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2016年帕金森病的初始治疗:重温2000年共识会议

Initial treatment of Parkinson's disease in 2016: The 2000 consensus conference revisited.

作者信息

Laurencin C, Danaila T, Broussolle E, Thobois S

机构信息

Service de neurologie C, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon/Bron, France; Faculté de médecine et de maïeutique Lyon Sud Charles-Mérieux, université de Lyon, université Claude-Bernard Lyon I, Lyon, France.

Service de neurologie C, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon/Bron, France.

出版信息

Rev Neurol (Paris). 2016 Aug-Sep;172(8-9):512-523. doi: 10.1016/j.neurol.2016.07.007. Epub 2016 Jul 29.

Abstract

In 2000, a French consensus conference proposed guidelines for the treatment of Parkinson's disease (PD). Since then, new drugs have been concocted, new studies have been published and clinicians have become aware of some drug-induced adverse effects that were little known in the past. This has led us to reconsider the recommendations published 16 years ago. Thus, the aim of the present review is to present the recent data related to the different medications and non-pharmacological approaches available for PD, with a special focus on early-stage PD. Levodopa (LD), dopamine agonists (DAs), catechol-O-methyltransferase inhibitors (COMT-Is), anticholinergics, monoamine oxidase inhibitors (MAOB-Is) and amantadine have been considered, and their efficacy and safety for both motor as well as non-motor aspects are reported here. This has led to our proposal for a revised therapeutic strategy for the initiation of treatment in newly diagnosed PD patients, based on the available literature and the relative benefits/side effects balance.

摘要

2000年,一场法国共识会议提出了帕金森病(PD)的治疗指南。从那时起,新的药物被研制出来,新的研究得以发表,临床医生也开始意识到一些过去鲜为人知的药物不良反应。这促使我们重新审视16年前发布的建议。因此,本综述的目的是介绍与PD可用的不同药物和非药物治疗方法相关的最新数据,特别关注早期PD。左旋多巴(LD)、多巴胺激动剂(DAs)、儿茶酚-O-甲基转移酶抑制剂(COMT-Is)、抗胆碱能药物、单胺氧化酶抑制剂(MAOB-Is)和金刚烷胺都在考虑范围内,本文报告了它们在运动和非运动方面的疗效和安全性。基于现有文献以及相对益处/副作用平衡,我们据此提出了针对新诊断PD患者起始治疗的修订治疗策略。

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