中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2006年
8期
168-169
,共2页
张文记%曾湘豫%王新德%张微微%高军民
張文記%曾湘豫%王新德%張微微%高軍民
장문기%증상예%왕신덕%장미미%고군민
震颤%丙醇胺类%肾上腺素能β受体拮抗剂
震顫%丙醇胺類%腎上腺素能β受體拮抗劑
진전%병순알류%신상선소능β수체길항제
背景:原发性震颤是具有遗传倾向的运动障碍性疾病,治疗常用β-肾上腺素能受体阻滞剂,但是需要服用的药物剂量大,患者常不能坚持治疗.盐酸阿罗洛尔是一种兼有α受体阻断作用的β受体阻断剂,药物副作用小,在日本被认为是一种较理想的治疗原发性震颤的药物.目的:观察盐酸阿罗洛尔在中国人中治疗原发性震颤的疗效和安全性.设计:病例分析.单位:卫生部北京医院和解放军北京军区总医院的神经内科.对象:选择1999-04/2000-12在北京医院、解放军北京军区总医院神经内科门诊被诊断为原发性震颤的患者30例,男19例,女11例;年龄21～74岁,病程1～40年,平均(15.8±12.6)年.方法:对患者上肢、头部及下肢震颤程度、手的功能障碍程度、写字,画圈时手颤的程度、对震颤所致痛苦的主诉6项症状由专门医生在患者服药前及服药第2,4,6周分别评分.根据其程度分为轻度,中度和重度,分别记分为1分,2分,3分.评估标准:①显效:治疗前后的分数之差大于7分以上.②有效:治疗前后的分数之差为6.5～3分.③稍有效:治疗前后的分数之差为3～1.5分.④无变化:治疗前后的分数之差为1～-1分.⑤恶化:治疗前后的分数之差小于-1.5分.同时观察患者的血压,心率及药物的副作用.主要观察指标:①疗效评估结果.②治疗前后血压和心率.③不良事件和副反应. 结果:30例患者均进入结果分析.①原发性震颤30例患者中,显效6例,有效11例,稍有效5例,无效7例,恶化1例.总有效率为73.4%.②治疗前平均血压为(138.5±14.6)/(84.2±6.4)mm Hg(1 mm Hg=0.133 kPa).1个疗程结束后的平均血压为(130±10)/(79.7±6.3)mm Hg.治疗前平均心率为(77.5±6.4)次/min,治疗后为(75±6.4)次/min.治疗前后比较,差异无显著性意义.③30例患者中有4例出现不同程度的副反应,占13.4%.1例服药后出现困倦感,1例服药后出现失眠,2例出现头胀头晕,其中1例自感震颤症状加重而退出治疗.结论:盐酸阿罗洛尔可明显改善患者的震颤症状,是治疗原发性震颤的有效药物,服用方便而且安全.
揹景:原髮性震顫是具有遺傳傾嚮的運動障礙性疾病,治療常用β-腎上腺素能受體阻滯劑,但是需要服用的藥物劑量大,患者常不能堅持治療.鹽痠阿囉洛爾是一種兼有α受體阻斷作用的β受體阻斷劑,藥物副作用小,在日本被認為是一種較理想的治療原髮性震顫的藥物.目的:觀察鹽痠阿囉洛爾在中國人中治療原髮性震顫的療效和安全性.設計:病例分析.單位:衛生部北京醫院和解放軍北京軍區總醫院的神經內科.對象:選擇1999-04/2000-12在北京醫院、解放軍北京軍區總醫院神經內科門診被診斷為原髮性震顫的患者30例,男19例,女11例;年齡21～74歲,病程1～40年,平均(15.8±12.6)年.方法:對患者上肢、頭部及下肢震顫程度、手的功能障礙程度、寫字,畫圈時手顫的程度、對震顫所緻痛苦的主訴6項癥狀由專門醫生在患者服藥前及服藥第2,4,6週分彆評分.根據其程度分為輕度,中度和重度,分彆記分為1分,2分,3分.評估標準:①顯效:治療前後的分數之差大于7分以上.②有效:治療前後的分數之差為6.5～3分.③稍有效:治療前後的分數之差為3～1.5分.④無變化:治療前後的分數之差為1～-1分.⑤噁化:治療前後的分數之差小于-1.5分.同時觀察患者的血壓,心率及藥物的副作用.主要觀察指標:①療效評估結果.②治療前後血壓和心率.③不良事件和副反應. 結果:30例患者均進入結果分析.①原髮性震顫30例患者中,顯效6例,有效11例,稍有效5例,無效7例,噁化1例.總有效率為73.4%.②治療前平均血壓為(138.5±14.6)/(84.2±6.4)mm Hg(1 mm Hg=0.133 kPa).1箇療程結束後的平均血壓為(130±10)/(79.7±6.3)mm Hg.治療前平均心率為(77.5±6.4)次/min,治療後為(75±6.4)次/min.治療前後比較,差異無顯著性意義.③30例患者中有4例齣現不同程度的副反應,佔13.4%.1例服藥後齣現睏倦感,1例服藥後齣現失眠,2例齣現頭脹頭暈,其中1例自感震顫癥狀加重而退齣治療.結論:鹽痠阿囉洛爾可明顯改善患者的震顫癥狀,是治療原髮性震顫的有效藥物,服用方便而且安全.
