Practice Parameter: Neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology
Practice Parameter: Neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology
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DOI：
10.1212/01.wnl.0000206363.57955.1b
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发表时间：
2006-04-11
期刊：
影响因子：
9.9
通讯作者：
Weiner, WJ
中科院分区：
文献类型：
--
作者：
Suchowersky, O;Gronseth, G;Weiner, WJ
目的：明确帕金森病（PD）治疗中与神经保护策略和替代治疗相关的关键问题，并提出循证治疗建议。方法：确定两个临床问题。1)在诊断为PD的患者中，是否有任何治疗方法可以减缓疾病进展？2)是否有任何非标准的药物或非药物治疗已被证明可以改善PD的运动功能？根据四级证据等级方案对文章进行分类。建议是以证据为基础的。结果与结论：1.左旋多巴似乎不会加速疾病进展。2.没有治疗显示出神经保护作用。3.没有证据表明维生素或食品添加剂可以改善PD的运动功能。4.运动可能有助于改善运动功能。5.言语治疗可能有助于提高言语量。6.没有手动治疗已被证明是有助于治疗运动症状，虽然在这方面的研究是有限的。需要使用严格的科学方法进行进一步的研究，以确定替代疗法的疗效。
Objective: To define key issues in the management of Parkinson disease (PD) relating to neuroprotective strategies and alternative treatments, and to make evidence-based treatment recommendations. Methods: Two clinical questions were identified. 1) In a patient diagnosed with PD, are there any therapies that can slow disease progression? 2) Are there any nonstandard pharmacologic or nonpharmacologic therapies that have been shown to improve motor function in PD? Articles were classified according to a four-tiered level of evidence scheme. Recommendations were based on the evidence. Results and conclusions: 1. Levodopa does not appear to accelerate disease progression. 2. No treatment has been shown to be neuroprotective. 3. There is no evidence that vitamin or food additives can improve motor function in PD. 4. Exercise may be helpful in improving motor function. 5. Speech therapy may be helpful in improving speech volume. 6. No manual therapy has been shown to be helpful in the treatment of motor symptoms, although studies in this area are limited. Further studies using a rigorous scientific method are needed to determine efficacy of alternative therapies.