Acta Neurol Taiwan. 2023 Sep 30;32(3):145-184.
Parkinson's disease (PD) is a common and disabling neurodegenerative disorder with a prevalence set to double by 2030. People with PD present both motor symptoms (such as tremor, rigidity, slowness of movements, and postural instability) and non-motor symptoms (such as dementia, psychiatric symptoms, and sleep disturbances). The treatment of PD is challenging and is highly individualized. The Taiwan Movement Disorder Society (TMDS) has published its treatment recommendations for PD in 2017. Since then, because the advent of medical and device-aided therapy has developed rapidly, the TMDS has recognized the need to disseminate the updated knowledge about the management of PD. The TMDS acknowledges the importance of evidence-based medicine (EBM) in clinical practice. Therefore, we strive to align our treatment recommendations with EBM principles. Nevertheless, it still needs to be emphasized that therapeutic recommendations should always be tailored to the individual patient, based not only on an accurate understanding of the efficacy and side effect profile of available treatments (the primary focus of guidelines), but also the physician's judgment, patient's preference, and the regulations of national health insurance. To ensure that the updated Taiwan treatment suggestions are appropriate and feasible, the treatment guideline subcommittee of TMDS referred to the guidelines from the International Movement Disorder Society and other treatment suggestions from United States and Europe concerning the level of evidence, recommendation levels, clinical efficacy, and potential adverse reactions of therapeutics for the treatment of motor and non-motor symptoms of PD. By incorporating the latest research, international guidelines, and treatment suggestions, the TMDS aims to provide comprehensive and up-to-date recommendations for the management of PD in Taiwan. These recommendations serve as a valuable resource for healthcare professionals to enhance their understanding of PD treatment options and optimize patient care. Key Words: Parkinson's disease; treatment; guidelines; evidence-based medicine.
帕金森病(PD)是一种常见且致残的神经退行性疾病,预计到 2030 年患病率将翻一番。PD 患者既有运动症状(如震颤、僵硬、运动缓慢和姿势不稳)又有非运动症状(如痴呆、精神症状和睡眠障碍)。PD 的治疗具有挑战性,且高度个体化。台湾运动障碍学会(TMDS)于 2017 年发布了 PD 治疗建议。自那时以来,由于医疗和设备辅助治疗的快速发展,TMDS 认识到需要传播 PD 管理方面的最新知识。TMDS 承认循证医学(EBM)在临床实践中的重要性。因此,我们努力使我们的治疗建议与 EBM 原则保持一致。然而,仍需强调的是,治疗建议应始终根据个体患者的情况进行调整,不仅要准确了解现有治疗方法的疗效和副作用特征(指南的主要重点),还要考虑医生的判断、患者的偏好以及国家健康保险的规定。为确保更新后的台湾治疗建议是合适且可行的,TMDS 的治疗指南小组委员会参考了国际运动障碍学会的指南以及来自美国和欧洲的其他治疗建议,涉及 PD 运动和非运动症状治疗的证据水平、推荐级别、临床疗效和潜在不良反应。通过纳入最新的研究、国际指南和治疗建议,TMDS 旨在为台湾 PD 的管理提供全面且最新的建议。这些建议为医疗保健专业人员提供了宝贵的资源,以增强他们对 PD 治疗选择的理解并优化患者护理。关键词:帕金森病;治疗;指南;循证医学。