brain of patients, and increase the oxygen content of brain cells.
Studies have shown that citicoline combined with Donepezil hydrochloride can improve cognitive function and quality of life in patients with Alzheimer’s disease.
There are few studies on the efficacy and safety of citicoline combined with Donepezil hydrochloride in Parkinson’s disease.
The purpose of this study was to investigate the efficacy and safety of citicoline combined with Donepezil hydrochloride in Parkinson’s disease, in order to provide new ideas and methods for clinical treatment of Parkinson’s disease.
Part 2 Materials and methods
Research object:
This study selected 115 patients with Parkinson’s disease who were treated in Panyu District Central Hospital of Guangzhou from January 2020 to June 2020 as the study objects.
All patients met the diagnostic criteria for Parkinson’s disease and signed informed consent.
The patients were randomly divided into control group (57 cases) and observation group (58 cases).
There was no significant difference in age, gender, course of disease and other baseline data between the two groups, which was comparable.
Treatment:
Control group: Donepezil hydrochloride given oral treatment. 5mg once per night before going to bed. 1 month later, increase to 10mg/ time, use the same as before.
Observation group: Citicoline injection given intravenously, once a day. After 2 weeks of treatment, citicoline sodium capsule replaced for oral treatment, 3 times/day, 0.2g/ time. At the same time, Donepezil hydrochloride tablets given for oral treatment with the same usage as the control group.
Observation indicators:
Mental state: The Simple Intelligent Mental State Examination Scale (MMSE) used to evaluate the mental state. It consists of 5 sections with a maximum score of 30 points. A total score of <24 indicates cognitive impairment, and a total score of <17 indicates dementia.
Cognitive abilities assessed using the Montreal Cognitive Assessment Scale (MoCA). When the score is greater than 26, the patient is considered normal.
Living ability: Assessed using the Activities of Daily Living Ability Scale (ADL). Full score of 100, when the patient’s score >60 points indicates that their life is basically self-care.
Part 3 Research results
After group treatment and observation of 115 patients with Parkinson’s disease (PD), the main results of this study are as follows:
Improvement of mental state, cognitive ability and life ability:
Before treatment, there were no significant differences between the control group and the observation group in the scores of the Simple Intelligent Mental State Examination Scale (MMSE), the Montreal Cognitive Assessment Scale (MoCA) and the Activities of Daily Living Scale (ADL), which ensured that patients in the two groups had similar mental state, cognitive ability and life ability before treatment. It provides a reliable basis for the follow-up comparison of curative effect.
Three months after treatment, the MMSE score of the observation group increased from 20.13±5.30 to 27.25±6.84, MoCA score from 21.53±3.38 to 27.38±4.36, ADL score from 70.27±9.36 to 87.31±14.52.
These scores were significantly higher than those of the control group after treatment (MMSE: 22.47±6.18, MoCA: 23.32±3.62, ADL: 79.82±12.36).
The statistical results showed that these differences were statistically significant (P<0.05).
This indicates that citicoline combined with Donepezil hydrochloride can significantly improve the mental state, cognitive ability and life ability of PD patients.
Comparison of treatment effect:
According to the evaluation criteria of treatment effect, the proportion of patients in the observation group who achieved obvious and effective treatment was significantly higher than that in the control group.
Specifically, the total effective rate of the observation group was 94.83% (55/58), of which 38 cases were effective and 17 cases were effective.
The total effective rate of the control group was 75.44% (43/57), of which 26 cases were effective and 17 cases were effective.
The difference was also statistically significant (P<0.05). This further proves the effectiveness of citicoline combined with Donepezil hydrochloride in the treatment of PD.
Comparison of adverse reactions:
In the course of treatment, a certain proportion of adverse reactions occurred in both the observation group and the control group, but there was no significant difference in the incidence of adverse reactions between the two groups.
In the observation group, 8.62% (5/58) of patients had adverse reactions, mainly including loss of appetite, abdominal distension, constipation, etc.
The proportion of adverse reactions in the control group was 7.02% (4/57), and the type of adverse reactions was similar to that in the observation group.
The statistical results showed that there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).
