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目的探讨在左旋多巴治疗原发性帕金森病“开-关”现象控制中卡比多巴/左旋多巴(Rytary)缓释胶囊的应用及其效果。方法选取2015年6月至2016年2月收治的132例经左旋多巴治疗且存在“开-关”现象的原发性帕金森病患者,根据随机数字表法将患者分为对照组及观察组,各66例,在常规治疗的基础上对照组采取甲磺酸雷沙吉兰治疗,观察组采取Rytary缓释胶囊治疗,治疗周期均为16周。比较两组患者治疗后T_1(第6周)、T_2(第12周)、T_3(第16周)平均每日“开”期、“关”期时间相对于T_0(治疗前)的变化及各时间点“开”期、“关”期时间占觉醒期的百分率,比较T_0、T_1、T_2、T_3各时间点两组患者统一帕金森评定量表(UPDRS)Ⅱ~Ⅳ各量表评分情况。结果 T_1、T_2、T_3时间点,两组患者的平均每日“关”期时间、UPDRSⅡ~Ⅳ各量表评分、“关”期时间占觉醒期时间百分率均明显低于T_0时间点(P<0.05,P<0.01),且观察组各时间点的平均每日“关”期时间、UPDRSⅡ~Ⅳ各量表评分、“关”期时间占觉醒期时间百分率均明显低于对照组(P<0.05,P<0.01)。T_1、T_2、T_3时间点,两组患者的平均每日“开”期时间、“开”期时间占觉醒期时间百分率均明显高于T_0时间点(P均<0.05),且观察组各时间点的平均每日“开”期时间、“开”期时间占觉醒期时间百分率均明显高于对照组(P<0.05,P<0.01)。结论Rytary缓释胶囊能有效缓解左旋多巴治疗原发性帕金森病所致的“开-关”现象,临床疗效确切,不良反应少,具有重要的临床应用价值。
OBJECTIVE: To investigate the application of levodopa in the treatment of primary Parkinson’s disease / “on-off” phenomenon and its effect on sustained-release capsules of carbidopa / levodopa (Rytary). Methods From January 2015 to February 2016, 132 patients with primary Parkinson’s disease who were treated with levodopa and had “on-off” were selected. Patients were divided into control group And observation group (n = 66). On the basis of routine treatment, the control group was treated with rasagiline mesylate, and the observation group was treated with Rytary sustained-release capsules. The treatment period was 16 weeks. The average daily “on” period and the “off” period of T_1 (6th week), T_2 (12th week) and T_3 (16th week) of the two groups were compared with T_0 (before treatment) , And the percentage of time of waking up in each time point of “ON” and “OFF”, and comparing the two groups of patients at T_0, T_1, T_2 and T_3 at different time points. The Unified Parkinson Rating Scale (UPDRS) Ⅱ ~ Ⅳ score the scale of the situation. Results At T 1, T 2 and T 3 time points, the average daily “off” period, UPDRS Ⅱ ~ Ⅳ scores, and “off” period accounted for significantly lower percentage of awakening time than those of T_0 (P <0.05, P <0.01), and the mean daily daily “off” period, UPDRS Ⅱ ~ Ⅳ scores, and “off” Significantly lower than the control group (P <0.05, P <0.01). At the time points of T 1, T 2 and T 3, the average daily “on” period and “on” period of the two groups were significantly higher than that of T 0 (P <0.05), and The average daily “on” period and “on” period of the observation group at each time point were significantly higher than that of the control group (P <0.05, P <0.01). Conclusion Rytary sustained-release capsules can effectively relieve the “on-off” phenomenon caused by levodopa in patients with idiopathic Parkinson’s disease. It has definite curative effect and few adverse reactions. It has important clinical value.