Restless Legs Syndrome.
Restless Legs Syndrome.
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DOI：
10.1007/s11940-999-0021-9
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发表时间：
1999-09-01
影响因子：
2
通讯作者：
Hening
中科院分区：
文献类型：
--
作者：
Hening
通过适当的药物治疗，患有任何程度的不宁腿综合征（RLS）的患者应该能够显着缓解症状。当医生根据患者的具体症状制定治疗方案并根据需要灵活尝试各种药物时，可以获得最佳的治疗成功。对于仅靠睡眠卫生和相关实践无法控制不宁腿综合征的患者，应进行治疗。然而，如果患者合理地认为他或她的生活质量因不宁腿综合症而受到损害，则不应拒绝提供该信息。一般患者治疗 RLS 的最佳初始方法通常是使用多巴胺能药物：较轻的病例使用低剂量左旋多巴，较严重的病例使用多巴胺激动剂。问题主要与睡眠有关的患者最初可以用苯二氮卓类药物治疗。主要在清醒时出现症状的患者最初可以使用多巴胺能药物或阿片类药物进行治疗。不宁腿综合症确实令人痛苦的患者最初可以用加巴喷丁治疗。两种或三种不同类别药物的联合治疗也可能有用。确定铁状态是 RLS 患者最重要的初始实验室评估。应按照指示使用铁补充剂。将来，口服药物以外的给药方式可能会带来显着的益处，尤其是在更严重的情况下。
With suitable pharmacotherapy, patients with any degree of restless legs syndrome (RLS) should be able to obtain substantial relief of symptoms. The best therapeutic success is attained when the physician tailors therapy to the patient's specific symptoms and can flexibly try a variety of agents, if needed. Therapy should be reserved for those in whom RLS cannot be managed with just sleep hygiene and related practices. It should not be withheld, however, if a patient reasonably believes that his or her quality of life is being impaired by RLS. The optimal initial approach to RLS in the general patient is usually the use of a dopaminergic agent: low-dose levodopa in milder cases, a dopamine agonist in more severe ones. Patients whose problems are primarily sleep related can initially be treated with a benzodiazepine. Patients who have symptoms primarily while awake can initially be treated with a dopaminergic agent or an opioid. Patients whose RLS discomfort is truly painful can initially be treated with gabapentin. Combination therapy with two or three agents from different classes can be useful as well. Determination of iron status is the most important initial laboratory evaluation in patients with RLS. Iron supplementation should be used as indicated. In the future, delivery modes other than oral administration of medications may be of significant benefit, especially in more severe cases.