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背景:原发性震颤是具有遗传倾向的运动障碍性疾病,治疗常用β-肾上腺素能受体阻滞剂,但是需要服用的药物剂量大,患者常不能坚持治疗。盐酸阿罗洛尔是一种兼有α受体阻断作用的β受体阻断剂,药物副作用小,在日本被认为是一种较理想的治疗原发性震颤的药物。目的:观察盐酸阿罗洛尔在中国人中治疗原发性震颤的疗效和安全性。设计:病例分析。单位:卫生部北京医院和解放军北京军区总医院的神经内科。对象:选择1999-04/2000-12在北京医院、解放军北京军区总医院神经内科门诊被诊断为原发性震颤的患者30例,男19例,女11例;年龄21～74岁,病程1～40年,平均(15.8±12.6)年。方法:对患者上肢、头部及下肢震颤程度、手的功能障碍程度、写字,画圈时手颤的程度、对震颤所致痛苦的主诉6项症状由专门医生在患者服药前及服药第2,4,6周分别评分。根据其程度分为轻度,中度和重度,分别记分为1分,2分,3分。评估标准:①显效:治疗前后的分数之差大于7分以上。②有效:治疗前后的分数之差为6.5～3分。③稍有效:治疗前后的分数之差为3～1.5分。④无变化:治疗前后的分数之差为1～-1分。⑤恶化:治疗前后的分数之差小于-1.5分。同时观察患者的血压,心率及药物的副作用。主要观察指标:①疗效评估结果。②治疗前后血压和心率。③不良事件和副反应。结果:30例患者均进入结果分析。①原发性震颤30例患者中,显效6例,有效11例,稍有效5例,无效7例,恶化1例。总有效率为73.4%。②治疗前平均血压为(138.5±14.6)/(84.2±6.4)mmHg(1mmHg=0.133kPa)。1个疗程结束后的平均血压为(130±10)/(79.7±6.3)mmHg。治疗前平均心率为(77.5±6.4)次/min,治疗后为(75±6.4)次/min。治疗前后比较,差异无显著性意义。③30例患者中有4例出现不同程度的副反应,占13.4%。1例服药后出现困倦感,1例服药后出现失眠,2例出现头胀头晕,其中1例自感震颤症状加重而退出治疗。结论:盐酸阿罗洛尔可明显改善患者的震颤症状,是治疗原发性震颤的有效药物,服用方便而且安全。
BACKGROUND: Essential tremor is a genetically motile disorder that treats beta-adrenergic receptor blockers, but doses of medications that are often taken are often beyond the patient’s treatment. Arotinolol, a β blocker with both α-receptor blockade and small drug side effects, is considered as an ideal drug for the treatment of essential tremor in Japan. Objective: To observe the efficacy and safety of arotinolol hydrochloride in the treatment of essential tremor in Chinese. Design: Case Analysis. SETTING: Department of Neurology, Beijing Hospital of Ministry of Public Health and Beijing Military Region General Hospital of People’s Liberation Army. PARTICIPANTS: Thirty patients, 19 males and 11 females, were selected from the Department of Neurology, Beijing Military Command General Hospital of Chinese PLA from April 1999 to December 2000 in 1999-04 / 2000-12. They were 21 to 74 years old with a course of 1 ~ 40 years, with an average of (15.8 ± 12.6) years. Methods: The patients’ upper extremities, head and lower extremities tremor, hand dysfunction, hand writing, the extent of hand tremor in the circle, the main complaint of the pain caused by tremor six symptoms by the specialists in patients before taking medication and medication 2 , 4 weeks and 6 weeks respectively. According to their degree is divided into mild, moderate and severe, were scored 1 point, 2 points, 3 points. Evaluation criteria: ① markedly effective: the difference between before and after treatment points greater than 7 points or more. ② effective: before and after treatment the difference between the scores of 6.5 to 3 minutes. ③ Slightly effective: the difference between before and after treatment was 3 to 1.5 points. ④ no change: the difference between before and after treatment is 1 ~ -1 points. ⑤ deterioration: the difference between before and after treatment is less than -1.5 points. At the same time observe the patient’s blood pressure, heart rate and side effects of drugs. MAIN OUTCOME MEASURES: ① Efficacy evaluation results. ② before and after treatment of blood pressure and heart rate. ③ adverse events and side effects. Results: All 30 patients entered the result analysis. ① Thirty patients with primary tremor were markedly effective in 6 cases, effective in 11 cases, slightly effective in 5 cases, ineffective in 7 cases, and deteriorated in 1 case. The total effective rate was 73.4%. ② The average blood pressure before treatment was (138.5 ± 14.6) / (84.2 ± 6.4) mmHg (1mmHg = 0.133kPa). The mean blood pressure after one course of treatment was (130 ± 10) / (79.7 ± 6.3) mmHg. The average heart rate before treatment was (77.5 ± 6.4) times / min and after treatment was (75 ± 6.4) times / min. Before and after treatment, the difference was not significant. ③30 patients had 4 cases of varying degrees of side effects, accounting for 13.4%. 1 patient had sleepy feeling after taking medicine, 1 patient had insomnia after taking medicine, 2 patients had bloating and dizziness, 1 patient exited the symptom of aggravating symptoms. Conclusion: Arotinolol can significantly improve the symptoms of tremor in patients and is an effective drug for the treatment of essential tremor. It is convenient and safe to take.