Rondot P, Ziegler M
Service de Neurologie, Centre Raymond Garcin, Paris, France.
J Neurol. 1992;239 Suppl 1:S28-34. doi: 10.1007/BF00819564.
Several controlled trials have shown that the dopamine agonist, Trivastal (piribedil), is active in the treatment of Parkinson's disease, particularly with regard to tremor. To determine its efficacy as monotherapy in patients previously untreated with levodopa, a 3-month multicentre study was conducted with Trivastal 50 mg LP in 113 patients with idiopathic Parkinson's disease. The study population consisted of 66 men and 47 women, aged 63.1, SD 0.6 (43-79) years with a 2.1, SD 0.2 (1-15) year history of Parkinson's disease. Mean disease stage was 1.82 (1-4) by the Hoehn and Yahr classification. Tremor was the predominant clinical feature in 42 patients; the remaining 71 patients displayed the full parkinsonian syndrom. Trivastal 50 mg LP was prescribed stepwise up to doses of 150-250 (207, SD 6.4) mg/day at the end of 3 months. No concomitant anti-parkinsonian medication was given. Patients were clinically assessed at 1, 2 and 3 months on the Webster scale, a specific tremor scale and the HARD depression scale. Mean results were as follows in the 90 patients completing the study. On the Webster scale, tremor fell from 1.7 to 1 (-41%, P less than 0.001), bradykinesia from 1.5 to 0.8 (-47%, P less than 0.001) and rigidity from 1.3 to 0.9 (-31%, P less than 0.001); on the specific scale, rest tremor decreased in daily duration and amplitude from 3.9 to 2.4 (-39%, P less than 0.001) and from 2.9 to 2.1 (-35%, P less than 0.001), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
多项对照试验表明,多巴胺激动剂曲司氯铵(piribedil)在帕金森病治疗中具有活性,尤其是在震颤方面。为确定其作为左旋多巴初治患者单一疗法的疗效,对113例特发性帕金森病患者进行了一项为期3个月的多中心研究,使用曲司氯铵50 mg LP。研究人群包括66名男性和47名女性,年龄63.1岁,标准差0.6(43 - 79)岁,帕金森病病史2.1年,标准差0.2(1 - 15)年。根据Hoehn和Yahr分类,平均疾病分期为1.82(1 - 4)期。42例患者以震颤为主要临床特征;其余71例患者表现为完整的帕金森综合征。曲司氯铵50 mg LP逐步给药,3个月末剂量增至150 - 250(207,标准差6.4)mg/天。未给予其他抗帕金森病药物。在第1、2和3个月时,根据韦伯斯特量表、特定震颤量表和HARD抑郁量表对患者进行临床评估。完成研究的90例患者的平均结果如下。在韦伯斯特量表上,震颤从1.7降至1(-41%,P<0.001),运动迟缓从1.5降至0.8(-47%,P<0.001),强直从1.3降至0.9(-31%,P<0.001);在特定量表上,静止性震颤的每日持续时间和幅度分别从3.9降至2.4(-39%,P<0.001)和从2.9降至2.1(-35%,P<0.001)。(摘要截短至250字)