A Study Of The Treatment Of Parkinson's Disease In Shandong Province

ObjectiveParkinson's disease(PD) is a kind of progressive neurodegenerative disease.The main clinical manifestations are static tremor,rigidity,bradykinesia and dysfunction of posture.It mainly occur in the aged people older than 65.A recent investigation shows that the morbidity rate is 1.7%in the people older than 65 in our country,which is similar to the west countries.Shandong is a province with a large number of population(more than 930 million).If we calculate with such a morbidity rate,there might be at least 100 thousands PD patients totally.As the mechanism of PD is unknown,the disease can not be cured.But proper medication can relieve the symptoms,improve the live standards and delay the complications. Furthermore,surgical approaches are available for advanced disease.As the disease progress,patients get less benefit from the drug therapy and motor complication will occur.PD not only bring harm to patients healthy,but also bring heavy economical burdens to their family and the whole society.Yet there is no investigation concerning the medication cost and the economical burden of PD in Shandong Province.We perform this study to offer basic theories to formulation related sanitation economic policy and disease prevention,and hope it will be useful to the clinical doctors.Methods1.There are 270 idiopathic Parkinson's Disease patients were recruited in this study.All these patients were from Qilu Hospital from March of 2008 to February of 2009.The diagnosis of PD referred to the UK PD Brain Bank criteria.The patients are all begin with unilateral symptoms.all of them received a investigation concerning their age,sex,occupation,living,course of disease,the drug in use and the dose.The investigator give a score according to the UPDRS and the Hoehn and Yahr staging,then have a statistical analysis about their drugs now in use,2.We divide all the patients into two groups,the Jinan group and the non-Jinan group,then according their course of disease divide each group into 4 subgroups,and doing comparisons about them.According to the characteristic of drugs used to treat the PD.in Shandong province,following drugs are in the scope of PD.-treating drugs: Madopar,Sinemet,Artane,Amantadine,Trastal,Sifrol,Comtan,those drugs as Coenzyme Q10 vitE and those Chinese traditional patent medicine as Yinxingye pian are not in the scope of this study.3.Statistic Manual:The data were analyzed using SAS.7.0.Compare whether the drug fee of the sub-groups having the same course but from different areas having a statistical difference,then get a P value,A level of significance of P＜0.05 was used. determining whether the Jinan group and the non-Jinan group are different.Results:There are 153 PD.patients in the Jinan group,and 117 patients in the non-Jinan group.There are 264 patients using the levodopa preparation(Madopar or Sinemet),and 127 patients using dopamine agonist(Trastall or Sifrol).There are 195 patients using Madopar,82 patients using Sinemet,76 patients using Artane,107 patients using Trastall,21 patients using Sifrol,16 patients using Amantadine,15patients using Comtan,the using of dopamine agonist and Artane have a statistical difference between the Jinan group and the non-Jinan group (P＜0.05).With 1 to 3 years of the course of disease,the Jinan group spend 108.20±72.10 yuan every month in average,and the non-Jinan group spend about 108.20±36.72 yuan every month in average,there is no significant discrepancy between the two groups(P＞0.05).With 4 to 5 years of the course of disease,the Jinan group spend about 209.74±177.97yuan every month in average,and the non-Jinan group spend about 258.50±222.19 yuan every month in average,there is no significant discrepancy between the two groups(P＞0.05).With 6 to 7 years of the course of disease,the Jinan group spend 258.50±222.19 yuan every month in average,and the non-Jinan group spend 240.41±339.41 yuan every month in average,there is no significant discrepancy between the two groups(P＞0.05).With 8 years or more of the course of disease,the Jinan group spend 401.97±601.45 yuan every month in average,and the non-Jinan group spend 408.42±374.15 yuan every month in average,there is no significant discrepancy between the two groups(P＞0.05).In addition,during the investigation,wo discoved some unusual side effects,as Madopar causing dental ulcer to 3 patients,and aggravating arhythmia to other 3 patients,and Sinemet CR induced melanin mole to 4 patients,wo should pay attention to the side effects.Conclusion:By means of the study,we conclude that as the course of disease progressing,the kinds of the drugs used increased,the cost also increased.But there was no significant statistics discrepancy between the Jinan group and the non-Jinan group.