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The Correlation Analysis of Individualized Treatment and Disease Progression of Parkinson Disease

Author: ZhaoHang
Tutor: LiangZhanHua
School: Dalian Medical University
Course: Neurology
Keywords: Parkinson's disease Individualized treatment Compliance Evaluate
CLC: R742.5
Type: Master's thesis
Year: 2011
Downloads: 20
Quote: 0
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Abstract


Objective: Parkinson disease (PD) is a chronic progressive disease, with symptoms mainly as follows: static tremor, rigidity, bradykinesia and abnormal gait and posture, as well as non-motor symptoms such as psychiatric symptoms and autonomic nerve dysfunction. At present, the etiology of PD is not fully understood. With the development of the etiology research and the emergence of new findings, a variety of new drugs are applied in clinic, and the drug therapy is still the primary treatment, that is, dopamine replacement therapy, symptomatic treatment and neuroprotective therapy. Because of the gradual progression of the disease, the demonds of the patients at different disease stages are not alike . There are differences between patients on age, medical history, underlying diseases, and the course of disease, medication compliance, the affordability, so different patients choose different drugs. Then the compatibility, dosage and drug tolerance and side effects are also not alike.In order to achieve better efficacity, the physicians are required to follow the general principles of treatment while emphasizing the individual characteristics. PD seriously endangers the health of the elderly and affects daily lives of the patients. At the end of the stage, PD could cause disability or loss of the ability to live independently. And the emotional problems, such as anxiety, depression and pessimism, will accelerate the progression of the disease, and then bring heavy burden to the patients and their families. Therefore, the ideal individual treatment of PD is an integrated one,which should include drug treatment, psychological counseling, health education and rehabilitation treatment. We now commonly use Hoehn-yahr Rating Scale, Unified Parkinson’s Disease Rating Scale (UPDRS scale), Schwab and England Activities of Daily Living Scale (Schwab scale) to evaluate patients’conditions, the courses of the disease and other basic information. The scales are also used to evaluate the effectiveness and applicability of the treatments, in order to decide whether the the treatment is suitable or not. With the progression of the disease, PD’s individualized treatment strategy is constantly changing. Only when the patients have good adherence ,can they obtian benefits and improves the therapeutic effect.At present, the implementation of clinical individual treatment on PD lacks statistical survey and analysis both at home and abroad. Therefor we select a part of patients with primary PD, in order to study the correlation analysis of individualized treatment and disease progression in PD.Method: 1.The appointed neurologists would establish treatment strategies for the enrollment patients with primary PD, according to the characteristics of the disease, for example, the course of the disease. The strategies included adjustments and re-establishments for the new patients and the older ones.Both the new and the older were required to come to the hospital every 3 months, then the doctors could adjust the strategies.2. According to the frequency of return visit, the patients were divided into three groups (Group 1: return visit every 3 months, Group 2: every 6 months, Group 3 : every 12 months). The neurologists evaluated the disease conditions at baseline (0M), at 6 months (6M) and at 12 months (12M), using Hoehn-Yahr scale, UPDRS scale and Schwab scale.Results: 1. There were no significant statistical differences on grades evaluated by Hoehn-Yahr scale among the three groups (P> 0.05).2. There were significant statistical differences on grades evaluated by UPDRS scale and Schwab scale at baseline and return visit on 12th month among the three groups (P<0.01).Conclusion: 1.UPDRS Scale and Schwab Scale could be used to evaluate the condition and the progression of PD and the improvement in the life quality.2. The systematical and normative individual treatment could palliate the disease progression, improve activities of the daily life and prolong the time to live independently. In all, the treatment could enhance the life quality.

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