Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
Parkinsonism Relat Disord. 2009 Dec;15 Suppl 3:S224-32. doi: 10.1016/S1353-8020(09)70820-X.
Non-motor symptoms are increasingly recognized to adversely impact on the quality of life of patients with in Parkinson's disease (PD), particularly as the disease progresses. Autonomic symptom severity in patients with PD seems to correlate with older age, greater disease severity, psychiatric complications, sleep disorders, and higher doses of dopaminergic medication. The following therapeutic strategies are frequently used in the treatment of PD-related dysautonomia: 1. Orthostatic hypotension: fludrocortisone, midodrine, and droxidopa; 2. Sialorrhea: glycopyrrolate and botulinun toxin injections; 3. Constipation: symbiotic yogurt and bulking agents, macrogol, lubiprostone, mosapride citrate and tegaserod, pyridostigmine bromide, botulinum toxin injections and sacral nerve stimulation; 4. Urinary frequency: oxybutynin, tolterodine, solifenacin, darifenacin, botulinum toxin injections; 5. Erectile dysfunction: sildenafil and other phosphodiesterase type 5 inhibitors. More effective symptomatic and pathogenesis-targeted therapies are needed to ameliorate the non-motor symptoms of PD that usually do not respond well to dopaminergic medications.
非运动症状日益被认为会对帕金森病（PD）患者的生活质量产生不利影响，尤其是随着疾病的进展。PD 患者自主症状的严重程度似乎与年龄较大、疾病严重程度较高、精神并发症、睡眠障碍和较高剂量的多巴胺能药物有关。以下是治疗 PD 相关自主神经功能障碍的常用治疗策略：1. 直立性低血压：氟氢可的松、米多君和屈昔多巴；2. 流涎：格隆溴铵和肉毒毒素注射；3. 便秘：共生酸奶和膨松剂、聚乙二醇、鲁比前列酮、枸橼酸莫沙必利和替加色罗、溴吡斯的明、肉毒毒素注射和骶神经刺激；4. 尿频：奥昔布宁、托特罗定、索利那新、达非那新、肉毒毒素注射；5. 勃起功能障碍：西地那非和其他磷酸二酯酶 5 抑制剂。需要更有效的对症和针对发病机制的治疗方法来改善 PD 的非运动症状，这些症状通常对多巴胺能药物反应不佳。
