普拉克索联合多巴丝肼治疗帕金森病的临床观察
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篇名: 普拉克索联合多巴丝肼治疗帕金森病的临床观察
TITLE: Clinical observation of pramipexole combined with levodopa-benserazide in the treatment of Parkinson’s disease
摘要: 目的 考察普拉克索联合多巴丝肼治疗帕金森病(PD)的临床疗效。方法将芜湖市第五人民医院2021年1月1日至2023年2月28日收治的108例PD患者按照随机数字表法分为观察组和对照组,各54例。对照组患者口服多巴丝肼,初始剂量为每次62.5mg,每天3次,1个月后将用药剂量增加至每次250mg,每天4次;观察组患者在对照组治疗的基础上,额外空腹口服普拉克索,初始剂量为每次0.25mg,每天2次,14d后将用药剂量增加至每次0.25mg,每天3次。两组疗程均为3个月。比较两组患者的近期疗效、安全性和远期预后情况。结果治疗后,与对照组比较,观察组患者的统一帕金森病综合评分量表第三部分(UPDRSⅢ)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及39项帕金森病生活质量调查问卷(PDQ-39)的评分更低,蒙特利尔认知评估(MoCA)量表、简易精神状态检查(MMSE)量表、Mattis痴呆评定量表(DRS)及生活质量(QOL)评分量表的评分更高(P<0.05)。两组患者的UPDRSⅢ和PDQ-39评分均比同组治疗前显著降低,DRS评分均比同组治疗前显著提高,但只有观察组患者MoCA量表、MMSE量表及QOL的评分比同组治疗前显著提高,HAMD和HAMA评分比同组治疗前显著降低(P<0.05)。两组患者的总不良反应发生率比较,差异无统计学意义(P>0.05)。为期12个月的随访结果显示,观察组患者的痴呆发生率和死亡率均显著低于对照组(P<0.05)。结论普拉克索联合多巴丝肼能显著改善PD患者的运动功能、认知功能、生活质量以及抑郁、焦虑症状,并可能降低PD患者远期痴呆和死亡的风险。
ABSTRACT: OBJECTIVE To investigate the clinical efficacy of pramipexole combined with levodopa-benserazide in the treatment of Parkinson’s disease (PD). METHODS A total of 108 PD patients treated at the Fifth People’s Hospital of Wuhu City from January 1, 2021, to February 28, 2023, were randomly divided into observation group and control group, with 54 cases in each group. Patients in the control group were administered levodopa-benserazide (initial dose of 62.5 mg per dose), three times daily; after one month, the dose was increased to 250 mg per dose, four times daily. Patients in the observation group received the same treatment as the control group, with the addition of pramipexole (initial dose of 0.25 mg per dose) orally twice daily on an empty stomach; after 14 days, the dose was increased to 0.25 mg per dose, three times daily. Both groups were treated for 3 months. The short-term efficacy, safety and long-term prognosis of the two groups were compared. RESULTS After treatment, the observation group had significantly lower scores on the Unified Parkinson’s Disease Rating Scale part Ⅲ (UPDRS-Ⅲ), the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA), and the Parkinson’s Disease Questionnaire-39( PDQ- 39) compared to the control group; in contrast, the observation group had higher scores on the Montreal Cognitive Assessment (MoCA) scale, the Mini-mental State Examination (MMSE) scale, the Mattis Dementia Rating Scale (DRS), and the Quality of Life (QOL) scale (P<0.05). Both groups showed a significant reduction in UPDRS-Ⅲ and PDQ-39 scores, and a significant increase in DRS scores compared to baseline (P<0.05). However, only the observation group showed a significant increase in MoCA scale, MMSE scale, and QOL scores, and a significant decrease in HAMD and HAMA scores compared to baseline (P< 0.05). The total incidence of adverse drug reactions in both groups was not significantly different (P>0.05). The 12 months follow-up results showed that the incidence of dementia and mortality rates in the observation group were significantly lower than the control group (P<0.05). CONCLUSIONS Pramipexole combined with levodopa-benserazide significantly improves motor function, cognitive function, quality of life and symptoms of depression and anxiety in PD patients, and may reduce the long-term risk of dementia and mortality in these patients.
期刊: 2025年第36卷第05期
作者: 徐珩;叶成荣;谢春明
AUTHORS: XU Heng,YE Chengrong,XIE Chunming
关键字: 普拉克索;多巴丝肼;联合用药;帕金森病;近期疗效;长期预后;运动功能;认知功能;生活质量
KEYWORDS: pramipexole; levodopa-benserazide; combination therapy; Parkinson’s disease; short-term efficacy; long-term
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