奥匹卡朋联合左旋多巴治疗帕金森病的疗效及安全性分析

Efficacy and safety of opicapine combined with levodopa in the treatment of Parkinson's disease

目的观察奥匹卡朋联合左旋多巴治疗帕金森病的疗效及安全性。方法选择2016年6月-2018年3月西安医学院第二附属医院神经内一科收治的首诊帕金森病患者70例作为研究对象,按随机数字表法分为2组,对照组38例接受左旋多巴单药治疗,研究组32例接受奥匹卡朋联合左旋多巴治疗。治疗12周后评估2组疗效及自主神经功能损伤情况、检测血清氧化应激指标[活性氧(ROS)、丙二醛(MDA)、还原型谷胱甘肽(GSII)、超氧化物歧化酶(SOD)]含量,记录治疗期间药物不良反应发生情况。结果治疗12周后,研究组患者的临床有效率为96. 88%,高于对照组患者的81.58%(χ~2=4. 015, P=0.045);帕金森病自主神经症状量表(SPOCA-AUT)总分及子项目中胃肠道、泌尿系统、心血管、瞳孔活动评分值低于对照组(t/P=1.850/0. 035、7.156/0. 000、4. 074/0. 000、4. 428/0.000、4.800/0.000),体温调节、性功能评分值与对照组比较无明显差异(P>0.05);血清ROS、MDA的含量低于对照组,GSH、SOD的含量高于对照组(t=5.104、4.182、5.034、7.495,P均=0.000)。治疗期间,研究组患者胃肠道反应、"开关"现象、日内波动现象、排尿困难等不良反应发生率低于对照组患者(χ~2/P=4.159/0. 041、4. 983/0. 026、4.015/0.045、4.534/0.033),2组间便秘、失眠症等不良反应发生率比较差异无统计学意义(P> 0. 05)。结论帕金森病患者在左旋多巴治疗同时加入奥匹卡朋进行联合治疗,可提升治疗效果,并减轻某些自主神经功能损伤及全身氧化应激反应,且具有良好的安全性。

Objective To observe the efficacy and safety of opiacapone combined with levodopa in the treatment of Parkinson's disease. Methods From June 2016 to March 2018,70 patients with Parkinson's disease who were admitted to the Department of Neurology,Second Affiliated Hospital of Xi'an Medical College,were selected as subjects. They were divided into 2 groups according to the random number table method and 38 cases in the control group. In the levodopa monotherapy,32 patients in the study group received opicampone plus levodopa. After 12 weeks of treatment,the efficacy and autonomic nerve damage of the two groups were evaluated,and serum oxidative stress indicators were measured reactive oxygen species (ROS),malondialdehyde (MDA),reduced glutathione (GSH),superoxide dismutase (SOD) content,recording the occurrence of adverse drug reactions during treatment. Results After 12 weeks of treatment,the clinical effective rate of the study group was 96.88%,which was higher than that of the control group (81.58%,χ^2=4.015, P =0.045);the Parkinson's Disease Autonomic Neurological Symptom Scale (SPOCA-AUT) total score and son The scores of gastrointestinal,urinary,cardiovascular,and pupillary activities in the project were lower than those in the control group ( t/P =1.850/0.035, t/P =7.156/0.000, t/P =4.074/0.000, t/P =4.428/0.000, t/P =4.800/0.000),there was no significant difference in body temperature regulation and sexual function scores compared with the control group ( P >0.05);serum ROS and MDA levels were lower than the control group,and the contents of GSH and SOD were higher than those of the control group. Control group ( t =5.104, t =4.182, t =5.034, t =7.495, P =0.000). During the treatment period,the incidence of adverse reactions such as gastrointestinal reactions,"switching" phenomenon,intraday fluctuations,and dysuria in the study group was lower than that of the control group (χ^2/ P =4.159/0.041,χ^2/ P =4.983/0.026,χ^2/ P =4.015/0.045,χ^2/ P =4.534/ 0.033 ),there was no significant difference in the incidence of adverse reactions such as constipation and insomnia between the two groups ( P >0.05). Conclusion In patients with Parkinson's disease,levodopa treatment combined with opicampone for combination therapy can improve the treatment effect,reduce some autonomic nerve damage and systemic oxidative stress,and has good safety.