Schapiro Randall T
The Schapiro Multiple Sclerosis Advisory Group and Clinical Professor of Neurology, University of Minnesota, USA.
Ann Indian Acad Neurol. 2009 Oct;12(4):291-5. doi: 10.4103/0972-2327.58278.
The management of multiple sclerosis (MS) revolves around disease management, symptom management, and person management. Of these, symptom management takes up the bulk of the time of the practicing physician. Some symptoms are easily managed whereas others are more difficult. Decisions have often to be made on whether to treat or to wait and watch. This article discusses the varied symptoms of MS and the approaches to management, which involves rehabilitation, pharmacological treatments, and surgical procedures. The skilled physician managing MS should be familiar with the multiple approaches to improving the quality of life of those with MS. After the diagnosis has been established and the decisions regarding treatment approaches have been made, the talk in a typical office appointment for MS usually turns to symptom management. Thus, the majority of management decisions made by the clinician revolve around that important topic. It is symptom management that will determine quality of life for those with MS, It is the basis for improving function, and, up until twenty years ago, it was the only basis for treating MS. Now, however, we can approach treatment by disease management, symptom management, and person management. The MS specialist must be well versed in all three areas.
多发性硬化症(MS)的管理围绕疾病管理、症状管理和患者管理展开。其中,症状管理占据了执业医师的大部分时间。有些症状易于管理,而有些则更具挑战性。通常需要决定是进行治疗还是等待观察。本文讨论了MS的各种症状以及管理方法,这包括康复、药物治疗和外科手术。擅长管理MS的医生应熟悉多种提高MS患者生活质量的方法。在确诊并做出关于治疗方法的决定后,MS患者在典型门诊预约中的谈话通常会转向症状管理。因此,临床医生做出的大多数管理决策都围绕这一重要主题。正是症状管理决定了MS患者的生活质量,它是改善功能的基础,并且直到二十年前,它还是治疗MS的唯一依据。然而现在,我们可以通过疾病管理、症状管理和患者管理来进行治疗。MS专家必须精通所有这三个领域。