OBJECTIVETo find out an effective therapy for Parkinson's disease.

METHODSSixty cases were randomly divided into an abdominal acupuncture group and a control group, 30 cases in each group. The abdominal acupuncture group were treated with Madopa and abdominal acupuncture at Zhongwan (CV 12), Xiawan (CV 10), Qi-hai (CV 6) and Guanyuan (CV 4), etc. ; and the control group were treated with Madopa.

RESULTSAfter treatment of 3 courses, the effective rate was 90.0% in the abdominal acupuncture group and 83.3% in the control group with a significant difference between the two groups (P<0.05).

CONCLUSIONAbdominal acupuncture combined with Madopa can elevate therapeutic effect of Madopa and reduce adverse effects of Madopa for the patient of primary Parkinson's disease.

Abdomen ; Acupuncture Therapy ; methods ; Adult ; Aged ; Benserazide ; therapeutic use ; Drug Combinations ; Female ; Humans ; Levodopa ; therapeutic use ; Male ; Middle Aged ; Parkinson Disease ; therapy

Acute Disease ; Adult ; Antidotes ; therapeutic use ; Antiparkinson Agents ; therapeutic use ; Benserazide ; Cholinesterase Inhibitors ; poisoning ; Humans ; Insecticides ; poisoning ; Levodopa ; therapeutic use ; Male ; Organophosphate Poisoning ; Parkinson Disease ; drug therapy ; pathology ; Pralidoxime Compounds ; therapeutic use ; Trihexyphenidyl ; therapeutic use

BACKGROUNDParkinson's disease (PD) is a complicated disease, commonly diagnosed among the elderly, which leads to degeneration of the central nervous system. It presently lacks an effective therapy for its complex pathogenesis. Adverse effects from Western drug-based medical intervention prevent long-term adherence to these therapies in many patients. Traditional Chinese medicine (TCM) has long been used to improve the treatment of PD by alleviating the toxic and adverse effects of Western drug-based intervention. Therefore, the aim of this study is to evaluate the efficacy and safety of Xifeng Dingchan Pill (XFDCP), a compound traditional Chinese herbal medicine, taken in conjunction with Western medicine in the treatment of PD patients at different stages in the progression of the disease.

METHODS AND DESIGNThis is a multicenter, randomized controlled trial. In total, 320 patients with early- (n = 160) and middle-stage PD (n = 160) will be enrolled and divided evenly into control and trial groups. Of the 160 patients with early-stage PD, the trial group (n = 80) will be given XFDCP, and the control group (n = 80) will be given Madopar. Of the 160 patients with middle-stage PD, the trial group (n = 80) will be given XFDCP combined with Madopar and Piribedil, and the control group (n = 80) will be given Madopar and Piribedil. The Unified Parkinson's Disease Rating Scale scores, TCM symptoms scores, quality of life, change of Madopar's dosage and the toxic and adverse effects of Madopar will be observed during a 3-month treatment period and through a further 6-month follow-up period.

DISCUSSIONIt is hypothesized that XFDCP, combined with Madopar and Piribedil, will have beneficial effects on patients with PD. The results of this study will provide evidence for developing a comprehensive therapy regimen, which can delay the progress of the disease and improve the quality of life for PD patients in different stages.

TRIAL REGISTRATIONThis trial has been registered in the Chinese Clinical Trial Registry with the identifer ChiCTR-TRC-12002150.

Benserazide ; therapeutic use ; Data Interpretation, Statistical ; Drug Combinations ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Levodopa ; therapeutic use ; Medicine, Chinese Traditional ; Parkinson Disease ; drug therapy ; psychology ; Phytotherapy ; Piribedil ; therapeutic use ; Quality of Life

