Selby G
Department of Neurology, Royal North Shore Hospital, Sydney, NSW.
Clin Exp Neurol. 1989;26:129-39.
This open trial is a study of the effect of adding bromocriptine (BC) to the treatment of patients who had taken a dopa-containing preparation (LD) for many years. Sixty-five patients entered the trial at an average age of 66.6 years. The mean duration of Parkinson's disease was 12.74 years and LD had been taken by one-half of them for more than 10 years and by an additional 27% for longer than 5 years. The duration of treatment with BC exceeded 2 years in 45% of cases and the average dose of BC was 19.27 mg/day. On the Hoehn and Yahr scale 70.8% of patients were classified as between stages II and IV, 24.6% were in stage I and 4.6% were in stage V. Dopa-induced involuntary movements were observed in 60% of patients at the beginning of the trial but were present in only 25% at the completion, due to the dopa-sparing effect of BC allowing a reduction of the dose of LD by an average of 34%. End-of-dose failure was reduced only slightly and on-off oscillations were not influenced by the addition of BC to LD. Tremor, rigidity, akinesia and dysarthria improved in 22% of all patients but BC offered no beneficial effect on the various gait disorders of Parkinson's disease. The conclusion of the study is that 47.7% of patients felt that the addition of BC to LD had reduced their involuntary movements and the disabilities of their disease.
这项开放性试验旨在研究在长期服用含多巴制剂（LD）的患者治疗中添加溴隐亭（BC）的效果。65名患者进入试验，平均年龄为66.6岁。帕金森病的平均病程为12.74年，其中一半患者服用LD超过10年，另有27%的患者服用超过5年。45%的病例使用BC治疗的时间超过2年，BC的平均剂量为19.27毫克/天。根据Hoehn和Yahr分级量表，70.8%的患者被归类为II至IV期，24.6%为I期，4.6%为V期。在试验开始时，60%的患者观察到多巴诱导的不自主运动，但在试验结束时仅25%的患者存在，这是由于BC的多巴节省效应使LD剂量平均减少了34%。剂量末期失效仅略有减少，而“开-关”波动不受在LD中添加BC的影响。所有患者中有22%的震颤、强直、运动不能和构音障碍有所改善，但BC对帕金森病的各种步态障碍没有有益作用。该研究的结论是，47.7%的患者认为在LD中添加BC减少了他们的不自主运动和疾病残疾。
