左旋多巴类药物短期“休假”在帕金森病治疗中的应用

The effect of L dopa short term “ drug holiday” in the patients with Parkinson disease

探讨对长期用左旋多巴（Ｌ－Ｄｏｐａ）类药物的帕金森病（ＰＤ）病人，经短期停用Ｌ－Ｄｏｐａ后能否提高疗效、降低Ｌ－Ｄｏｐａ剂量和减少并发症。方法选择２０例ＰＤ病人，均存在明显的疗效减退或药物并发症。在较严密观察下停Ｌ－Ｄｏｐａ类药物７～１０天，再从小剂量开始服用，并且分别在停药前及重新服药１、３和６个月对病人的病情和并发症等进行分级。结果短期“休假”疗法后，Ｌ－Ｄｏｐａ类药物剂量减少近５０％；连续观察１、３和６个月分别有５３％、４３％和４５％的病人病情较停药前好转；功能好转的程度和并发症减少均达３０％。结论ＰＤ病人长期服用Ｌ－Ｄｏｐａ类药物的期间，可以通过短期的Ｌ－Ｄｏｐａ类药物“休假”疗法提高疗效、降低药物剂量和减少并发症等。

Objectives To attempt to improve the L dopa drug response and to reduce the occurrence of complications in the patients with Parkinson disease on long term administration with L dopa drugs. [WT5”HZ〗Methods 20 cases of Parkinson disease patients who were on long term treatment with L dopa drugs for 2￣8 years and had severe drug complications (e.g. shortening of dose response time,“on off” phenomenon or mental disorders) were traced for the study. With strict care,the patients withdrew L dopa for 7￣10 days (“drug holiday”) . Then lower doses of L dopa were reintroduced. Before the drug withdrawal and 1, 3 and 6 months after drug reintroduction, the severity of the disease were evaluated with standard scales. [WT5”HZ〗Results After the “drug holiday”, the L dopa drug dosage was reduced for about 50% and the complications decreased about 30%,but the patient's functions were significantly improved in 1 to 6 months. Conclusion Short term “drug holiday” is an effective method to avoid or reduce L dopa drug complications and to improve L dopa response in the Parkinson disease patients with long term L dopa drug treatment.