Coelho Miguel, Ferreira Joaquim, Rosa Mário, Sampaio Cristina
Neurological Clinical Research Unit, Institute of Molecular Medicine, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal.
Expert Opin Pharmacother. 2008 Mar;9(4):523-35. doi: 10.1517/14656566.9.4.523.
Late-stage Parkinson's disease is characterised by patients dependent on caregivers for their activities of daily living, even under the best levodopa benefit. Non-motor signs that overcome the well-known motor signs of Parkinson's disease dominate late-stage Parkinson's disease and few systematic data exist for the treatment of these signs. The objective of this study was to review the treatment options for Parkinson's disease dementia, psychosis, falls, bone fractures, joint and skeletal deformities, pain, orthostatic hypotension, gastrointestinal abnormalities and urological dysfunction in late-stage Parkinson's disease. The study analysed the available controlled clinical trials for the above medical conditions. When absent, data from case series and the authors' own experience was considered. Few controlled clinical trials specifically addressed late-stage Parkinson's disease as a target population. There is a need for therapeutic data on the symptoms that most afflict late-stage Parkinson's disease patients.
晚期帕金森病的特点是，即使在左旋多巴疗效最佳的情况下，患者的日常生活活动仍需依赖照料者。在晚期帕金森病中，那些掩盖了帕金森病著名运动症状的非运动症状占据主导地位，而针对这些症状的治疗，系统数据很少。本研究的目的是回顾晚期帕金森病中帕金森病痴呆、精神病、跌倒、骨折、关节和骨骼畸形、疼痛、体位性低血压、胃肠道异常及泌尿功能障碍的治疗选择。该研究分析了针对上述病症的现有对照临床试验。若缺乏此类试验，则考虑病例系列数据及作者自身经验。很少有对照临床试验专门将晚期帕金森病作为目标人群。对于最折磨晚期帕金森病患者的症状，需要有治疗数据。
