{"id":4041,"date":"2019-03-07T14:59:00","date_gmt":"2019-03-07T07:59:00","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=4041"},"modified":"2019-03-07T15:28:46","modified_gmt":"2019-03-07T08:28:46","slug":"thu-nghiem-ngau-nhien-khoi-dau-muon-voi-levodopa-trong-dieu-tri-parkinson","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/thu-nghiem-ngau-nhien-khoi-dau-muon-voi-levodopa-trong-dieu-tri-parkinson\/","title":{"rendered":"Th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, kh\u1edfi \u0111\u1ea7u mu\u1ed9n v\u1edbi levodopa trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Parkinson"},"content":{"rendered":"<p>Levodopa (t\u00ean bi\u1ec7t d\u01b0\u1ee3c l\u00e0 <a href=\"https:\/\/www.vnras.com\/drug\/syndopa\">Syndopa<\/a>, <a href=\"https:\/\/www.vnras.com\/drug\/madopar\">Madopar<\/a> c\u1ee7a Roche) l\u00e0 thu\u1ed1c ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng cho b\u1ec7nh Parkinson. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh li\u1ec7u levodopa c\u00f3 th\u1ec3 l\u00e0m ch\u1eadm ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh hay kh\u00f4ng c\u00f3 th\u1ec3 gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng th\u1eddi \u0111i\u1ec3m th\u00edch h\u1ee3p \u0111\u1ec3 b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng levodopa.<\/p>\n<h2>Ph\u01b0\u01a1ng ph\u00e1p<\/h2>\n<p>Trong m\u1ed9t th\u1eed nghi\u1ec7m \u0111a trung t\u00e2m, m\u00f9 \u0111\u00f4i, c\u00f3 \u0111\u1ed1i ch\u1ee9ng v\u1edbi placebo v\u00e0 c\u00f3 kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb mu\u1ed9n, c\u00e1c b\u1ec7nh nh\u00e2n m\u1eafc Parkinson m\u1edbi kh\u1edfi ph\u00e1t \u0111\u01b0\u1ee3c ph\u00e2n ng\u1eabu nhi\u00ean v\u00e0o hai nh\u00f3m: Nh\u00f3m 1 (b\u1eaft \u0111\u1ea7u s\u1edbm) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng levodopa (100 mg x 3 l\u1ea7n\/ng\u00e0y) ph\u1ed1i h\u1ee3p v\u1edbi carbidopa (25 mg x 3 l\u1ea7n\/ng\u00e0y) trong v\u00f2ng 80 tu\u1ea7n; Nh\u00f3m 2 (b\u1eaft \u0111\u1ea7u mu\u1ed9n) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng placebo trong 40 tu\u1ea7n \u0111\u1ea7u, sau \u0111\u00f3 d\u00f9ng levodopa ph\u1ed1i h\u1ee3p carbidopa trong 40 tu\u1ea7n ti\u1ebfp theo.<\/p>\n<p>Ch\u1ec9 ti\u00eau ch\u00ednh c\u1ee7a nghi\u00ean c\u1ee9u l\u00e0 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111i\u1ec3m trung b\u00ecnh gi\u1eefa hai nh\u00f3m x\u00e9t t\u1eeb th\u1eddi \u0111i\u1ec3m tr\u01b0\u1edbc khi d\u00f9ng thu\u1ed1c \u0111\u1ebfn tu\u1ea7n \u0111i\u1ec1u tr\u1ecb th\u1ee9 80 t\u00ednh theo Thang \u0111\u00e1nh gi\u00e1 b\u1ec7nh Parkinson UPDRS (kho\u1ea3ng \u0111i\u1ec3m dao \u0111\u1ed9ng t\u1eeb 0 \u0111\u1ebfn 176, \u0111i\u1ec3m c\u00e0ng cao \u1ee9ng v\u1edbi b\u1ec7nh c\u00e0ng n\u1eb7ng).<\/p>\n<p>C\u00e1c ch\u1ec9 ti\u00eau kh\u00e1c bao g\u1ed3m s\u1ef1 c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng d\u1ef1a tr\u00ean thang UPDRS t\u1eeb tu\u1ea7n 4 \u0111\u1ebfn tu\u1ea7n 40 v\u00e0 s\u1ef1 kh\u00f4ng thua k\u00e9m c\u1ee7a vi\u1ec7c b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb s\u1edbm so v\u1edbi \u0111i\u1ec1u tr\u1ecb mu\u1ed9n t\u1eeb tu\u1ea7n 44 \u0111\u1ebfn tu\u1ea7n 80 v\u1edbi bi\u00ean \u0111\u1ed9 ch\u00eanh l\u1ec7ch 0,055 \u0111i\u1ec3m\/tu\u1ea7n.