Quattrini A, Paggi A, Del Pesce M, Di Bella P
Riv Patol Nerv Ment. 1978 May-Jun;99(3):150-63.
Antiparkinsonian treatment with L-Dopa gives rise to a number of problems: I) lack of initial response in a few cases; II) side-effects; III) becoming less effective after the first few years of treatment. Consequently, various drugs have been tried to replace, or combine with, L-Dopa. Among those drugs bromocriptine has been described the most effective. Twelve patients suffering from severe parkinsonism, all being intolerant to L-Dopa, have been treated with Bromocriptine. They fell into stage V of the Hoehn and Yahr's scale after 8 days of complete withdrawal of therapy with L-Dopa. Benefit and side-effects have been assessed as follows: a) L-Dopa alone; b) bromocriptine alone; c) combination of a and b. A daily dose of 30 mg of bromocriptine was given for 4 months. This was then reduced to 15 mg with the addition of L-Dopa for another 4 months. The results were: I) bromocriptine scored higher in all patients except one; II) bromocriptine has been consistently less effective than L-Dopa; III) side-effects were similar to those of L-Dopa but less frequent; IV) the combined effect of the two drugs was superior to each drug given alone.
I)少数病例缺乏初始反应;II)副作用;III)治疗最初几年后疗效降低。因此,人们尝试了各种药物来替代左旋多巴或与左旋多巴联合使用。在这些药物中,溴隐亭被描述为最有效。12例患有严重帕金森病且均对左旋多巴不耐受的患者接受了溴隐亭治疗。在完全停用左旋多巴治疗8天后,他们的病情发展到了Hoehn和Yahr量表的V期。对疗效和副作用进行了如下评估:a)单独使用左旋多巴;b)单独使用溴隐亭;c)a和b联合使用。给予每日30毫克溴隐亭,持续4个月。然后减至15毫克,并加用左旋多巴,再持续4个月。结果如下:I)除1例患者外,溴隐亭在所有患者中的评分更高;II)溴隐亭的疗效始终低于左旋多巴;III)副作用与左旋多巴相似,但频率较低;IV)两种药物的联合效果优于单独使用每种药物。