普拉克索与美多芭联合应用治疗帕金森病的临床效果分析

Analysis of clinical efficacy on pramipexole combined with madopar in the treatment of Parkinson's disease

【目的】分析普拉克索与美多芭联用治疗帕金森病的效果。【方法】收集2015年4月至2016年1月90例帕金森病患者并随机分组。单用组采用美多芭单独治疗,初始阶段125 mg/次,3次/d。第2周开始125 mg/次,4次/d后,每周可逐渐增加剂量,直至750 mg/次,1次/d维持治疗。联用组采用普拉克索与美多芭联合治疗。其中,美多芭治疗方法同上。普拉克索初始阶0.125 mg/次,3次/d。第2周开始0.25 mg/次,4次/d。后每周可逐渐增加剂量,直至4.5 mg/次,1次/d维持治疗。比较两组患者在帕金森病治疗的总有效率以及治疗后阅读和理解、表达能力、记忆力、时间概念、干预前后患者简易智能精神状态检查量表评分(mini mental state examination,MMSE)、蒙特利尔认知评估量表评分(montreal cognitive assessment,MoCA)、帕金森综合评分量表评分(parkinson comprehensive rating scale,UPDRS)的差异、治疗过程不良反应发生率以及两组患者治疗前后生活质量水平的差异。【结果】联用组患者帕金森病治疗总有效率高于单用组(P<0.05);联用组治疗后阅读和理解、表达能力、记忆力、时间概念评分优于单用组(P<0.05);干预前两组MMSE、MoCA、UPDRS相近(P>0.05);干预后联用组MMSE、MoCA、UPDRS优于单用组(P<0.05)。两组患者均未出现严重不良反应(P>0.05)。干预前两组生活质量水平相近(P>0.05);干预后联用组生活质量水平优于单用组(P<0.05)。【结论】普拉克索与美多芭联用治疗帕金森病的效果确切,可有效改善患者临床症状,控制病情,改善认知功能,且无明显治疗过程不良反应,安全性较高,值得在临床推广和应用。

[Objective ] To analyze the clinical efficacy of pramipexole combined with madopar in the treatment of Parkinson＇s disease. [ Methods ] Ninety cases with Parkinson＇s disease were collected from April 2015 to January 2016 and randomly divided into the single group and the combination group. The patients in the single group were treated with madopar alone, 125 mg/time, 3 times/d in the initial stage and 125 mg/time, 4 times/w from the 2nd week when the dose could be gradually increased until the maintenance treatment of 750 rag/d, once/d. Those in the combination group were treated with pramipexole and madopar. The treatment of madopar was the same as above, while pramipexole was given as follows： 0.125 mg/time, 3 times/d in the initial stage, 0.25 mg/time, 4 times/w from the 2nd week when the dose was gradually increased until the maintenance treatment of 4.5 mg/time and once/d. The total effective rate and scores of reading and understanding, expression ability, memory, time concept,before and after the intervention were compared between the two groups. The difference of mini mental state examination scale （MMSE）, Montreal cognitive assessment scale （MoCA）, Parkinson comprehensive rating scale （UPDRS） difference, the incidence of adverse reactions in the treatment process and the level of quality of life was analyzed. [Results] The total effective rate in the combination group was higher than that in the single group （P 〈 0.05）; the scores of reading and understanding, expression ability, memory, time concept after the treatment in the combination group were betterthan those in the single group （P 〈 0.05）; the scores of MMSE, MoCA and UPDRS before the intervention were similar between the two groups （P〉0.05）;the scores of MMSE, MoCA and UPDRS after theintervention in the combination group were better than those in the single group （P〈0.05）. There were no serious adverse reactions in both groups （P〉0.05）. The levels of quality of life before the intervention were similar in both groups （P〉0.05）; the level of quality of life after the inte^cention in the combination group was better than that in the single group （P〈0.05）. [Conclusion] Pramipexole and Madopar with exact efficacy on Parkinson＇s disease, can effectively improve the clinical symptoms, control the state of the disease and ameliorate the cognitive function. Moreover, there are no obvious adverse reactions in the treatment process. Therefore, the treatment is of high safety, and worth popularizing and applying in clinic.