Objective: To explore the clinical and genetic characteristics of children with dopa-responsive dystonia (DRD) caused by tyrosine hydroxylase (TH) gene variations. Methods: Clinical data of 9 children with DRD caused by TH gene variations diagnosed in the Department of Children Rehabilitation, the Third Affiliated Hospital of Zhengzhou University from January 2017 to August 2022 were retrospectively collected and analyzed, including the general conditions, clinical manifestations, laboratory tests, gene variations and follow-up data. Results: Of the 9 children with DRD caused by TH gene variations, 3 were males and 6 were females. The age at diagnosis was 12.0 (8.0, 15.0) months. The initial symptoms of the 8 severe patients were motor delay or degression. Clinical symptoms of the severe patients included motor delay (8 cases), truncal hypotonia (8 cases), limb muscle hypotonia (7 cases), hypokinesia (6 cases), decreased facial expression (4 cases), tremor (3 cases), limb dystonia (3 cases), diurnal fluctuation (2 cases), ptosis (2 cases), limb muscle hypertonia (1 case) and drooling (1 case). The initial symptom of the very severe patient was motor delay. Clinical symptoms of the very severe patient included motor delay, truncal hypotonia, oculogyric crises, status dystonicus, hypokinesia, decreased facial expression, and decreased sleep. Eleven TH gene variants were found, including 5 missense variants, 3 splice site variants, 2 nonsense variants, and 1 insertion variant, as well as 2 novel variants (c.941C>A (p.T314K), c.316_317insCGT (p.F106delinsSF)). Nine patients were followed up for 40 (29, 43) months, and no one was lost to follow-up. Seven of the 8 severe patients were treated by levodopa and benserazide hydrochloride tablets and 1 severe patient was treated by levodopa tablets. All the severe patients responded well to levodopa and benserazide hydrochloride tablets or levodopa tablets. Although the weight of the patients increased and the drug dosage was not increased, the curative effect remained stable and there was no obvious adverse reaction. One severe patient developed dyskinesia in the early stage of treatment with levodopa and benserazide hydrochloride tablets and it disappeared after oral administration of benzhexol hydrochloride tablets. Until the last follow-up, motor development of 7 severe patients returned to normal and 1 severe patient still had motor delay due to receiving levodopa and benserazide hydrochloride tablets for only 2 months. The very severe patient was extremely sensitive to levodopa and benserazide hydrochloride tablets and no improvement was observed in this patient. Conclusions: Most of the DRD caused by TH gene variations are severe form. The clinical manifestations are varied and easily misdiagnosed. Patients of the severe patients responded well to levodopa and benserazide hydrochloride tablets or levodopa tablets, and it takes a long time before full effects of treatment become established. Long-term effect is stable without increasing the drug dosage, and no obvious side effect is observed.
Female ; Humans ; Infant ; Male ; Benserazide/therapeutic use* ; Dystonia/genetics* ; Hypokinesia/drug therapy* ; Levodopa/pharmacology* ; Muscle Hypotonia ; Retrospective Studies ; Tyrosine 3-Monooxygenase/genetics*

OBJECTIVETo observe the effect of TCM treatment according to syndrome differentiation in en-hancing curative effect and reducing side-effect of madopa in patients with Parkinson' s disease (PD).

METHODSThe trial was conducted in 101 PD patients with a prospective stratified randomized and controlled method. They were assigned to group 1 in which the patients of rigidity were treated with Pabing Recipe 1 (PR1) plus Madopa tablets, group 2 with those of tremor given Pabing Recipe 3 (PR3) plus Madopa tablets, and group 3 given a fixed Chinese recipe plus Madopa tablets as the control. The treatment course for all the groups was 3 months. Clinical efficacy was evaluated with unified Parkinson's disease rating scale (UPDRS) and the adverse reactions observed before and after treatment.

RESULTSAfter treatment, the 4 partial scores and the total score of UPDRS decreased significantly in group 2 (P<0.01), and the former of them and the total score declined in group 1 and 3 (P<0.01), the improvement was better in group 1 and 2 than that in group 3 (P<0.01); the improvement rate in group 1 to 3 was 95.5%, 100.0% and 83.7%, respectively, which was significantly higher in group 1 and 2 than that in group 3 (P<0.05).

CONCLUSIONTCM treatment according to syndrome differentiation could improve the clinical symptoms and reduce complications in PD patients, which could enhance curative effect and reduce side-effect of madopa.

Aged ; Aged, 80 and over ; Benserazide ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Dopamine Agents ; adverse effects ; therapeutic use ; Drug Combinations ; Drug Synergism ; Drug Therapy, Combination ; Drug-Related Side Effects and Adverse Reactions ; etiology ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Levodopa ; adverse effects ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Parkinson Disease ; diagnosis ; drug therapy ; Phytotherapy ; Prospective Studies ; Syndrome ; Treatment Outcome