Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
BMJ. 2014 Dec 19;349:g6258. doi: 10.1136/bmj.g6258.
Parkinson's disease is one of the most common neurodegenerative disorders seen in the United States and United Kingdom. The disease is characterised by two processes-cellular degeneration and the resulting biochemical deficiency of dopamine. Although these processes are inter-related, they are approached separately in the clinical setting. Currently, no proven neuroprotective or disease modifying treatment is available for Parkinson's disease. Several agents can be used to treat the motor symptoms associated with dopamine deficiency, and it is important to choose wisely when starting treatment. Drugs can have mild, moderate, or high potency, and the patient's goals, comorbidities, and the short and long term implications of choosing a specific agent should be taken into account when selecting the appropriate agent. Non-motor symptoms, such as depression, fatigue, and disorders of sleep and wakefulness, also need to be evaluated and treated. Research is under way to deliver dopaminergic therapy more effectively, but studies aimed at slowing or stopping disease progression have not shown promise.
帕金森病是美国和英国最常见的神经退行性疾病之一。该疾病的特征是两个过程——细胞退化和由此导致的多巴胺生化缺乏。尽管这些过程相互关联，但在临床环境中它们是分开处理的。目前，尚无针对帕金森病的经证实的神经保护或疾病修正治疗方法。有几种药物可用于治疗与多巴胺缺乏相关的运动症状，在开始治疗时明智地选择药物非常重要。药物的效力有轻度、中度和高度之分，在选择合适的药物时，应考虑患者的目标、合并症以及选择特定药物的短期和长期影响。还需要评估和治疗非运动症状，如抑郁、疲劳以及睡眠和觉醒障碍。目前正在进行更有效地提供多巴胺能治疗的研究，但旨在减缓或阻止疾病进展的研究并未显示出前景。
