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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*
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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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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