氯氮平片联合多巴丝肼片治疗帕金森病伴发精神障碍的临床研究  

Clinical trial of clozapine tablets combined with levodopaand benserazide hydrochloride tablets in the treatment of Parkinson's disease with mental disorders

作　　者：周俊[1] 占达飞 欧小凡[1] 黄胜[1] 喻爱军 周德生[2] 

机构地区：[1]海南省安宁医院心理康复科,海口570100 [2]湖南中医药大学第一附属医院脑病科,长沙410007

出　　处：《中国临床药理学杂志》2016年第24期2257-2260,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 观察氯氮平片联合多巴丝肼片治疗帕金森病伴发精神障碍的临床疗效及安全性。方法 将156例帕金森病伴发精神障碍患者随机分为对照组78例和试验组78例。2组患者院外予以口服多巴丝肼250-1000 mg tid,试验期间维持原治疗药物剂量。在此基础上,对照组予以口服奥氮平5-15 mg bid;试验组予以口服氯氮平50-200 mg bid。2组患者均治疗4周。用帕金森综合评分量表第三部分（UPDRSⅢ）评定2组患者的运动功能,用阳性和阴性症状量表（PANSS）评估2组患者的精神状态。比较2组患者的临床疗效及药物不良反应的发生情况。结果 治疗后,试验组和对照组的总有效率均为100.00%（78/78例）,差异无统计学意义（P〉0.05）。治疗后4周,试验组和对照组的PANSS量表总分评分分别为（39.00±5.02）,（40.14±5.62）分;阳性症状量表评分分别为（10.14±2.40）,（9.38±2.64）分;精神病理量表评分分别为（19.58±2.94）,（20.36±3.55）分,差异均无统计学意义（P〉0.05）。治疗后4周,试验组和对照组的阴性症状量表评分分别为（9.28±2.50）,（10.33±3.21）分;UPDRSⅢ评分分别为（20.19±3.43）,（34.76±5.06）分,差异均有统计学意义（P〈0.05）。2组患者发生的药物不良反应主要有嗜睡、便秘、直立性低血压以及窦性心动过速。试验组和对照组的药物不良反应发生率分别为24.36%和17.95%,差异无统计学意义（P〉0.05）。结论 氯氮平片联合多巴丝肼片方案与奥氮平联合多巴丝肼片方案治疗帕金森病伴发精神障碍的临床疗效相当,前者能显著改善患者的精神状态和运动功能,后者在改善患者精神障碍的同时恶化其运动功能。Objective To observe the clinical efficacy and safety of clozapine tablets combined with levodopaand benserazide hydrochloride tablets in the treatment of Parkinson＇ s disease with mental disorders. Methods A total of 156 patients of Parkinson＇ s disease with mental disorders were randomly divided into control group （n = 78 cases） and treatment group （n = 78 cases）. Patients in the two groups were given oral levodopaand benserazide hydrochloride tablet 250 - 1000 mg tid, and the original dose was maintained during the trial. On this basis, the control group was given oral olanzapine 5 - 15 mg bid, and treatment group was given oral clozapine 50 -200 mg bid. Two groups were treated for 4 weeks. The motor function and mental state were evaluated by unified Parkinson＇ s disease rating scale section Ⅲ （ UPDRS Ⅲ） score and positive and negative syndrome scale （ PANSS）, re-spectively. The clinical efficacy and adverse drug reactions were compared in two groups. Results After treatment, the total effective rates were 100. 00% （78/78 cases） in treatment and control groups without significant difference （P 〉 0. 05 ）. After 4 weeks of treatment, the main indexes were compared in two groups ： the total scores of PANSS were （ 10. 14 ±2. 40）, （9.38 ± 2.64） points; the scores of positive negative syndrome scale were （ 10.14 ± 2. 40）, （9. 38 ±2. 64） points, the psychopathology scores were （ 19.58 ±2. 94）, （20. 36 ±3.55） points, without statistically significant difference （P 〉 0. 05 ）. After 4 weeks of treatment, the scores of negative syndrome scale were （9.28 ± 2.50）, （ 10. 33 ± 3.21 ） points ; the UPDRS Ⅲ scores were （20. 19 ± 3.43 ）, （ 34. 76 ± 5.06） points, with significant difference （P 〈 0. 05）. The adverse drug reactions in two groups were based on lethargy, constipation, ortho-static hypotension and sinus tachycardia. The incidence of adverse drug reactions in treatment and control groups were 24. 36% and 17. 95%, with

关 键 词：氯氮平 奥氮平 帕金森病 精神障碍 运动症状 

分 类 号：R971[医药卫生—药品]