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左旋多巴与脱羧酶抑制剂治疗帕金森综合征:一项电生理与临床研究。

Treatment of parkinsonism with l-dopa and a decarboxylase inhibitor. An electrophysiological and clinical study.

作者信息

Dietrichson P, Presthus J, Holmsen R

出版信息

Eur Neurol. 1975;13(4):339-49. doi: 10.1159/000114688.

Abstract

Twelve parkinsonian patients with an unsatisfactory therapeutic result on L-Dopa alone due to nausea, vomiting and involuntary movements were treated WITH L-Dopa and decarboxylase inhibitor. The daily dose reached 800mg L-Dopa and 200 mg decarboxylase inhibitor. Single doses of each of the components were also given. Electrophysiological examination of hypokinesia, tremor and rigidity, and clinical observation revealed clear evidence of rapid improvement on small doses of L-Dopa combined with decarboxylase inhibitor. Most of the improvement occurred during the 1st week before the maximal dose was reached. A single oral dose of decarboxylase inhibitor resulted in an improvement, suggesting the presence in the organism of a small AMOUNT OF L-Dopa. This work also shows the absence of liver toxicity of the drug used. Elimination of the extracerebral side effects nausea and vomiting in our opinion is a principle advantage of the compound compared to L-Dopa alone, wheras abnormal involuntary movements, which were found in all patients, remain the limiting adverse side effect.

摘要

12名帕金森病患者因恶心、呕吐和不自主运动,仅使用左旋多巴治疗效果不佳,遂接受左旋多巴和脱羧酶抑制剂联合治疗。每日剂量达800毫克左旋多巴和200毫克脱羧酶抑制剂。还分别给予了两种成分的单次剂量。对运动减退、震颤和强直进行的电生理检查以及临床观察显示,小剂量左旋多巴与脱羧酶抑制剂联合使用有明显快速改善的证据。大部分改善发生在达到最大剂量前的第1周。单次口服脱羧酶抑制剂即有改善,提示机体中存在少量左旋多巴。这项研究还表明所使用药物无肝毒性。我们认为,与单独使用左旋多巴相比,该化合物的主要优势在于消除了脑外副作用恶心和呕吐,而在所有患者中均发现的异常不自主运动仍是限制其应用的不良副作用。

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