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目的 评定单用美多巴 (L dopa) ,L dopa与多巴胺受体激动剂 [溴麦角隐亭碱 (BM)或甲磺酸培高利特 (PM) ]合用治疗帕金森病的疗效和安全性。方法 采用多中心、开放式分组 ,单用L dopa组 4 7例 ,L dopa +BM组 4 3例和L dopa +PM组 4 8例。临床疗效采用改良Webster量表和帕金森病运动功能量表 (MDRSPD)进行治疗前后的评定。同时取血检测肝肾功能 ,血、尿常规 ,测量血压、脉搏和做心电图检查。单用L dopa组平均日用量 (5 2 3 3± 2 35 9)mg;L dopa +BM组平均日用量为L dopa(5 2 6 7± 2 4 1 3)mg ,BM(7 3± 1 5 )mg;L dopa +PM组平均日用量为L dopa(5 5 8 3± 192 9)mg,PM(0 2 35± 0 0 4 5 )mg。结果 Webster量表、MDRSPD量表的临床总有效率 ,单用L dopa组均为74 5 % ,L dopa +BM组分别为 6 9 8%和 79 1% ,L dopa +PM组分别为 77 9%和 81 3%。不良反应发生率单用L dopa组为 2 7 7% ,L dopa +BM组为 39 5 % ,L dopa+PM组为 18 8%。结论 单用L dopa ,L dopa+BM和L dopa +PM治疗帕金森病均有效 ,对于早期帕金森病可以选用单一L dopa治疗 ;对于晚期帕金森病 ,可以选用L dopa与多巴胺受体激动剂联合治疗
Objectives To evaluate the efficacy and safety of L dopa alone, L dopa in combination with dopamine receptor agonist [bromocriptine (BM) or pergolide mesylate] in the treatment of Parkinson’s disease . Methods A multicenter, open group was used. In the L dopa group alone, 47 patients were treated with L dopa + BM and 43 patients with L dopa + PM were treated with L dopa + PM. Clinical Efficacy Assessments before and after treatment with the modified Webster scale and the Parkinson’s Disease Motor Function Scale (MDRSPD). At the same time, blood test liver and kidney function, blood, urine, blood pressure, pulse and ECG check. The average daily dose of L dopa was (523 ± 2 359) mg, while that of L dopa + BM was L dopa (5267 ± 2 413 mg) and that of BM (73 ± 1 5) mg. L dopa (5583 ± 192 9) mg, PM (0 35 ± 0 0 45) mg daily. Results The total effective rate of Webster scale and MDRSPD scale were 74 5% in L dopa group alone, 69.8% and 79.1% in L dopa + BM group and 77 9 in L dopa + PM group respectively % And 81 3%. The incidence of adverse reactions was 27.7% for L dopa alone, 39.5% for L dopa + BM, and 18.8% for L dopa + PM. Conclusions The treatment of Parkinson’s disease with L dopa, L dopa + BM and L dopa + PM alone is effective. For patients with early Parkinson’s disease, single L dopa can be used. For advanced Parkinson’s disease, L dopa and dopamine receptor agonist Combination therapy