恩他卡朋片联合左旋多巴片对帕金森病患者的临床研究  

Clinical trial of entacapone tablets combined with levodopa tablets in the treatment of Parkinson patients

作　　者：王源江 赵振强[1] 许叶 袁勇[2] 王埮[1] WANG Yuan-jiang;ZHAO Zhen-qiang;XU Ye;YUAN Yong;WANG Tan(Department of Neurology,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;College of Traditional Chinese Medicine,Hainan Medical University,Haikou 571199,China)

机构地区：[1]海南医学院第一附属医院神经内科,海口570102 [2]海南医学院中医学院,海口571199

出　　处：《中国临床药理学杂志》2019年第2期112-114,共3页The Chinese Journal of Clinical Pharmacology

基　　金：海南省自然科学基金资助项目(2017817378);海南医学院附属医院2015年度中青年培育基金资助项目(HYFYPY201505)

摘　　要：目的观察恩他卡朋片联合左旋多巴片对帕金森病患者的临床疗效和安全性及其对神经递质的影响。方法将96例帕金森病患者随机数分为对照组和试验组,每组48例。对照组给予左旋多巴,初始剂量250 mg,口服,每天3次,根据患者耐受程度,每3～7 d增加1次剂量,增加范围在每日125～750 mg,直至达到理想疗效剂量,每日最大剂量不超过6 g;试验组在对照组的基础上口服恩他卡朋0. 2 g,每天3次。2组均连续治疗16周。比较2组患者的临床疗效、神经递质、帕金森统一评分量表(UPDRS)评分及药物不良反应发生情况。结果治疗后,试验组和对照组总有效率分别为91. 67%(44例/48例),70. 83%(34例/48例),差异有统计学意义(P <0. 05)。试验组和对照组血清脑源性神经营养因子(BDNF)分别为(24. 85±2. 38)和(18. 59±2. 51) ng·mL^(-1),5-羟色胺(5-HT)分别为(270. 08±28. 73)和(236. 71±19. 87) ng·mL^(-1),去甲肾上腺素(NE)分别为(44. 02±5. 83)和(32. 82±4. 54) ng·mL^(-1),差异均有统计学意义(均P <0. 05)。治疗期间,对照组出现恶心呕吐3例,皮疹2例,头痛1例,血清肌酸酐轻度升高1例,药物不良反应总发生率分别为14. 58%(7例/48例);试验组出现恶心呕吐2例、皮疹2例、头痛1例,药物不良反应总发生率为10. 42%(5例/48例),差异无统计学意义(P> 0. 05)。结论恩他卡朋治疗帕金森病的临床疗效显著,可有效改善患者神经递质,且用药安全性高。Objective To observe the clinical effect and safety of entacapone tablets combined with levodopa tablets in the treatment of Parkinson patients. Methods Ninety-six cases of Parkinson patients were randomly divided into treatment group and control group,48 cases in each group. Control group was given levodopa orally,the initial dose of 250 mg,tid,according to the patient’s tolerance,increased 1 dose per 3-7 d,increasing the range of 125-750 mg per day until the ideal therapeutic dose was reached,the maximum daily dose was no more than 6 g. On the basis of control group,treatment group was given entacapone 0. 2 g,orally,tid. Two groups were treated for 16 consecutive weeks.The clinical efficacy,neurotransmitters,Parkinson ’s unified scoring scale( UPDRS) score and adverse drug reactions between the two groups were compared. Results After treatment,the total effective rates of treatment group and control group were 91. 67%( 44 cases/48 cases)and 70. 83%( 34 cases/48 cases),with significant difference( P < 0. 05). The serum brain derived neurotrophic factor( BDNF) in treatment group and control group were( 24. 85 ± 2. 38) and( 18. 59 ± 2. 51) ng·m L^-1,the 5-hydroxytryptamine( 5-HT) were( 270. 08 ± 28. 73) and( 236. 71 ± 19. 87) ng·m L^-1,the norepinephrine( NE) were( 44. 02 ± 5. 83) and( 32. 82 ± 4. 54) ng·mL^-1,all with significant difference( all P < 0. 05). During treatment,there were 3 cases of nausea and vomiting,2 cases of skin rash,1 case of headache,1 case of serum creatine liver mild elevation in the control group,with the incidence of 14. 58%( 7 cases/48 cases). There were 2 cases of nausea and vomiting,1 case of skin rash,1 case of headache in the treatment group,with the incidence of 10. 42%( 5 cases/48 cases),there was no significant difference( P > 0. 05). Conclusion Entacapone is good for Parkinson,which can effectively improve the patients of neurotransmitters,and safety.

关 键 词：帕金森 左旋多巴 儿茶酚胺氧位甲基转移酶抑制剂 神经递质 

分 类 号：R97[医药卫生—药品]