摘要目的 研究多巴丝肼片合用普拉克索或吡贝地尔的疗效与安全性. 方法 选择自2008年8月至2010年1月在福建医科大学附属第一医院神经内科门诊接受治疗的40例PD患者,根据治疗药物的不同分为多巴丝肼片+普拉克索片组(普拉克索组)和多巴丝肼片+泰舒达组(泰舒达组),每组20例.经12周联合用药治疗后,以统一帕金森病评定量表(UPDRS)各部分评分相对于基线(治疗前评分)的变化为指标评估疗效.同时监测血压,观察患者不良反应,比较2组治疗方案的安全性. 结果 经12周治疗后2组UPDRS各项评分相对基线均有下降,差异有统计学意义(P＜0.05).普拉克索组UPDRS-Ⅰ(精神、行为和情感)评分、UPDRS-Ⅳ(治疗的并发症)评分较吡贝地尔组评分下降更多,差异有统计学意义(P＜0.05).普拉克索组临床总有效率为80％,泰舒达组临床总有效率为75％,差异无统计学意义(P＞0.05).2组药品不良反应发生率分别为55％和70％,差异无统计学意义(P＞0.05). 结论 普拉克索或吡贝地尔与多巴丝肼合用治疗PD可获得较显著的近期疗效；在改善PD患者精神、行为和情感及运动波动并发症方面的疗效,普拉克索优于吡贝地尔.

abstractsObjective To evaluate the efficacy, safety and tolerability ofdopamine agonists (pramipexole or piribedil) in the treatment of patients with Parkinson' disease (PD) as an adjunct to levodupa and benserazide. Methods Included in the present study were 40 PD patients who received pramipexole or piribedil as an adjunct to levodopa and benserazide for 12 weeks in our institute. They were divided into a Madopa + pramipexole group (n=20) and a Madopa + piribedil group (n=20)according to the therapeutic drugs they received. The efficacy of dopamine agonist was assessed by the UTDRS score. The safety and tolerability were assessed on the basis of adverse events and blood pressure. Results After respective administration of pramipexole and piribedil for 12 weeks, the UPDRS Ⅰ -Ⅳ scores in the 2 groups were significantly reduced (P＜0.05).The average UPDRS-Ⅰ score improved from 2.85±2.41 to 1.2±l.64 points in the pramipexole group and from 2.8+1.28 to 1.85±1.35points in the piribedil group, with significant differences (P＜0.05). The average UPDRS-Ⅳ score improved respectively from 1.85±2.60 to 0.5±0.83 in the pramipexole group and from 1.75±1.74 to 0.75±0.91 in the piribedil,as compared with base-line and week 12,showing superiority ofpramipexole over piribedil in these aspects.The total clinical efficacy was 80％ in the pramipexole group and 75％ in the piribedil group,with no significant difference between the 2 groups (P＞0.05).No significant difference was found between the pramipexole and piribedil groups in terms of adverse events (55％ versus 70％)(P＞0.05). Conclusions Pramipexole or piribedil is effective and well-tolerated in the treatment of patients with Parkinson's disease as an adjunct to levodopa and benserazide,at least with short-term use.Pramipexole may be superior to piribedil in terms of improvement of complications in psychiatrics,behavior,emotion and motion of the PD patients.