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帕金森病吞咽困难的药物治疗效果:一项叙述性综述

Effectiveness of pharmacologic treatment for dysphagia in Parkinson's disease: a narrative review.

作者信息

Chang Min Cheol, Park Jin-Sung, Lee Byung Joo, Park Donghwi

机构信息

Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.

Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.

出版信息

Neurol Sci. 2021 Feb;42(2):513-519. doi: 10.1007/s10072-020-04865-w. Epub 2020 Nov 17.

Abstract

BACKGROUND

The effectiveness of pharmacological treatment on dysphagia in Parkinson's disease (PD) is debatable. We reviewed the literature for analyzing the effect of pharmacological treatment on the improvement of dysphagia in PD patients.

METHODS

We searched the PubMed database for papers published before June 21, 2020, that evaluated the effect of pharmacologic treatments for improving dysphagia in patients with PD. The following inclusion criteria were applied for the selection of articles: 1) studies performed on patients with dysphagia due to PD, 2) studies where pharmacologic treatment was applied for improvement of dysphagia, and 3) those where follow-up evaluation was performed after the treatment.

RESULTS

The primary literature search yielded 415 relevant papers. After reading their titles and abstracts and assessing their eligibility based on the full-text articles, we finally included nine studies in this review. In five previous studies, the positive effects of dopaminergic drugs on dysphagia were reported, whereas two showed no significant positive results. The remaining two studies showed equivocal results.

CONCLUSION

We found that dopaminergic drugs have some potential to improve dysphagia in patients with PD. However, studies with high-quality evidence are lacking. For the clear elucidation of the effect of dopaminergic drugs on dysphagia in patients with PD, randomized controlled trials with large cohorts and detailed analyses should be conducted in the future.

摘要

背景

药物治疗对帕金森病(PD)吞咽困难的有效性存在争议。我们回顾文献以分析药物治疗对PD患者吞咽困难改善的影响。

方法

我们在PubMed数据库中检索了2020年6月21日前发表的评估药物治疗对改善PD患者吞咽困难效果的论文。以下纳入标准用于文章的选择:1)对因PD导致吞咽困难的患者进行的研究;2)应用药物治疗改善吞咽困难的研究;3)治疗后进行随访评估的研究。

结果

初步文献检索得到415篇相关论文。在阅读标题和摘要并根据全文评估其合格性后,我们最终在本综述中纳入了9项研究。在之前的5项研究中,报道了多巴胺能药物对吞咽困难有积极作用,而2项研究显示无显著阳性结果。其余2项研究结果不明确。

结论

我们发现多巴胺能药物有改善PD患者吞咽困难的潜力。然而,缺乏高质量证据的研究。为了明确阐明多巴胺能药物对PD患者吞咽困难的影响,未来应进行大样本队列的随机对照试验和详细分析。

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