普拉克索治疗帕金森病的系统评价  

Systematic review on Parkinson＇s disease treated with pramipexole

作　　者：刘振国[1] 周明珠[1] 干静[1] 陈伟[1] 

机构地区：[1]上海交通大学医学院附属新华医院神经科,200092

出　　处：《中华神经科杂志》2008年第3期147-151,共5页Chinese Journal of Neurology

基　　金：国家教育部留学回国人员基金资助项目（2006-331）;上海市教委发展基金资助项目（06BZ048）;上海市浦江人才计划资助项目

摘　　要：目的系统评价普拉克索治疗帕金森病（Pakinson＇s disease，PD）的临床疗效。方法通过检索Pubmed、Embase、Cochrane Database及中国生物医学文献数据库，检索国内外2007年4月前已发表的普拉克索对照安慰剂治疗PD的临床研究。对所纳入的研究进行质量评价及meta分析。结果共纳入10项随机对照试验（RCT）研究（纳入患者1738例），meta分析结果显示：普拉克索可以降低PD患者统一PD评分量表（UPDRS）总分[加权均数差值（WMD）=-10．01，95％CI（-12．76～-7．26）]、UPDRS Ⅱ分值[WMD=-2．44，95％CI（-2．93～-1．95）]以及UPDRS Ⅲ分值[WMD=-6．61，95％CI（-8．38～-4．84）]；普拉克索还可以降低晚期PD患者UPDRS Ⅳ分值[WMD=-0．73，95％CI（-1．16～-0．30）]，以上结果皆有统计学意义（P〈0．05）。3项研究比较了普拉克索与安慰剂治疗震颤的疗效，研究间存在异质性，其中2项研究显示疗效差异有统计学意义。结论普拉克索可以缓解患者的运动症状，改善生活质量。普拉克索具有改善治疗震颤的趋势，还需要更多的RCT研究进一步证实。Objective To systemically evaluate the therapeutic effect of pramipexole in treating Parkinson＇ s disease. Methods Pubmed, Embase, Cechrane Database were used to search for randomized control trials （RCTs） on Parkinson＇ s disease treated with pramipexole. Meticulous data wre extracted and meta-analysis was performed according to a preset protocol. Results Ten RCTs involving 1738 patients were included. The results of meta-analysis showed that pramipexole decreased the total scores of unified Parkinson＇ s disease rating scale [ UPDRS, WMD = - 10.01,95% CI （ - 12. 76, - 7.26） ], UPDRS part Ⅱ [WMD= -2.44, 95%CI （ -2.93, -1.95）], and UPDRS part Ⅲ [WMD = -6.61, 95%CI （ -8.38, -4. 84）]. Pramipexole also reduced the score of UPDRS part Ⅳ [ WMD = -0. 73, 95% CI （ - 1.16, - 0. 30） ] in advanced patients （ P 〈 0. 05 ）. Three studies referred to the effect of pramipexole in treating parkinsonian tremor. However there was a clinical heterogeneity among the studies, and two of them revealed a significant difference. Conclusions Pramipexole might improve motor symptoms and the quality of life in advanced patients, as well as improve tremor, which needs more RCTs to be confirmed.

关 键 词：帕金森病 噻唑类 多巴胺激动剂 药物评价 

分 类 号：R686[医药卫生—骨科学]