美多巴单用及与多巴胺受体激动剂合用治疗帕金森病的临床疗效观察  

Open-label and non-randomized study of therapeutic effect of Parkinson's disease with Madopar monotherapy and concomitant Madopar therapy with dopamine agonists

作　　者：秦斌[1] 曾湘豫[1] 蒋雨平[2] 陈生弟[3] 罗德儒[4] 张本恕[5] 张文记[1] 陈海波[1] 郑剑辉 蒋景文[1] 王新德[1] 

机构地区：[1]卫生部北京医院神经内科,100730 [2]复旦大学医学院附属华山医院神经内科 [3]上海第二医科大学瑞金医院神经内科 [4]四川大学华西医院神经内科 [5]天津医科大学总医院神经内科

出　　处：《中华神经科杂志》2002年第5期286-289,共4页Chinese Journal of Neurology

基　　金：国家"九五"医学科技攻关项目资助 (96 90 60 0 5 0 8)

摘　　要：目的　评定单用美多巴 (L dopa) ,L dopa与多巴胺受体激动剂 [溴麦角隐亭碱 (BM)或甲磺酸培高利特 (PM) ]合用治疗帕金森病的疗效和安全性。方法　采用多中心、开放式分组 ,单用L dopa组 4 7例 ,L dopa +BM组 4 3例和L dopa +PM组 4 8例。临床疗效采用改良Webster量表和帕金森病运动功能量表 (MDRSPD)进行治疗前后的评定。同时取血检测肝肾功能 ,血、尿常规 ,测量血压、脉搏和做心电图检查。单用L dopa组平均日用量 (5 2 3 3± 2 35 9)mg;L dopa +BM组平均日用量为L dopa(5 2 6 7± 2 4 1 3)mg ,BM(7 3± 1 5 )mg;L dopa +PM组平均日用量为L dopa(5 5 8 3± 192 9)mg,PM(0 2 35± 0 0 4 5 )mg。结果　Webster量表、MDRSPD量表的临床总有效率 ,单用L dopa组均为74 5 % ,L dopa +BM组分别为 6 9 8%和 79 1% ,L dopa +PM组分别为 77 9%和 81 3%。不良反应发生率单用L dopa组为 2 7 7% ,L dopa +BM组为 39 5 % ,L dopa+PM组为 18 8%。结论　单用L dopa ,L dopa+BM和L dopa +PM治疗帕金森病均有效 ,对于早期帕金森病可以选用单一L dopa治疗 ;对于晚期帕金森病 ,可以选用LObjective The clinical efficacy and safety of L dopa monotherapy and concomitant L dopa therapy with dopamine agonists (bromocriptine or pergolide) of the treatment of Parkinson's disease Methods The clinical trial was performed in the multicentre,open label study L dopa group: 47 cases,L dopa plus bromocriptine group: 43 cases and L dopa plus pergolide group: 48 cases The clinical efficacy was assessed with modified Webster's scale and motor dysfunction rating scale for Parkinson's disease ( MDRSPD ),and safety data included blood hepatic and renal function tests,blood and urine routine tests,arterial blood pressure,heart rate measurements and electrocardiogram were also analyzed at the beginning and end of study The average daily dose of L dopa in levedopa group was (523 3±235 9) mg,The average daily dose of L dopa and bromocriptine were (526 7±241 3) mg and (7 3±1 5) mg in L dopa plus bromocriptine group,respectively The average daily dose of L dopa and pergolide were (558 3±192 9)mg and (0 235±0 045) mg in L dopa plus pergolide group separately Result The clinical improvement was about 74 5%both in assessment of modified Webster's scale and MDRSPD in L dopa group The clinical score was improved in 69 8% (Webster's scale) and 79 1% (MDRSPD) in L dopa plus bromocriptine group,respectively The clinical improved rates were 77 9%( Webster's scale ) and 81 3%( MDRSPD ) in L dopa plus bergolide group The incidence rates of side effects were 27 7%in L dopa group,39 5%in L dopa plus bromocriptine and 18 8%in L dopa plus pergolide groups Conclusion There was an efficacy in treatment of Parkinson's disease in either L dopa monotherapy or combination with bromocriptine or pergolide The treatment of L dopa alone was more effective in the early stage of Parkinson's disease and concomitant L dopa therapy with dopamine agonists were more effective in the advanced stage of Parkinson's disease,pergolide was not only more effective,safe and tolerable,but also

关 键 词：美多巴 多巴胺受体激动剂 治疗 帕金森病 疗效观察 

分 类 号：R742.5[医药卫生—神经病学与精神病学]