Observation Of Curative Effect Related To Entacapone’s Addition Treatment In The Middle And Advanced Parkinson’s Disease With Wearing-off

Objective:Estimate the curative effect of entacapone’s treatment in the middle and advanced Parkinson’s disease patients with wearing-off who have accepted the levodopa compound preparation.Methods:Form February 2015 to September 2016,41 Hoehn-Yahr phases 3~4patients who come from Neurology clinic of the Second Affiliated Hospital of Nanchang University were screened out to join the study.Add entacapone treatment of Parkinson’s disease patients who have accepted the levodopa compound preparation.Taking entacapone before and after sixth weeks,Twelfth weeks and twenty-eighth weeks to evaluate patients.The evaluation includes:“on”and“off”time;UPDRS part two and part three score;Non motor symptom screening scale(NMSS)score,evaluate NMSS only at taking entacapone before and after twenty-eighth weeks;levodopa compound daily dosage;adverse drug reaction.Results:After the entacapone’s addition at the sixth week,at the twelfth week,at the twenty-eighth week and the baseline interiew the“on”time were(8.41±2.17)h,(8.65±2.22)h,(8.96±2.32)h and(8.20±2.15)h,the“off”time were(7.92±2.45)h,(7.57±2.47)h,(7.14±2.31)and(8.04±2.36)h.The“on”and“off”time at the sixth week,at the twelfth week and at the twenty-eighth week comparing to the baseline interiew showned significant differences(P<0.05)after the entacapone’s addition.After the entacapone’s addition at the sixth week,at the twelfth week,at the twenty-eighth week and the baseline interiew the score of UPDRS part two were(17.27±8.31),(16.02± 8.89),(15.49±8.91)and(18.07±8.22),the score of UPDRS part three were(21.76±7.25),(20.59±6.92),(19.32±6.71)and(24.83±6.42).The score of UPDRS part two at the sixth week,at the twelfth week and at the twenty-eighth week comparing to the baseline interiew showned no significant differences(P>0.05)after the entacapone’s addition;The score of UPDRS part three at the sixth week,at the twelfth week and at the twenty-eighth week reduced comparing to the baseline interiew,shownedsignificant differences(P<0.05)after the entacapone’s addition.cardiovascular score,sleep and fatigue score,anxiety and depression score,hallucination and illusion score,attention and memory score,gastrointestinal symptom score,urinary symptom score,sexual function score,other items score and NMSS score at the twenty-eighth week were(2.7±1.6),(6.1±2.2),(8.9±3.8),(2.0±1.1),(6.9±2.8),(7.9±3.7),(4.5±2.6),(2.0±1.6),(7.7±3.4)and(48.6±21.5).at the baseline interiew were(2.6±1.3),(8.4±3.5),(13.2±4.3),(2.2±0.7),(7.3±3.2),(7.8±3.4),(5.3±3.2),(3.9±2.3),(8.2±3.5)and(58.8±23.4).The score of NMSS score,sleep and fatigue score,anxiety and depression score,sexual function score at the twenty-eighth week comparing to the baseline interiew showned significant differences(P<0.05)after the entacapone’s addition.The score of cardiovascular score,hallucination and illusion score,attention and memory score,gastrointestinal symptom score,urinary symptom score,other items score at the twenty-eighth week comparing to the baseline interiew showned no significant differences(P>0.05)after the entacapone’s addition.After the entacapone’s addition at the sixth week,at the twelfth week,at the twenty-eighth week and the baseline interiew levodopa compound daily dosage were(528.25±157.72)mg/d,(517.34±162.27)mg/d,(532.68±178.83)mg/d and(536.27±153.46)mg/d.levodopa compound daily dosage at the sixth week,at the twelfth week and at the twenty-eighth week reduced8.02 mg,18.93 mg,3.59 mg than that at baseline nteriew after the entacapone’s addition(all P>0.05).Of the 41 patients who completed the study,we observed 2 cases of patients with dizziness headache,4 cases of patients with nausea and vomiting,6cases of patients with urine color change,4cases of patients with dyskinesia.Conclusion: entacapone’s treatment in the middle and advanced PD patients with wearing-off could prolong “on”time and shorten“off”time;decrease the score of UPDRS part three,improve the symptoms of PD patients;Some non-motor symptoms such as sleep and fatigue,anxiety and depression,sexual function have certain improvement effect.The tolerance of entacapone’s treatment in this study was well,and the adverse reaction was not much.