Clinical Research On The Treatment Of L-dopa Induced Dyskinesia

Objective The first reason why we observed the clinical effect of zhichan decoction Parkinson's disease(PD)with dyskinesia is to provide the basis for the treatment of Parkinson's disease with dyskinesia by Chinese medicine.The second one is to expand the scope of application of zhichan decoction,and to lay a foundation for the further exploration of Chinese and Western medicine treatment of L-dopa induced dyskinesia(LID)in the future as well.Methods In this study,patients with L-dopa induced dyskinesia were selected as the research subjects by using random method,double-blind method,placebo parallel control method.The pharmaceutical company generated random numbers,prepared blind bases for trials and safely filed them.After confirming that the subjects met the criteria for inclusion or exclusion,the researchers allocated the coded drugs,including zhichan decoction as the treatment group and zhichan decoction placebo as the control group,according to the order of the subjects in the group.At the same time,all the patients continued to use their original anti-Parkinson's disease drugs(Madopa or Sinemet)after enrollment.The treatment period was 12 weeks for all the patients.Before treatment,4 weeks±4 days,8 weeks±4 days and 12 weeks±4 days after treatment respectively,we evaluated the severity of Parkinson's disease motor symptoms and L-dopa induced dyskinesia by Unified Score III and IV-A(UPDRS III and UPDRS IV-A),evaluated the severity of L-dopa induced dyskinesia by the involuntary motor scale(AIMS),and evaluated the symptom change of TCM tremor syndrome by scoring method of dysfunction of senile tremor syndrome in Traditional Chinese Medicine.And I carefully observed and recorded the adverse reactions of medication,and completed the case observation tables as well.Then the blindness data were collected,and the results were analyzed by SPSS21.00 statistical software.The curative effect of zhichan decoction and zhichan decoction placebo on the symptoms ofParkinson's disease and the improvement of TCM syndromes were compared.Results(1)A total of 80 cases of L-dopa induced dyskinesia were collected: 40 cases in the treatment group and 40 cases in the control group.In the course of treatment,75 cases were actually completed: 37 cases in the treatment group,3 cases in the abscission group,38 cases in the control group and 2 cases in the abscission group.The abscission rate was 6.25%.(2)UPDRS III score: There was statistical significance between the treatment group and the control group after treatment(P < 0.05).It can be concluded that the therapeutic effect of the treatment group on Parkinson's motion symptoms was better than that of the control group.There was statistical significance in the treatment group in each period(P < 0.01).It can be concluded that the treatment group had significant improvement on Parkinson's motion symptoms,and the longer was the treatment time,the more significant was the curative effect.There was statistical significance between the two groups at the 8th and 12 th week after treatment(P < 0.01).It can be concluded that the therapeutic effect of the treatment group on Parkinson's disease motor symptoms after the 8th week was significantly better than that of the control group.(3)UPDRS IV-A score: There was statistical significance between the treatment group and the control group after treatment(P < 0.05).It can be concluded that the treatment group was better than the control group in the treatment of L-dopa induced dyskinesiaa.There was statistical significance in the treatment group in each period(P <0.01).It can be concluded that the treatment group had a significant improvement in L-dopa induced dyskinesia,the longer was the treatment time,the more significant was the curative effect.There was statistical significance between the two groups at the 8th and 12 th week(P < 0.01).It can be concluded that the therapeutic effect of the treatment group on L-dopa induced dyskinesia after the 8th week was significantly better than that of the control group.(4)AIMS score: There was statistical significance between the treatment group and the control group after treatment(P < 0.05).It can be concluded that the treatment group was better than the control group in improving the symptoms of involuntary movement.There was statistical significance in the treatment group in each period(P < 0.01).It can be concluded that the treatment group had a significant improvement in the symptoms of involuntary movement,and the longer the treatment time was,the more significant the effect was.There was statistical significance between the two groups at the 8th and12 th week(P < 0.01).It can be concluded that the therapeutic effect of the treatment group on involuntary motor symptoms after 8 weeks was significantly better than that of the control group.(5)TCM elderly tremor dysfunction scale: There was statistical significance between the treatment group and the control group after treatment(P < 0.05).It can be concluded that the treatment group was better than the control group in improving the curative effect of TCM tremor.There was statistical significance in the treatment group in each period(P < 0.01).It can be concluded that the treatment group had significant improvement on TCM tremor syndrome,and the longer the treatment time was,the more significant the curative effect was.There was statistical significance between the two groups at the 4th,8th and 12 th week after treatment(P < 0.05).It can be concluded that the treatment group had better effect on TCM tremor syndrome than the control group after the 4th week.(6)The evaluation of clinical effectiveness: There was statistical significance between the two groups(P < 0.01).It can be concluded that the treatment group had a more significant effect on improving the overall efficacy and involuntary motor symptoms of L-dopa induced dyskinesia than the control group.(7)The evaluation of the curative effect of TCM syndromes:there was statistical significance between the two groups(P < 0.01).It can be concluded that the treatment group had a more significant effect on improving TCM tremor than the control group.Conclusion Zhichan decoction can improve the motor symptoms of Parkinson's disease and its concurrent dyskinesia symptoms.It can also improve the TCM symptoms of L-dopa induced dyskinesia,and it is safe,non-toxic and has no side effects in the course of treatment.