Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Brain diseases > Paralysis agitans syndrome

Analysis of Dose-effect Relationship of Pramipexole in the Treatment of Parkinson's Disease

Author ZhouZuoZuo
Tutor LiangZhanHua
School Dalian Medical University
Course Neurology
Keywords Parkinson’s disease dopamine agonists pramipexole Levodopaand Benserazide Hydrochlo-ride piribedil
CLC R742.5
Type Master's thesis
Year 2013
Downloads 32
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Objective: The purpose of this study is to research dose-effect relationship of thenew dopamine receptor agonist pramipexole added for the treatment of Parkinson’sdisease, and provide a more optimized treatment plan for the future treatment ofParkinson’s disease.Methords: Select the179cases patients with idiopathic Parkinson’s disease of theNeurology department of the First Affiliated Hospital of Dalian Medical Universityfrom March2011-December2012. The clinical diagnostic criteria are in line withParkinson’s disease diagnosis and treatment guidelines of2006Royal MedicalAssociation (UK-PDS). Exclusion criteria:Parkinson’s plus syndrome, essential tremorand PD symptoms caused by other diseases, HY stage five, severe liver and kidneyfunction insufficiency, patients with schizophrenia, allergy caused by pramipexole,levodopa,piribedil, can not be followed up regularly. Patients were divided into3groups: the first group of PD patients started treatment alone with oral pramipexole;Group2PD patients were treated with levodopa efficacy loss and severer motorsymptoms, added Pramipexole; Group3PD patients with previous oral levodopa andpiribedil due to severer motor symptoms, conversed to levodopa and pramipexole. UseUnified Parkinson’s Disease Rating Scale3.0I,II,III,IV part score changes before andafter treatment to analyze the efficacy of pramipexole. Futher, Group1,2patients weredivided into sub-group in accordance with the different doses of Pramipexole0.75mg,1.0mg,1.25mg,1.5mg,2.0mg, Group3patients were divided into sub-group inaccordance with the Pramipexole doses of Pramipexole1.0mg,1.25mg,1.5mg,2.0mg.Observe group1patients were treated with different doses of pramipexole, UPDRSI, II,III score changes compared with baseline.Observe group2and3patients were treatedwith different doses of pramipexole, UPDRSI II III, IV each part score changescompared with baseline, and then analyzes the different doses of pramipexole dose-response relationship in the treatment of Parkinson’s disease. The score of UPSRSobtaind by trained clinicians. The data obtained were analyzed with SPSS17.0software.Results: UPDRS various parts of the three groups of patients treated with differentdoses of pramipexole mean baseline score has no significant difference (P>0.05).UPDRS mean were decreased after treatment compared with baseline, the differencewas statistically significant (P <0.05).Group1: Group1patients were treated with different doses of pramipexole0.75mg,1.0mg,1.25mg,1.5mg,2.0mg the total UPDRSI mean score compared tobaseline were down0.58points,0.70points,0.72points,0.78points,0.80points, thedifference was not statistically significant (P>0.05); UPDRSII total mean scorecompared to baseline decreased by2.00,2.60,3.45,4.50,4.90, differences werestatisticallysignificant (P <0.05); UPDRSIII total mean score compared to baseline weredown1.75points,3.70,4.81,6.14,6.90, to compare differences were statisticallysignificant (P <0.05).Group2: Group2patients were treated with different doses of pramipexole0.75mg,1.0mg,1.25mg,1.5mg,2.0mg the total UPDRSI mean score compared tobaseline were down0.55points,0.93points,0.95points,1.61points,1.76points, thedifference was not statistically significant (P <0.05); total score mean of the UPDRSIIcompared with baseline were down1.05points,2.06,2.66,2.27,3.60, differences werestatistically significant (P <0.05); UPDRSIII total mean score from baseline,respectively, compared dropped1.65points,2.93,4.75,6.50,7.06, differences werestatistically significant (P <0.05); UPDRSIV total mean score compared to baselinewere down0.35points,0.80points,0.58points,0.88points,0.93points, the differencewas not statistically significant (P>0.05).Group3: Group3patients were treated with different doses of Pramipexole1.0mg,1.25mg,1.5mg,2.0mg the total UPDRSI mean score compared to baseline were down0.82points,0.85points,1.22points,1.71points differences were statisticallysignificant (P <0.05); total score mean of the UPDRSII compared with baselinedecreased2.37points,3.14points,5.11points,5.57points difference was statisticallysignificant (P <0.05); UPDRSIII the total mean score compared to baseline were down3.50points,6.00points,8.22points,9.42points, compare the differences werestatistically significant (P <0.05); total score mean of the UPDRSIV compared withbaseline were down0.50points,0.71points,0.88points,0.85points, the difference wasnot statistically significant (P>0.05). Conclusion:1Pramipexole has the exact efficacy for the treatment of Parkinson’s disease asthe initial single used drug.2Levodopaand Benserazide Hydrochlo-ride as a initial drug treatment forParkinson’s disease, when decreased efficacy in conjunction pramipexole, can improvethe patient’s motor and non-motor symptoms.3. The piribedil and Levodopaand Benserazide Hydrochlo-ride as the treatment ofParkinson’s disease, due to the the decreased efficacy of Piribedil so converse toPramipexole, motor and non-motor symptoms improved, shows that Pramipexole ismore effective than piribedil.4. With the increased dose of Pramipexole in patients with Parkinson’s disease,motor symptoms and activities of daily living improved more significantly,;mental,behavioral and emotional improvement probably have relationship with dose ofPramipexole,;the improvement of the treatment of complications have no relationshipwith dose of pramipexole.

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