CAJ | 학술논문

目的研究多巴丝肼片合用普拉克索或吡贝地尔的疗效与安全性. 方法选择自2008年8月至2010年1月在福建医科大学附属第一医院神经内科门诊接受治疗的40例PD患者,根据治疗药物的不同分为多巴丝肼片+普拉克索片组(普拉克索组)和多巴丝肼片+泰舒达组(泰舒达组),每组20例.经12周联合用药治疗后,以统一帕金森病评定量表(UPDRS)各部分评分相对于基线(治疗前评分)的变化为指标评估疗效.同时监测血压,观察患者不良反应,比较2组治疗方案的安全性. 结果经12周治疗后2组UPDRS各项评分相对基线均有下降,差异有统计学意义(P＜0.05).普拉克索组UPDRS-Ⅰ(精神、行为和情感)评分、UPDRS-Ⅳ(治疗的并发症)评分较吡贝地尔组评分下降更多,差异有统计学意义(P＜0.05).普拉克索组临床总有效率为80％,泰舒达组临床总有效率为75％,差异无统计学意义(P＞0.05).2组药品不良反应发生率分别为55％和70％,差异无统计学意义(P＞0.05). 结论普拉克索或吡贝地尔与多巴丝肼合用治疗PD可获得较显著的近期疗效；在改善PD患者精神、行为和情感及运动波动并发症方面的疗效,普拉克索优于吡贝地尔.
목적 연구다파사정편합용보랍극색혹필패지이적료효여안전성. 방법 선택자2008년8월지2010년1월재복건의과대학부속제일의원신경내과문진접수치료적40례PD환자,근거치료약물적불동분위다파사정편+보랍극색편조(보랍극색조)화다파사정편+태서체조(태서체조),매조20례.경12주연합용약치료후,이통일파금삼병평정량표(UPDRS)각부분평분상대우기선(치료전평분)적변화위지표평고료효.동시감측혈압,관찰환자불량반응,비교2조치료방안적안전성. 결과 경12주치료후2조UPDRS각항평분상대기선균유하강,차이유통계학의의(P＜0.05).보랍극색조UPDRS-Ⅰ(정신、행위화정감)평분、UPDRS-Ⅳ(치료적병발증)평분교필패지이조평분하강경다,차이유통계학의의(P＜0.05).보랍극색조림상총유효솔위80％,태서체조림상총유효솔위75％,차이무통계학의의(P＞0.05).2조약품불량반응발생솔분별위55％화70％,차이무통계학의의(P＞0.05). 결론 보랍극색혹필패지이여다파사정합용치료PD가획득교현저적근기료효；재개선PD환자정신、행위화정감급운동파동병발증방면적료효,보랍극색우우필패지이.
Objective To evaluate the efficacy, safety and tolerability ofdopamine agonists (pramipexole or piribedil) in the treatment of patients with Parkinson' disease (PD) as an adjunct to levodupa and benserazide. Methods Included in the present study were 40 PD patients who received pramipexole or piribedil as an adjunct to levodopa and benserazide for 12 weeks in our institute. They were divided into a Madopa + pramipexole group (n=20) and a Madopa + piribedil group (n=20)according to the therapeutic drugs they received. The efficacy of dopamine agonist was assessed by the UTDRS score. The safety and tolerability were assessed on the basis of adverse events and blood pressure. Results After respective administration of pramipexole and piribedil for 12 weeks, the UPDRS Ⅰ -Ⅳ scores in the 2 groups were significantly reduced (P＜0.05).The average UPDRS-Ⅰ score improved from 2.85±2.41 to 1.2±l.64 points in the pramipexole group and from 2.8+1.28 to 1.85±1.35points in the piribedil group, with significant differences (P＜0.05). The average UPDRS-Ⅳ score improved respectively from 1.85±2.60 to 0.5±0.83 in the pramipexole group and from 1.75±1.74 to 0.75±0.91 in the piribedil,as compared with base-line and week 12,showing superiority ofpramipexole over piribedil in these aspects.The total clinical efficacy was 80％ in the pramipexole group and 75％ in the piribedil group,with no significant difference between the 2 groups (P＞0.05).No significant difference was found between the pramipexole and piribedil groups in terms of adverse events (55％ versus 70％)(P＞0.05). Conclusions Pramipexole or piribedil is effective and well-tolerated in the treatment of patients with Parkinson's disease as an adjunct to levodopa and benserazide,at least with short-term use.Pramipexole may be superior to piribedil in terms of improvement of complications in psychiatrics,behavior,emotion and motion of the PD patients.