普拉克索治疗原发性不宁腿综合征的临床研究

目的观察普拉克索治疗原发性不宁腿综合征(RLS)的效果和安全性。方法选择自2009年11月至2011年11月在我院就诊的28例原发性RLS患者,给予普拉克索0.125～0.75mg,持续治疗12周。利用国际RLS研究小组的RIS严重程度量表(IRIS)对患者治疗前后的IRLS症状严重程度进行评估,并对结果进行统计学分析。结果治疗后患者的IRIS评分较治疗前明显降低,比较差异有统计学意义(P<0.05)。结论普拉克索治疗原发性RLS是安全有效的。目的观察普拉克索治疗原发性不宁腿综合征(RLS)的效果和安全性。方法选择自2009年11月至2011年11月在我院就诊的28例原发性RLS患者,给予普拉克索0.125～0.75mg,持续治疗12周。利用国际RLS研究小组的RIS严重程度量表(IRIS)对患者治疗前后的IRLS症状严重程度进行评估,并对结果进行统计学分析。结果治疗后患者的IRIS评分较治疗前明显降低,比较差异有统计学意义(P<0.05)。结论普拉克索治疗原发性RLS是安全有效的。     

不宁腿综合征治疗药物加巴喷丁恩那卡比

不宁腿综合征为临床常见中枢神经系统感觉运动障碍性疾病,发病机制尚不明确,可能与遗传因素或多巴胺能系统功能失调有关。加巴喷丁恩那卡比最初由美国XenoPort公司研发,之后由英国葛兰素史克公司通过并购获得,临床试验验证了其治疗不宁腿综合征的有效性。综述了加巴喷丁恩那卡比的研发背景、合成方法、药理学、药动学、临床评价、安全性和耐受性等研究进展,以期为临床上更好地应用提供依据。     

普拉克索治疗原发性不宁腿综合征临床观察

目的:观察普拉克索治疗原发性不宁腿综合征的疗效及安全性。方法:21例原发性不宁腿综合征患者应用普拉克索逐步加量治疗的方法,采用自身前后对照,以不宁腿严重程度量表(IRLS)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)评估疗效。结果:治疗后21例患者的IRLS、PSQI、HAMA分值较治疗前均有不同程度的下降,差异有统计学意义(P<0.05)。结论:普拉克索治疗原发性不宁腿综合征疗效较好,不良反应相对轻微,对老年不宁腿综合征患者较适合。     

不宁腿综合征及其药物治疗

不宁腿综合征(RLS)是一种常见的神经系统感觉运动障碍性疾病,其发病机制尚不完全清楚,但中枢神经系统铁相对缺乏引起的多巴胺能系统功能失调与RLS的发病密切相关。对于继发性RLS,应首先治疗原发病;对于中、重度原发性RLS, 需要药物对症治疗。目前,口服多巴类药物是RLS的一线治疗方法,尤以口服小剂量多巴胺受体激动剂为首选。多巴胺受体激动剂能最大限度地改善症状,且耐受性良好;可避免由左旋多巴引起的晨间症状反跳和症状加重。选用合理、规范、适时、正确的药物治疗,可改善绝大部分RLS患者的症状,减少周期性肢动,改善睡眠障碍,提高生活质量。     

不宁腿综合征的研究进展

不宁腿综合征（Restlesslegssyndrome，RLS）是近几年再次引起国内外倍加重视的常见、多发病。由于该征的主要临床表现多集中在小腿深部强烈地异样不适感，休息或夜晚睡眠时加重，活动后暂时缓解，故有“胫骨不安症”、“腿部神经过敏”、“无力性脚感觉异常”、“肌性焦虑”、“夜间阵挛综合征”等诊断名称，１９４５年Ekbom对５０００人调查和１７５例复习总结后提出RLS诊断命名延用至今。但该综合征的多因素性和缺乏专科识别性，往往归因于失眠症、精神紧张、关节炎、神经质或老化性改变。随着病理生理学、分子生物学、药理学和神经…     

普拉克索治疗不宁腿综合症的疗效研究

目的探讨普拉克索对不宁腿综合症(RLS)患者治疗的临床疗效。方法将30例患者随机分为对照组和治疗组,两组为继发性RLS患者均治疗原发病,同时给予非药物治疗和氯硝西泮,治疗组在上述治疗的基础上加用普拉克索,以治疗前后匹兹堡睡眠质量指数(PSQI)和RLS严重程度量表(IRLSSG)评分进行评估疗效。结果两组治疗后PSQI和IRLSSG评分明显降低,组内和组间比较差异均有统计学意义(P<0.05)。结论普拉克索治疗RLS有效,值得临床应用。     

中药治疗原发性不宁腿综合征疗效观察

目的探索原发性不宁腿综合征的治疗方案。方法应用纯中药口服治疗原发性不宁腿综合征,观察其治疗效果。结果20例患者中,治愈9例,好转11例,无效0例,总有效率100%。结论应用中药口服治疗原发性不宁腿综合征疗效确切,值得推广。     

