Mark M H, Sage J I
Department of Neurology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903.
Ann Clin Lab Sci. 1989 Mar-Apr;19(2):101-6.
Twelve of 23 patients with Parkinson's disease and motor fluctuations who entered a double-blind study comparing controlled-release carbidopa/levodopa (Sinemet CR-4) with standard Sinemet (SS) continued into open label follow-up on a combination of CR-4 and SS (C/S); the rest continued on CR-4 alone. Significant improvement on C/S compared with CR-4 was noted for shorter duration and reduced disability of dyskinesias, and more hours "on" without dyskinesias (all p less than 0.05). Total number of hours "off" was improved on C/S over SS (p less than 0.01). Sinemet CR-4 proved to be better than C/S for sleep disturbance (p less than 0.05). Although the total number of tablets and doses per day of CR-4 was reduced during the C/S period, total levodopa dosage per day was not significantly changed from either of the previous periods. The C/S therapy for advanced parkinsonism can be more efficacious for fluctuators than either CR-4 or SS alone.
23例患有帕金森病且存在运动波动的患者进入了一项双盲研究，该研究比较了控释卡比多巴/左旋多巴（息宁控释片CR-4）与标准息宁（SS），其中12例患者继续接受CR-4与SS联合用药（C/S）的开放标签随访；其余患者继续单独使用CR-4。与CR-4相比，C/S在缩短异动症持续时间、减轻异动症残疾程度以及增加无异动症的“开”期时长方面有显著改善（所有p值均小于0.05）。与SS相比，C/S在减少“关”期总时长方面有改善（p值小于0.01）。在睡眠障碍方面，息宁控释片CR-4被证明比C/S更好（p值小于0.05）。尽管在C/S阶段CR-4的每日药片总数和服药次数减少了，但每日左旋多巴总剂量与之前任何一个阶段相比均无显著变化。对于晚期帕金森病患者，C/S疗法对存在运动波动的患者可能比单独使用CR-4或SS更有效。
