左旋多巴联合普拉克索治疗帕金森病的临床研究

Therapeutic effect of levodopa combined with pramipexole on subjects with Parkinson′s disease

目的观察左旋多巴联合普拉克索治疗帕金森病的疗效及对改善运动功能的影响。方法回顾性分析2013年6月至2015年1月,杭州师范大学附属医院收治的帕金森病患者72例,随机分为研究组和对照组,每组36例。对照组单纯口服左旋多巴治疗,研究组在对照组的基础上再口服普拉克索,两组均治疗18周,比较两组患者对患者负性情绪、运动功能、生活质量、临床疗效的影响。结果治疗后,研究组汉密顿焦虑量表(HAMA)评分、汉密顿抑郁量表(HAMD)评分均低于对照组,差异有统计学意义(t=4.422、4.032,均P<0.05)。治疗后6、12、18周,研究组UPDRSⅢ评分均低于对照组,差异均有统计学意义(t=3.454、4.267、4.806,均P<0.05)。治疗后,研究组生存质量量表(WHOQOL2BREF)中生理领域、心理领域、独立性领域、社会关系领域、环境领域得分均高于对照组,差异有统计学意义(t=3.342、3.526、3.503、3.114、3.051,均P<0.05)。研究组总有效率91.67%(33/36),对照组72.22%(26/36),差异有统计学意义(χ~2=6.635,P<0.05)。结论左旋多巴联合普拉克索治疗帕金森病能够更快、更好地改善患者运动功能,缓解负性情绪,提高患者生活质量,且未增加不良反应发生率,值得临床推广应用。

Objective To observe the therapeutic effect of levodopa combined with pramipexole in the treatment patients with Parkinson＇s disease and to understand its influence on the mobility of patients. Methods 72 patients with Parkinson＇s disease in Affiliated Hospital of Hangzhou University from June 2013 to January 2015 were enrolled and randomly divided into two groups with 36 cases of each. Patients in study group were treated with both levodopa and pramipexole, while patients in control group were only given levodopa. The therapeutic effects were compared after 18 weeks of oral treatment. Results The scores of HAMA and HAMD of patients in study group were lower than that of controls, the difference was statistically significant （t=4.422, 4. 032, P〈0. 05）. Meanwhile, the UPDRS Ⅲ scores of patients in study group in treatment time points of 6, 12 and 18 weeks were all significantly lower than that of controls （t=3. 454, 4. 267, 4. 806, P〈0.05）. After treatment, patients in study group received higher scores in physical, psychological, independent, social and environmental aspects of WHOQOL2BREF compared with patients in control group （t = 3. 342, 3. 526, 3. 503, 3. 114, 3. 051, P%0.05）. The overall effective rate of patients treated with both levodopa and pramipexole was much higher than that of those treated with only levodopa （91.67% vs. 72.22%, x^2 =6. 635, P〈0.05）. Conclusions Levodopa combined with pramipexole in the treatment of patients with Par- kinsonPs disease can effectively improve their mobility, relieve their negative emotions and improve the quality of life while does not cause more adverse reactions.