米氮平致不宁腿综合征分析

目的总结米氮平致不宁腿综合征的诊治经验。方法回顾分析13例米氮平治疗抑郁症致不宁腿综合征的识别、治疗及转归情况。结果米氮平致不宁腿综合征以双下肢感觉异常为突出表现,静息时出现或加重,活动及被动运动症状缓解或消失,夜间症状突出而导致睡眠障碍,加重病人焦虑抑郁症状,使病人对米氮平依从性差。结论米氮平致不宁腿综合征诊断主要依据特征性的临床表现,其发生率较高,但易被误诊漏诊,及时发现利于调整治疗方案。     

不宁腿综合征病因机制及治疗进展

不宁腿综合征(Restless legs syndrome,RLS)是一种常见的中枢神经感觉运动障碍性疾病。该病发病机制和病理生理尚未完全明了,且其诊断及治疗各异。因此,笔者收集了近些年国内外的医学文献,从RLS的发病机制、诊断、治疗进展进行综述。     

不宁腿综合征和周期性肢体运动的研究进展

不宁腿综合征(restless legs syndrome,RLS)和周期性肢体运动(periodic limb movement,PLM)同属临床上常见的睡眠障碍性疾患,其临床症状相似,以休息时下肢出现感觉异常,夜间症状明显,活动后症状暂时缓解为主要表现,这两种疾病临床上极为容易误诊、漏诊。现综述如下。1概述RLS主要表现为睡眠或安静时下肢的不适感觉,如刺痛、蚁走感、烧灼感、瘙痒等,活动下肢后可以部分或者完全缓解     

Cost-effectiveness of licensed treatment options for restless legs syndrome in the UK and Sweden

ABSTRACT

Objective: To estimate the cost-effectiveness of pramipexole versus no treatment and ropinirole in moderate to very severe idiopathic restless legs syndrome (RLS) in the UK and Sweden.

Methods: A Markov model was developed using clinical trial data for pramipexole and ropinirole. Model health states were based on the International RLS Study Group Rating Scale (IRLS) scores. Health states were: no (IRLS 0), mild (IRLS 1–14), moderate (IRLS 15–24), severe (IRLS 25–34), very severe RLS (IRLS 35–40) and death. Patients entered the model with an IRLS score?>?15 matching the trial inclusion criteria of the pramipexole trials. Resource use and utilities were based on trial data, literature, a patient survey and a panel of physicians from the UK and Sweden in the absence of published information. A healthcare sector perspective was taken for the UK and a societal perspective for Sweden using 2004–2005 unit costs. The base case analysis took a 1-year timeframe.

Results: In the UK the incremental cost per quality-adjusted life year (QALY) for pramipexole was £3349 versus no treatment and a cost-saving of £92 against ropinirole. In Sweden, pramipexole produced cost-savings of Swedish Krona (SEK) 2381 (£176) versus no treatment and SEK?3564 (£264) against ropinirole. QALY gains in both countries were 0.095 versus no treatment and 0.007 versus ropinirole. Results compare well with UK cost–effectiveness thresholds of £20?000/£30?000 per QALY and are cost-saving for Sweden. One-way and probabilistic sensitivity analyses showed results to be robust.

Conclusions: Pramipexole is cost-effective compared to no treatment and ropinirole for patients with moderate to very severe RLS.     

Ropinirole treatment for restless legs syndrome

Background: Restless legs syndrome (RLS) is a chronic neurological disorder associated with sleep disturbance. Objective: Prepare a drug evaluation of the non-ergot dopamine agonist ropinirole in RLS. Methods: Review of scientific literature on RLS, particularly focusing on treatment with ropinirole. Conclusion: Ropinirole has been studied for treatment of moderate to severe primary RLS in a comprehensive clinical development program. Ropinirole significantly improved symptoms of RLS, versus placebo, in patients with primary RLS. These improvements are supported by data from individual studies and pooled analyses. Significant improvements in RLS symptoms were observed within two nights of treatment. Ropinirole also produced significant benefits on objective measures of RLS motor symptoms, such as periodic leg movements, and subjective measures of sleep. Ropinirole was generally well tolerated.     