배경:원발성진전시구유유전경향적운동장애성질병,치료상용β-신상선소능수체조체제,단시수요복용적약물제량대,환자상불능견지치료.염산아라락이시일충겸유α수체조단작용적β수체조단제,약물부작용소,재일본피인위시일충교이상적치료원발성진전적약물.목적:관찰염산아라락이재중국인중치료원발성진전적료효화안전성.설계:병례분석.단위:위생부북경의원화해방군북경군구총의원적신경내과.대상:선택1999-04/2000-12재북경의원、해방군북경군구총의원신경내과문진피진단위원발성진전적환자30례,남19례,녀11례;년령21～74세,병정1～40년,평균(15.8±12.6)년.방법:대환자상지、두부급하지진전정도、수적공능장애정도、사자,화권시수전적정도、대진전소치통고적주소6항증상유전문의생재환자복약전급복약제2,4,6주분별평분.근거기정도분위경도,중도화중도,분별기분위1분,2분,3분.평고표준:①현효:치료전후적분수지차대우7분이상.②유효:치료전후적분수지차위6.5～3분.③초유효:치료전후적분수지차위3～1.5분.④무변화:치료전후적분수지차위1～-1분.⑤악화:치료전후적분수지차소우-1.5분.동시관찰환자적혈압,심솔급약물적부작용.주요관찰지표:①료효평고결과.②치료전후혈압화심솔.③불량사건화부반응. 결과:30례환자균진입결과분석.①원발성진전30례환자중,현효6례,유효11례,초유효5례,무효7례,악화1례.총유효솔위73.4%.②치료전평균혈압위(138.5±14.6)/(84.2±6.4)mm Hg(1 mm Hg=0.133 kPa).1개료정결속후적평균혈압위(130±10)/(79.7±6.3)mm Hg.치료전평균심솔위(77.5±6.4)차/min,치료후위(75±6.4)차/min.치료전후비교,차이무현저성의의.③30례환자중유4례출현불동정도적부반응,점13.4%.1례복약후출현곤권감,1례복약후출현실면,2례출현두창두훈,기중1례자감진전증상가중이퇴출치료.결론:염산아라락이가명현개선환자적진전증상,시치료원발성진전적유효약물,복용방편이차안전.
BACKGROUND: Essential tremor is a kind of dyskinesia disease with a tendency to heredity. β-adnephrin receptor blocker is mainly used for treatment, but the dosage was great, patients could not persist in treatment. Hydrochloric-acid arotinolol, which characterizes by little side effect, is a β-receptor blocking agent combined with blocking effect of α receptor, and is an ideal drug to treat essential tremor in Japan.OBJECTIVE: To observe the reliability and curative effect of hydrochloric-acid arotinolol on essential tremor among Chinese people.DESIGN: Case analysis.SETTING: Neurological Departments of Beijing Hospital of Ministry of Public Health and General Hospital of Beijing Military Area Command of Chinese PLA.PARTICIPANTS: Totally 30 patients with essential tremor, 19 males and 11 females, aged from 21 to 74 years, with course of 1-40 years, average of (15.8±12.6) years, were selected from Neurological Departments of Beijing Hospital of Ministry of Public Health and General Hospital of Beijing Military Area Command of Chinese PLA from April 1999 to December 2000.METHODS: Tremor degree of upper limb, caput and lower limb, degree of dysfunction of hand, tremor degree of hand during writing and circling, and chief complaint of pain caused by tremor were scored before medication and 2, 4 and 6 weeks after medication. Scores were determined as 1 point, 2 points and 3 points according to mild, moderate and severe degree respectively. Evaluated criteria: ① Obviously effective: Differences were more than 7 points before and after treatment. ② Effective: Differences were 6.5-3 points before and after treatment. ③ A little effective: Differences were 3-1.5 points before and after treatment. ④ No changes: Differences were from 1 to -1 points before and after treatment. ⑤ Worse: Differences were less than -1.5 points before and after treatment. Meanwhile, blood pressure and heart rate of patients and side effect of drug were observed.MAIN OUTCOME MEASURES: ① Results of effective evaluation; ②Blood pressure and heart rate before and after treatment; ③ Adverse events and side effect.RESULTS: Totally 30 patients entered the final analysis. ① Among 30 patients with essential tremor, 6 had obvious effect, 11 had effect, 5 had a little effect, 7 had no effect, and 1 was worse. ② Average of blood pressure before treatment was (138.5±14.6)/(84.2±6.4) mm Hg (1 mm Hg=0.133 kPa), and was (130±10)/(79.7±6.3) mm Hg after 1 course. Average heart rate was (77.5±6.4) times/minute before treatment and (75±6.4) times/minute after treatment. The difference was not significant. ③ Among 30 patients, 4 had side effect at various degrees which was accounted for 13.4%; 1 had distress after medication, 1 had agrypnia, 2 had fullness in head and dizziness, and 1 gave up the treatment because of deteriorated tremor.CONCLUSION: Hydrochloric-acid arotinolol can improve tremor symptom of patients obviously and is an effective drug to treat essential tremor with convenient and safe medication.
