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·药物与临床·


          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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          徐 珩 ,叶成荣 ,谢春明 (1.安徽省皖南康复医院/芜湖市第五人民医院神经内科,安徽 芜湖 241000;2.东
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                 1*
                                   2 #
          南大学附属中大医院神经内科,南京 210009)
          中图分类号  R969.4;R971      文献标志码  A      文章编号  1001-0408(2025)05-0584-05
          DOI  10.6039/j.issn.1001-0408.2025.05.14

          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62.5 mg,每天3次,1个月后将用药剂量增加至每次250 mg,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0.25 mg,每天2次,14 d后将用药剂量增加至每次0.25 mg,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
         (UPDRS Ⅲ)、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UPDRS Ⅲ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。
          关键词  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

          Clinical  observation  of  pramipexole  combined  with  levodopa-benserazide  in  the  treatment  of  Parkinson’s
          disease
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                                  1
          XU Heng ,YE Chengrong ,XIE Chunming(1.  Dept.  of  Neurology,  Wannan  Rehabilitation  Hospital  of  Anhui
          Province/Wuhu Fifth People’s Hospital, Anhui Wuhu 241000, China;2. Dept. of Neurology, Zhongda Hospital,
          Southeast University, Nanjing 210009, China)
          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
              Δ 基金项目 国家自然科学基金项目(No.82071204)                  groups  was  not  significantly  different  (P>0.05).  The  12
             * 第一作者 副 主 任 医 师 。 研 究 方 向 :帕 金 森 病 。 E-mail:
                                                              months  follow-up  results  showed  that  the  incidence  of
          hengxu006@163.com
              # 通信作者 研究员,主任医师,博士生导师,博士。研究方向:神                 dementia  and  mortality  rates  in  the  observation  group  were
          经变性、神经认知与神经功能影像学。E-mail:chmxie@163.com              significantly  lower  than  the  control  group  (P<0.05).


          · 584 ·    China Pharmacy  2025 Vol. 36  No. 5                               中国药房  2025年第36卷第5期
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