Soykan I, Sarosiek I, Shifflett J, Wooten G F, McCallum R W
Department of Medicine, University of Virginia, Charlottesville, USA.
Mov Disord. 1997 Nov;12(6):952-7. doi: 10.1002/mds.870120618.
This study investigated whether domperidone could improve gastrointestinal symptoms in patients with Parkinson's disease who were receiving levodopa therapy. A total of 11 patients were studied. Following a baseline gastric emptying test, patients were treated with a starting dose of domperidone 20 mg p.o. q.i.d. A follow-up gastric emptying test was repeated at least 4 months after starting domperidone therapy. At the beginning and at each 3-month follow-up visit, symptoms of nausea, vomiting, anorexia, abdominal bloating, heartburn, regurgitation, dysphagia, and constipation were evaluated and scored on a scale of 0-3. The overall mean follow-up period was 3 years. Compared with their baseline evaluation, patients experienced a significant improvement in all symptoms (p < 0.05) except dysphagia and constipation. Gastric emptying of an isotope-labeled solid meal was significantly faster, with a baseline result of 60.2 +/- 6.4% retention of isotope 2 h after the meal compared with 37.0 +/- 2.2% retention during domperidone therapy (p < 0.05). Patients' global assessment of Parkinson's disease remained stable or improved. Serum prolactin was elevated in all patients after domperidone therapy (p < 0.05). Domperidone therapy significantly reduces upper gastrointestinal symptoms and accelerates gastric emptying of a solid meal, but does not interfere with response to antiparkinsonism treatment.
本研究调查了多潘立酮是否能改善正在接受左旋多巴治疗的帕金森病患者的胃肠道症状。共研究了11例患者。在进行基线胃排空试验后，患者开始接受多潘立酮口服治疗，起始剂量为20毫克，每日4次。在开始多潘立酮治疗至少4个月后重复进行随访胃排空试验。在开始时以及每3个月的随访中，对恶心、呕吐、厌食、腹胀、烧心、反流、吞咽困难和便秘等症状进行评估，并按0 - 3分进行评分。总体平均随访期为3年。与基线评估相比，除吞咽困难和便秘外，患者所有症状均有显著改善（p < 0.05）。同位素标记固体餐的胃排空明显加快，餐后2小时同位素保留率基线结果为60.2±6.4%，而在多潘立酮治疗期间为37.0±2.2%（p < 0.05）。患者对帕金森病的整体评估保持稳定或有所改善。多潘立酮治疗后所有患者的血清催乳素均升高（p < 0.05）。多潘立酮治疗可显著减轻上消化道症状并加速固体餐的胃排空，但不干扰抗帕金森病治疗的反应。
