ABSTRACT
BACKGROUND:Patients with Parkinson disease (PD) are always supplied exogenous dopamine so as to balance a disproportion of neurotransmitter.However,a long-term administration may easily cause drug resistance;therefore,it is not able to solve nerve injuries at all.A lot of researches suggest that ganglioside can promote neural axon growth,improve neurotrophy,and resist cellular toxicity mediated by glutamic acid (GA).OBJECTIVE:To probe into the duration and effect of oraL administration of ganglioside on improving clinical symptoms of PD patients.DESIGN:Retrospective case analysis.SETTING:Department of Internal Medicine.Shanghai Electric Power Hospital;Departments of Neurosurgery and Internal Medicine,the First Affiliated Hospital of Kunming Medical College.PARTICIPANTS:A total of 6 344 PD patients were selected from Heilongjiang,Hebei,Shandong,Henan, Beijing,Jiangsu,Gansu,Qinghai.Guizhou,Fujian,Hunan,Shanxi, Hubei,Sichuan,Chongqing,Jiangxi, Shanghai and Yunnan from January 2001 to January 2005.All patients met the diagnostic and typing criteria of PD in Practical Neurology.They orally took≥10 mg/d ganglioside for more than 1 month,and all of them were provided the consent.METHODS:Patients who were treated with oral ganglioside accepted neural functional rehabilitation. Every oral solution of ganglioside contained 0.25 g/L ganglioside [including monosialoteterahexosyl ganglioside 1 (21%),diplo-sialoteterahexosyl ganglioside 1a(40%),diplo-sialoteterahexosyl ganglioside 1 b(16%),and tri-sialoteterahexosyl ganglioside 1b(19%)],and patients fastingly took two ampoules in every morning and 2 in every evening before sleeping, or took 4 ampoules in every evening before sleeping. Every 3 months was regarded as a course, and patients were always treated for two or three courses;especially,patients having a long-term duration were treated for above 4 courses.Regular follow-up was performed during the administration to observe the improvements of PD patients on the aspects of chatter, myotone, bradypraxia,posture irregularity, etc. Effective evaluation: Iilness improvements of PD patients who orally took ganglioside were observed within 3,6,9 months and 1 year.Excellent effective: Chatter and myotone disappeared after gradually stopping administration of dopamine preparation;improvement: Symptoms mentioned above were relieved after gradually reducing administration of dopamine preparation (effect=apparent effect+improvement);inefficacy:Symptoms mentioned above were not changed.MAIN OUTCOME MEASURES:Effect at various time Points of administration.RESULTS:Among 5 937 patients who met the inclusion criteria,all of them were involved in the final analysis without any loss.① Improvement of clinical symptoms at various time points of administration:There were 669 PD patients with the effective improvements within 1-3 months.941 within 4-6 months and 1713 within 7-12 months.The total effective rate was 56%.② Therapeutic effective rate of PD patients at various administrating times:The therapeutic effective rates of patients who received administration from 1 to 3 months,from 4 to 6 months and from 7 to 12 months were 30%,57%and 84%respectively.The rate was higher of patients administrated from 4 to 6 months than.of those from 1 co 3 months(P<0.05),and also higher of those from 7 to 12 months than of those from 4 tp 6 months and from 1 to 3 months (P<0.05,P<0.01).CONCLUSION:Ganglioside can effectively improve clinical symptoms,such as chatter,myotone,bradypraxia,posture irregularity,etc.In addition,it has a better effect during a long-term administration.