This indicates that citicoline combined with Donepezil hydrochloride has good safety in the treatment of PD and does not significantly increase the risk of adverse reactions in patients.
In summary, this study compared the efficacy and safety of citicoline combined with Donepezil hydrochloride and Donepezil hydrochloride alone in the treatment of PD, and the following clear research results obtained:
The treatment of citicoline combined with Donepezil hydrochloride can significantly improve the mental state, cognitive ability and life ability of PD patients, improve the total effective rate of treatment, and have good safety, without significantly increasing the risk of adverse reactions in patients.
These results provide new ideas and options for the treatment of PD in clinical practice.
Part 4 Research and discussion
Parkinson’s disease (PD) is a common degenerative disease of the central nervous system, and its treatment has always been a clinical difficulty.
By comparing the efficacy of citicoline combined with Donepezil hydrochloride and Donepezil hydrochloride alone in the treatment of PD, this study found that the combination of citicoline showed significant advantages in improving patients’ mental state, cognitive ability and living ability.
As an acetylcholinesterase inhibitor, Donepezil hydrochloride has widely used in the treatment of PD, which mainly improves the cognitive function of patients by increasing the concentration of acetylcholine in the synaptic gap.
The effect of single drug often limited, and it is difficult to meet clinical needs.
In this study, the observation group given citicoline on the basis of Donepezil hydrochloride, and the results showed that the improvement of MMSE, MoCA and ADL scores in the observation group better than that in the control group, indicating that the addition of citicoline further enhanced the therapeutic effect.
Citicoline, as a neurotrophic drug, can promote the metabolism of brain cells and improve brain function.
It can protect brain cells from ischemia, hypoxia and other injuries by increasing cerebral blood flow and improving the utilization rate of oxygen in brain cells.
In the treatment of PD, citicoline may reduce patients’ mental symptoms, cognitive impairment and improve their ability to live by improving the energy metabolism and microenvironment of brain cells.
This study also found that the total effective rate of treatment in the observation group was significantly higher than that in the control group, while the incidence of adverse reactions was not significantly different between the two groups.
This further proves the efficacy and safety of citicoline combined with Donepezil hydrochloride in the treatment of PD.
The combination of drugs can not only improve the treatment effect, but also does not increase the risk of adverse reactions, which is of great significance for improving the quality of life of patients.
Part 5 Research conclusion
Citicoline combined with Donepezil hydrochloride is an effective and safe treatment for Parkinson’s disease, which can significantly improve the cognitive function, mental status and life ability of patients, improve the therapeutic effect, and do not increase the risk of adverse reactions.
This conclusion provides a new idea for the treatment of Parkinson’s disease and has important clinical significance and application value.
The application effect of this combination regimen in patients with different types and severity of Parkinson’s disease, as well as the safety and efficacy of long-term treatment can further discussed.
Research review
In this paper, the efficacy and safety of citicoline combined with Donepezil hydrochloride in Parkinson’s disease (PD) were studied, which provided a new strategy for the treatment of PD.
The study design is scientific and reasonable. By setting up control group and observation group, the difference between single drug and combination drug effectively compared, which makes the research results more convincing.
The mental state, cognitive ability and life ability of the patients evaluated comprehensively by various assessment scales, which provided strong data support for the research results.
The results of the study were encouraging, showing that the combination medication can significantly improve cognitive function, mental status and life ability of PD patients, and the total response rate is higher than that of the single medication group.
The combination of drugs did not increase the incidence of adverse reactions, indicating that the treatment has a good safety. The study also had some limitations.
For example, the relatively small sample size may have affected the general applicability of the results;
The observation period was short and the long-term effect of the combination could not evaluated.
Future studies could further expand the sample size and extend the observation time to more fully evaluate the efficacy and safety of the combination. This study provides a new idea and method for the treatment of PD, which has high clinical guiding significance and academic value.
Literature source:
[1] Liang Aijun, He Guozhen. Efficacy and safety of citicoline combined with Donepezil hydrochloride in patients with Parkinson’s disease [J]. Chinese Journal of Modern Pharmaceutical Application, 20, 14 (18) : 209-211.
