韩露,吴瑢,王晓平

• 1:上海交通大学附属第一人民医院神经科

摘要(Abstract)：

帕金森病(Parkinson's disease,PD)的治疗目前主要以左旋多巴等传统药物治疗为金标准,但临床上仍存在对传统治疗不敏感的案例,同时,患者长期服用左旋多巴造成的运动并发症是治疗过程中更为棘手的问题。患者起病年龄、病程阶段以及用药剂量等都会影响左旋多巴等药物的治疗效果。近年来,脑深部电刺激术(DBS)、非左旋多巴类新型药物、细胞治疗及基因治疗等替代治疗已逐步在临床上广泛应用,相关的基础研究也成为关注的焦点。PD的治疗是一个长期过程,不同的临床阶段需要结合治疗效果调整治疗方案。本文将综述目前常用PD非传统治疗方法的基础研究与临床实践的现状及进展。

关键词(KeyWords)： 帕金森病;脑深部电刺激术;新型药物剂型;针灸治疗

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81071065#)

作者(Author): 韩露,吴瑢,王晓平

参考文献(References)：

• [1]Hughes AJ,Ben-Shlomo Y,Daniel SE,et al.What features improve the accuracy of clinical diagnosis in Parkinson's disease:a clinicopathologic study[J].Neurology,1992,42(6):1142-1146.
• [2]佚名.帕金森病诊疗指南[J].中国临床医生,2010,38(2):77-79.
• [3]Benabid AL,Pollak P,Gross C,et al.Acute and long-term effects of subthalamic nucleus stimulation in Parkinson's disease[J].Stereotact Funct Neurosurg,1994,62(1-4):76-84.
• [4]Fasano A,Deusch G.Patients and DBS targets:is there any rationale for selecting them[J].Basal Ganglia,2012,2:210-211.
• [5]王晓平,张巍峰,吴斌.帕金森病治疗的思考:从药物到脑深部电刺激手术[J].世界临床药物,2011,32(6):321-323.
• [6]Gradinaru V,Mogri M,Thompson KR,et al.Optical deconstruction of Parkinsonian neural circuitry[J].Science,2009,324(5925):354-359.
• [7]Castrioto A,Lozano AM,Poon YY,et al.Ten-year outcome of subthalamic stimulation in Parkinson disease:a blinded evaluation[J].Arch Neurol,2011,68(12):1550-1556.
• [8]Follett KA,Weaver FM,Stern M,et al.Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease[J].N Engl J Med,2010,362(22):2077-2091.
• [9]Taba HA,Wu SS,Foote KD,et al.A closer look at unilateral versus bilateral deep brain stimulation:results of the National Institutes of Health COMPARE cohort[J].J Neurosurg,2010,113(6):1224-1229.
• [10]Kirsch-Darrow L,Zahodne LB,Marsiske M,et al.The trajectory of apathy after deep brain stimulation:from pre-surgery to 6months post-surgery in Parkinson's disease[J].Parkinsonism Relat Disord,2011,17(3):182-188.
• [11]Moro E,Lozano AM,Pollak P,et al.Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease[J].Mov Disord,2010,25(5):578-586.
• [12]Merola A,Zibetti M,Artusi CA,et al.Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease:a role for age at disease onset?[J].J Neurol Neurosurg Psychiatry,2012,83(3):251-257.
• [13]Parent B,Awan N,Berman SB,et al.The relevance of age and disease duration for intervention with subthalamic nucleus deep brain stimulation surgery in Parkinson's disease[J].J Neurosurg,2011,114(4):927-931.
• [14]Singer C.Managing the patient with newly diagnosed Parkinson disease[J].Cleve Clin J Med,2012,79(Suppl 2):S3-S7.
• [15]Sanford M,Scott LJ.Rotigotine transdermal patch:a review of its use in the treatment of Parkinson's disease[J].CNS Drugs,2011,25(8):699-719.
• [16]Lyons KE,Friedman JH,Hermanowicz N,et al.Orally disintegrating selegiline in Parkinson patients with dopamine agonist related adverse effects[J].Clin Neuropharmacol,2010,33(1):5-10.
• [17]Hoy SM,Keating GM.Rasagiline:a review of its use in the treatment of idiopathic Parkinson's disease[J].Drugs,2012,72(5):643-669.
• [18]Iansek R,Danoudis M.A single-blind cross over study investigating the efficacy of standard and controlled release levodopa in combination with entacapone in the treatment of end-of-dose effect in people with Parkinson's disease[J].Parkinsonism Relat Disord,2011,17(7):533-536.
• [19]Shinkar DM,Dhake AS,Setty CM.Drug delivery from the oral cavity:a focus on mucoadhesive buccal drug delivery systems[J].PDA J Pharm Sci Technol,2012,66(5):466-500.
• [20]Herrlich S,Lorenz T,Marker M,et al.Miniaturized osmotic pump for oromucosal drug delivery with external readout station[J].Conf Proc IEEE Eng Med Biol Soc,2011:8380-8383.
• [21]Grosset KA,Grosset MF.Inhaled apomorphine(VR040)for‘off’periods in Parkinson's Disease[J].Mov Dosord,2011,26(Suppl 2):S129.
• [22]García Ruiz PJ,Sesar Ignacio A,Ares Pensado B,et al.Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson's disease with motor fluctuations:a multicenter study[J].Mov Disord,2008,23(8):1130-1136.
• [23]Johan L kk,Nilsson M.Frequency,type and factors associated with the use of complementary and alternative medicine in patients with Parkinson's disease at a neurological outpatient clinic[J].Parkinsonism Relat Disord,2010,16(8):540-544.
• [24]Yang JL,Chen JS,Yang YF.Neuroprotection effects of retained acupuncture in neurotoxin-induced Parkinson's disease mice[J].Brain Behav Immun,2011,25(7):1452-1459.
• [25]Yeo S,Choi YG,Hong YM,et al.Neuroprotctive changes of thalamic degeneration-related gene expression by acupuncture in an MPTP mouse model of parkinsonism:microarray analysis[J].Gene,2013,515(2):329-338.
• [26]Kim ST,Moon W,Chae Y,et al.The effect of electroaucpuncture for 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced proteomic changes in the mouse striatum[J].J Physiol Sci,2010,60(1):27-34.
• [27]Choi YG,Yeo S,Hong YM,et al.Neuroprotective changes of striatal degeneration-related gene expression by acupuncture in an MPTP mouse model of Parkinsonism:microarray analysis[J].Cell Mol Neurobiol,2011,31(3):377-391.
• [28]Rui G,Guangjian Z,Yong W,et al.High frequency electroacupuncture enhances striatum DAT and D1 receptor expression,but decreases D2 receptor level in 6-OHDA lesioned rats[J].Behav Brain Res,2013,237:263-269.
• [29]Lam YC,Kum WF,Durairajan SS,et al.Efficacy and safety of acupuncture for idiopathic Parkinson's disease:a systematic review[J].J Altern Complement Med,2008,14(6):663-671.