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帕金森病运动和非运动症状的治疗选择。

Treatment Options for Motor and Non-Motor Symptoms of Parkinson's Disease.

机构信息

Department of Pathology and Laboratory Medicine, The University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

出版信息

Biomolecules. 2021 Apr 20;11(4):612. doi: 10.3390/biom11040612.

Abstract

Parkinson's disease (PD) usually presents in older adults and typically has both motor and non-motor dysfunctions. PD is a progressive neurodegenerative disorder resulting from dopaminergic neuronal cell loss in the mid-brain substantia nigra pars compacta region. Outlined here is an integrative medicine and health strategy that highlights five treatment options for people with Parkinson's (PwP): rehabilitate, therapy, restorative, maintenance, and surgery. Rehabilitating begins following the diagnosis and throughout any additional treatment processes, especially vis-à-vis consulting with physical, occupational, and/or speech pathology therapist(s). Therapy uses daily administration of either the dopamine precursor levodopa (with carbidopa) or a dopamine agonist, compounds that preserve residual dopamine, and other specific motor/non-motor-related compounds. Restorative uses strenuous aerobic exercise programs that can be neuroprotective. Maintenance uses complementary and alternative medicine substances that potentially support and protect the brain microenvironment. Finally, surgery, including deep brain stimulation, is pursued when PwP fail to respond positively to other treatment options. There is currently no cure for PD. In conclusion, the best strategy for treating PD is to hope to slow disorder progression and strive to achieve stability with neuroprotection. The ultimate goal of any management program is to improve the quality-of-life for a person with Parkinson's disease.

摘要

帕金森病(PD)通常发生在老年人中,通常既有运动功能障碍,也有非运动功能障碍。PD 是一种进行性神经退行性疾病,由中脑黑质致密部多巴胺能神经元丧失引起。这里概述了一种整合医学和健康策略,强调了五种治疗帕金森病患者(PwP)的选择:康复、治疗、恢复、维持和手术。康复始于诊断后,并贯穿于任何其他治疗过程中,尤其是在与物理、职业和/或言语病理治疗师咨询时。治疗采用每日给予多巴胺前体左旋多巴(与卡比多巴)或多巴胺激动剂,这些药物可保留残余多巴胺和其他特定的运动/非运动相关化合物。恢复采用剧烈的有氧运动方案,具有神经保护作用。维持采用补充和替代医学物质,可能支持和保护大脑微环境。最后,当 PwP 对其他治疗选择反应不佳时,会采用手术,包括深部脑刺激。目前尚无治愈 PD 的方法。总之,治疗 PD 的最佳策略是希望减缓疾病进展,并努力通过神经保护实现稳定。任何管理计划的最终目标都是提高帕金森病患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6c7/8074325/06cff75f16fd/biomolecules-11-00612-g001.jpg

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