目的 探討卡巴拉汀聯(lián)合左旋多巴治療帕金森病的臨床效果。方法 選擇2015年8月—2017年7月在北京市隆福醫(yī)院就診的帕金森病患者126例，隨機(jī)分成對(duì)照組（63例）和治療組（63例）。對(duì)照組口服左旋多巴片，初始劑量為250 mg/次，3次/d，隨后依據(jù)患者病情和耐受程度，每5～7天增加劑量100～750 mg，最大劑量低于6 g，并分成4～6次服用。治療組在對(duì)照組基礎(chǔ)上口服重酒石酸卡巴拉汀膠囊，3 mg/次，2次/d。兩組患者均連續(xù)治療12周。比較治療前后兩組患者帕金森病評(píng)分量表（UPDRS）、自主神經(jīng)癥狀量表（SCOPT-AUT）評(píng)分、臨床痙攣指數(shù)（CSI）評(píng)分、多巴胺轉(zhuǎn)運(yùn)體（DAT）活性和生活質(zhì)量評(píng)分。比較兩組左旋多巴片的用量情況。結(jié)果 治療后，兩組患者UPDRS評(píng)分和CSI各項(xiàng)指標(biāo)評(píng)分較治療前顯著降低，SCOPT-AUT評(píng)分和WHO生存質(zhì)量量表各領(lǐng)域得分均顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些評(píng)分明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者患側(cè)DAT活性均較治療前明顯降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05），但治療組降低幅度小于對(duì)照組（P<0.05）。治療后，對(duì)照組健側(cè)DAT活性明顯降低（P<0.05）。對(duì)照組患者每日左旋多巴片用量為0.75～5.85 g，平均用量（3.74±0.95）g；治療組每日左旋多巴片用量為0.75～4.68g，平均用量（2.25±0.57）g，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 卡巴拉汀聯(lián)合左旋多巴治療帕金森病可有效改善患者肌強(qiáng)直，療效確切。

Objective To investigate the clinical effect of rivastigmine combined with levodopa in treatment of Parkinson disease. Methods Patients (126 cases) with Parkinson disease in Beijing Longfu Hospital from August 2015 to July 2017 were randomly divided into control (63 cases) and treatment (63 cases). Patients in the control group were po administered with Levodopa Tablets, the initial dosage was 250 mg/time, three times daily, then increased by 100-750 mg for every 5-7 d based on patient's condition and tolerance, and the max dosage was less than 6 g for 4-6 times. Patients in the treatment group were po administered with Rivastigmine Hydrogen Tartrate Capsules on the basis of the control group, 3 mg/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, UPDRS, SCOPT-AUT and CSI scores, DAT activity and the quality of life in two groups before and after treatment were compared. The dosage of Levodopa Tablets in two groups was compared. Results After treatment, the UPDRS and CSI scores in two groups were significantly decreased, but the SCOPT-AUT and WHOQOL-BREF scores were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these scores in the treatment group after treatment were significantly better than those in the control group (P < 0.05). After treatment, the DAT activity of lesion side in two groups was significantly decreased, and there were differences in the same group (P < 0.05). And the decreasing extant in the treatment group after treatment was significant lower than that in the control group (P < 0.05). After treatment, the DAT activity of the other side in the control group was significantly decreased (P < 0.05). The daily dosage of Levodopa Tablets in the control group was 0.75-5.85 g, and the average dosage was (3.74±0.95) g. The daily dosage of Levodopa Tablets in the treatment group was 0.75-4.68 g, and the average dosage was (2.25±0.57) g, and there were differences between two groups (P < 0.05). Conclusion Rivastigmine combined with levodopa can effectively improve myotonic rigidity in treatment of parkinson disease with exact effect.