Rabin Marcie L, Stevens-Haas Claire, Havrilla Emilyrose, Rosenstein Adam, Toffey Brittany, Devi Tanvi, Earnhardt Mary Cathryn, Kurlan Roger
Atlantic Neuroscience Institute Overlook Medical Center Summit New Jersey USA.
Mov Disord Clin Pract. 2015 Jun 29;2(3):205-212. doi: 10.1002/mdc3.12170. eCollection 2015 Sep.
Nearly half of all patients with Parkinson's disease (PD) utilize some form of complementary therapy often identified on the Internet and frequently not reported to their physicians. Treating physicians are sometimes unaware of such treatments, including their rationale, mechanisms, potential efficacy, and potential adverse effects.
Methods for this study included systematic Internet search of products recommended for PD, medical literature review to determine scientific rationale, any evidence of efficacy, and potential risks.
A large number of complementary therapies are recommended for patients with PD, generally falling into the following categories: dietary and nutritional; chelation; and physical. Most have reasonable justifications based on mechanism of action and current theories on causes of neurodegeneration in PD, but few have documented evidence of benefit. Fortunately, most have few risks and side effects, although some are very expensive. The protein redistribution diet has substantial evidence of symptomatic benefit. Some antioxidative or -inflammatory supplements, aerobic exercise, Tai chi, and dance and music therapy have preliminary evidence of symptomatic benefit or potential neuroprotective effects, but more research is needed to establish efficacy.
Patients with PD are faced with many recommendations for complementary therapies. Physicians should know about these in order to have informed discussions with their patients. Some deserve further study.
近半数帕金森病（PD）患者会采用某种形式的辅助疗法，这些疗法通常是在互联网上找到的，且常常未告知其医生。治疗医生有时并不知晓此类治疗方法，包括其原理、机制、潜在疗效和潜在不良反应。
本研究的方法包括对推荐用于PD的产品进行系统的互联网搜索、查阅医学文献以确定科学原理、任何疗效证据及潜在风险。
大量辅助疗法被推荐给PD患者，一般可分为以下几类：饮食与营养；螯合疗法；以及物理疗法。大多数疗法基于作用机制和当前关于PD神经退行性变病因的理论有合理依据，但很少有已记录的获益证据。幸运的是，大多数疗法风险和副作用较少，尽管有些费用高昂。蛋白质再分配饮食有大量症状改善获益的证据。一些抗氧化或抗炎补充剂、有氧运动、太极拳以及舞蹈和音乐疗法有症状改善获益或潜在神经保护作用的初步证据，但需要更多研究来确定疗效。
PD患者面临许多辅助疗法的推荐。医生应该了解这些，以便与患者进行充分知情的讨论。有些疗法值得进一步研究。