<\/p>\n<h2>K\u1ebft qu\u1ea3<\/h2>\n<p>Trong t\u1ed5ng s\u1ed1 445 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u00e2n ng\u1eabu nhi\u00ean: c\u00f3 222 b\u1ec7nh nh\u00e2n thu\u1ed9c nh\u00f3m b\u1eaft \u0111\u1ea7u s\u1edbm (nh\u00f3m 1) v\u00e0 223 b\u1ec7nh nh\u00e2n thu\u1ed9c nh\u00f3m b\u1eaft \u0111\u1ea7u mu\u1ed9n (nh\u00f3m 2). \u0110i\u1ec3m UPDRS trung b\u00ecnh (\u00b1 SD) \u1edf th\u1eddi \u0111i\u1ec3m tr\u01b0\u1edbc d\u00f9ng thu\u1ed1c c\u1ee7a nh\u00f3m 1 l\u00e0 28,1 \u00b1 11,4 \u0111i\u1ec3m v\u00e0 nh\u00f3m 2 l\u00e0 29,3 \u00b1 12,1 \u0111i\u1ec3m. S\u1ef1 thay \u0111\u1ed5i s\u1ed1 \u0111i\u1ec3m UPDRS c\u1ee7a 2 nh\u00f3m cho \u0111\u1ebfn tu\u1ea7n \u0111i\u1ec1u tr\u1ecb th\u1ee9 80 l\u1ea7n l\u01b0\u1ee3t l\u00e0 -1,0 \u00b1 13,1 \u0111i\u1ec3m v\u00e0 -2,0 \u00b1 13,0 \u0111i\u1ec3m (kh\u00e1c bi\u1ec7t: 1,0 \u0111i\u1ec3m; kho\u1ea3ng tin c\u1eady 95%: -1,5 &#8211; 3,5; p = 0,44); \u0111i\u1ec1u n\u00e0y cho th\u1ea5y kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea gi\u1eefa 2 nh\u00f3m \u1edf tu\u1ea7n 80, ngh\u0129a l\u00e0 levodopa kh\u00f4ng gi\u00fap l\u00e0m ch\u1eadm ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh Parkinson.<\/p>\n<p>Trong tu\u1ea7n 4 \u0111\u1ebfn tu\u1ea7n 40, t\u1ec9 l\u1ec7 c\u1ea3i thi\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng \u1edf hai nh\u00f3m (t\u00ednh theo \u0111i\u1ec3m UPDRS\/tu\u1ea7n) l\u1ea7n l\u01b0\u1ee3t l\u00e0 0,04 \u00b1 0,23 v\u00e0 0,06 \u00b1 0,34 (kh\u00e1c bi\u1ec7t: -0,02; kho\u1ea3ng tin c\u1eady 95%: -0,07 &#8211; 0,03). T\u1ec9 l\u1ec7 t\u01b0\u01a1ng t\u1ef1 t\u1eeb tu\u1ea7n 44 \u0111\u1ebfn tu\u1ea7n 80 l\u1ea7n l\u01b0\u1ee3t l\u00e0 0,10 \u00b1 0,25 v\u00e0 0,03 \u00b1 0,28 (kh\u00e1c bi\u1ec7t: 0,07; kho\u1ea3ng tin c\u1eady \u0111\u1ed1i x\u1ee9ng 90%: 0.03 &#8211; 0.10); k\u1ebft qu\u1ea3 n\u00e0y kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111\u01b0\u1ee3c ti\u00eau ch\u00ed v\u1ec1 hi\u1ec7u qu\u1ea3 kh\u00f4ng k\u00e9m h\u01a1n c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb s\u1edbm b\u1eb1ng levodopa so v\u1edbi khi \u0111i\u1ec1u tr\u1ecb mu\u1ed9n. T\u1ec9 l\u1ec7 g\u1eb7p r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng v\u00e0 nh\u1eefng thay \u0111\u1ed5i v\u1ec1 \u0111\u00e1p \u1ee9ng v\u1eadn \u0111\u1ed9ng li\u00ean quan \u0111\u1ebfn levodopa kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 gi\u1eefa hai nh\u00f3m.<\/p>\n<h2>K\u1ebft lu\u1eadn<\/h2>\n<p>\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n Parkinson giai \u0111o\u1ea1n s\u1edbm \u0111\u01b0\u1ee3c theo d\u00f5i trong v\u00f2ng 80 tu\u1ea7n, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng levodopa ph\u1ed1i h\u1ee3p v\u1edbi carbidopa kh\u00f4ng gi\u00fap l\u00e0m ch\u1eadm ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh.<\/p>\n<p>Ngu\u1ed3n: <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1809983\" rel=\"noopener\">https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1809983<\/a><\/p>\n<p>Ng\u01b0\u1eddi t\u1ed5ng h\u1ee3p: Nguy\u1ec5n Th\u1ecb Thu H\u00e0 &#8211; Thu Huy\u1ec1n.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Levodopa (t\u00ean bi\u1ec7t d\u01b0\u1ee3c l\u00e0 Syndopa, Madopar c\u1ee7a Roche) l\u00e0 thu\u1ed1c ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng cho b\u1ec7nh Parkinson. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh li\u1ec7u levodopa c\u00f3 th\u1ec3 l\u00e0m ch\u1eadm ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh hay kh\u00f4ng c\u00f3 th\u1ec3 gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng th\u1eddi \u0111i\u1ec3m th\u00edch h\u1ee3p \u0111\u1ec3 b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng levodopa. Ph\u01b0\u01a1ng ph\u00e1p Trong m\u1ed9t [&#8230;]\n","protected":false},"author":1,"featured_media":3059,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4041","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/4041","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=4041"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/4041\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/3059"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=4041"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=4041"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=4041"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}