运动疗法在血液透析不宁腿综合征治疗中有效性的Meta分析

目的 系统分析运动疗法在血液透析不宁腿综合征治疗中的有效性.方法 依据PICOS原则通过电子检索和人工检索综合检索公开发表的中文或英文相关运动治疗血液透析不宁腿综合征的随机对照试验文献,检索年限均为建库至2015年5月.按照纳入标准和排除标准筛选文献,提取资料和进行质量评价后,采用RevMan5.1软件进行分析.结果 纳入4个随机对照试验,Meta分析结果显示:(1)运动可有效改善病人不宁腿综合征量表积分,和对照组相比有统计学意义[WMD=-7.29,95%CI(-10.33,-4.24),P<0.00001].(2)负荷运动可有效改善病人ZUNG抑郁量表积分,和对照组相比有统计学意义[WMD=-6.27,95%CI(-9.53,-3.00),P=0.0002].(3)负荷运动可有效改善病人Epworth嗜睡量表评积分,和对照组相比有统计学意义[WMD=-1.32,95%CI(-2.50,-0.14),P=0.03].(4)负荷运动可有效改善病人SF-36量表心理维度积分,和对照组相比无统计学意义[WMD=12.02,95%CI(-1.20,-25.23),P=0.07],心理维度积分,和对照组相比无统计学意义[WMD=17.76,95%CI(-2.23,37.75),P=0.08].结论 该系统评价结果显示,运动可有效改善血液透析不宁腿综合征病人的症状、改善抑郁及睡眠质量,但在改善生活质量方面缺乏足够证据.未来应开展大样本、多中心的、双盲的随机对照试验,并增加相关终点指标的研究.     

Clinical experience with pramipexole in the treatment of restless legs syndrome

Pramipexole is a non-ergoline dopamine agonist with a high selectivity for D(2) and D(3) receptors. Initially approved for Parkinson's disease, it was approved by the FDA and EMEA in 2006 for the treatment of idiopathic restless legs syndrome in adults. A single oral dose of pramipexole of between 0.125 and 0.750 mg, taken 2 - 3 h before bedtime, is usually able to control sensory symptoms and motor signs of restless legs syndrome. In clinical practice, tailoring pramipexole treatment based on demographic and clinical characteristics of patients is recommended. In addition, pramipexole seems to be safe and well tolerated. Augmentation, the most common side effect of levodopa, is less prevalent after treatment with pramipexole. In addition, the recurrence of unpleasant symptoms due to pramipexole is uncommon.     

Pramipexole for the treatment of restless legs syndrome

Restless legs syndrome (RLS) is a common disorder that is estimated to affect 10% of Americans. However, it remains largely undiagnosed and untreated by clinicians. The primary symptoms of this condition are leg discomfort or an urge to move that is temporarily relieved by movement and is worse at rest and at bedtime. RLS impacts the quality of life of the sufferer by disrupting sleep and disturbing or curtailing work and social activities. Approximately 80% of RLS sufferers also have periodic limb movements during sleep, in which repetitive leg movements fragment sleep and may result in daytime drowsiness. RLS may be treated by dopaminergic agents, benzodiazepines, anticonvulsants and opiates; dopamine agonists are currently considered first-line therapy for this condition. Pramipexole has been studied in the treatment of RLS since 1998. This article reviews the role of this medication in the management of this serious neurological disorder.     

Diagnosing restless legs syndrome (RLS) in primary care

SUMMARY

This paper represents a review of current opinion and information on the effective diagnosis of restless legs syndrome (RLS) in a primary care setting. RLS can be a distressing condition - it can cause serious sleep disturbance and has a significant impact on quality of life comparable to that of depression or type 2 diabetes. The prevalence of adults whose RLS is severe enough to warrant medical advice has been estimated to be approximately 3%, but only a small proportion of these patients currently report having been diagnosed in primary care, despite stating that they have presented to their GP. The benefits of increased understanding of the symptoms of RLS and how patients present in primary care are discussed, with emphasis on how this will help GPs more effectively diagnose and manage the patients affected. Guidelines on how to diagnose RLS in a primary care setting are given - when a patient presents with sleep disturbance, RLS should be routinely considered and, where existing, be readily diagnosed in a primary care setting on the basis of the patient's clinical history, a physical examination and with the aid of four questions based on the International RLS Study Group (IRLSSG) four essential diagnostic criteria.     

普拉克索联合持续正压通气对阻塞性睡眠呼吸暂停低通气综合征合并不宁腿综合征患者睡眠障碍的影响

目的观察普拉克索联合持续正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并不宁腿综合征(RLS)患者睡眠障碍的影响。方法将40例OSAHS合并RLS患者随机分为对照组和观察组,每组20例。对照组在CPAP治疗基础上加用安慰剂,每晚1次;观察组在CPAP治疗基础上加用普拉克索0.125 mg,每晚1次。疗程6 mo。比较2组治疗前后睡眠呼吸紊乱指数(AHI)、周期性腿动指数(PLMI)、腿动指数(LMI)、国际不宁腿量表(IRLS)评分和Epworth嗜睡量表(ESS)评分。结果 2组治疗后各指标均较治疗前有显著下降(P<0.05,P<0.01),治疗后AHI、PLMI、LMI在组间有非常显著差异(均P<0.01)。对照组和观察组IRLS评分(12.00±3.13 vs.7.00±2.13)和ESS评分(3.51±1.28 vs.6.39±1.35)组间比较均有非常显著差异(P<0.01)。结论普拉克索联合CPAP治疗OSAHS合并RLS患者睡眠障碍安全、有效。