Tremor paralysis, also known as Parkinson's disease, is a chronic disease of the central nervous system that affects the activity of patients. So why do you get Parkinson's disease? It's named because a British doctor named Parkinson first described these symptoms, including dyskinesia, tremor and muscle stiffness.
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The incidence rate incidence rate increases gradually with age, and the incidence rate is about 1&permil. The incidence rate is about 60 years old. The incidence rate of 3&permil is 70 to 50~65 years old. 5&permil is about 1700000.
At present, the data show that the incidence of Parkinson's disease in men is slightly higher than that in women. So far, the treatment of Parkinson's disease is symptomatic treatment, and there is no radical cure method to recover degenerative nerve cells.
Etiology and classification of Parkinson's disease
The cause of Parkinson's disease is not very clear. At present, it is generally recognized that the cause of the disease is degeneration of nerve cells, and the main lesions are in substantia nigra and striatum. There is a kind of nerve cells called substantia nigra cells. The gradual decrease in the number and function of substantia nigra cells leads to the decrease of a substance called dopamine, which causes the above symptoms. According to the results of animal experiments and epidemiology, Parkinson's disease is also related to heredity.
According to the cause of the disease, tremor paralysis symptoms can be divided into two categories, one is called primary tremor paralysis, that is, there is no clear cause or the cause of the disease may be genetically related, we call it Parkinson's disease or Parkinson's disease. The other is called secondary tremor paralysis, which is caused by certain encephalitis, poisoning (such as carbon monoxide, manganese, cyanide, reserpine poisoning, phenothiazines, butyrylphthalides, tricyclic antidepressants, etc.), cerebrovascular disease, brain injury, brain tumor, etc. we also call it Parkinson's syndrome or Parkinson's syndrome, tremor paralysis syndrome
Treatment of Parkinson's disease
1、 Drug therapy: drug therapy mainly increases the content and function of dopamine in the brain and reduces the activity of acetylcholine. The symptoms of most patients can be alleviated, but it can not prevent the natural progression of the disease. It is suggested that when the symptoms of patients have significantly affected their daily life and work, the dopamine activity in the brain has been in the decompensated period, the drug should be started, and early physical therapy and physical therapy should be adopted as far as possible.
（1） Anticholinergic drugs: these drugs can inhibit the activity of acetylcholine, improve the effect of dopamine in the brain and adjust the balance of neurotransmitters in the striatum. It is suitable for the treatment of early mild patients and as an adjunctive drug of levodopa. Commonly used drugs are: antam 2 ~ 4mg, 2 ~ 3 times / D; benzotropine 1 ~ 3mg, 2 ~ 3 times / D; kaimajun 2.5 ~ 5mg, 3 / D, with dry mouth, dizziness, nausea and other side effects, and glaucoma.
（2） Dopaminergic drugs: these drugs are used to supplement the lack of dopamine in the brain. Exogenous dopamine can not enter the brain, but L-dopa can pass through the brain barrier and be decarboxylated into dopamine by dopa decarboxylase to supplement the serious deficiency of dopamine in striatum. Compound L-dopa is a mixed preparation of L-dopa and an extracellular decarboxylase inhibitor which can not pass through the blood-brain barrier. It can reduce the extracellular decarboxylation of L-dopa and increase the content of L-dopa into the brain, so as to reduce the daily dose of L-dopa and alleviate the peripheral side effects of L-dopa.
1. Levodopa: the initial dose is 125-250 mg, three times a day, with an increase of 250 mg every 3-5 days. The daily dose is usually 3 G, generally no more than 5 g, and it is taken after meals in 4-6 times. The daily dose is more effective and less side effect. The effective rate is about 80%. The effect on myotonia and bradykinesia is better than tremor. Generally, the curative effect is satisfactory in the first 3-5 years after treatment, and then it becomes worse and worse, leading to failure.
2. Madopa, also known as Benserazide, is a mixture of levodopa and methyldopa, an inhibitor of extracerebral decarboxylase. Madopar '125' contains 100 mg of levodopa and 25 mg of Benserazide, which is equivalent to 500 mg of levodopa. Take one tablet on the first Sunday, and then add one tablet every other week every day. Generally, take 8 tablets a day in batches.
3. Sinemet: it is a mixture of levodopa and methyldopa hydrazine (carbidopa), an inhibitor of extracerebral decarboxylase. There were 10 / 100, 25 / 250, 25 / 100 tablets in the ratio of 10:1 or 4:1, respectively. The denominator was levodopa content, and the molecule was methyldopa hydrazine. The content was calculated in mg. The dosage of zenimax was 10 / 100 half tablets, three times a day, and then 1 tablet was added every 2-3 days. The daily dosage was 6-8 tablets. 25 / 100 tablets can be used for intractable cases, and the daily dose should not exceed 4 tablets.
The side effects of levodopa and compound levodopa can be divided into peripheral and central. Peripheral side effects often occur after taking medicine, and show symptoms of the system outside the central nervous system, such as nausea, vomiting, anorexia, skin pain, palpitation, arrhythmia, location hypotension, urinary incontinence or urinary retention, blood urea nitrogen increase, and * cause excessive dopamine in the surrounding tissues. The side effects of compound levodopa were relatively mild. Central side effects may include insomnia, restlessness, depression, hallucination, delusion and other mental symptoms; all kinds of non random movement, such as dance, hand and foot movements, and fluctuation of movement symptoms. The latter can have on-off phenomenon, which refers to the sudden inability to move and sudden freedom of movement, which can occur alternately in a few minutes to dozens of minutes. The above neurological symptoms appear in the long-term treatment, some patients have serious side effects and have to stop the drug.
Levodopa or compound levodopa should not be combined with vitamin B6, type a monoamine oxidase inhibitors such as phenothiazines, Rauvolfia, rimianning, diazepam, etc. It should not be used in patients with severe liver, kidney and heart dysfunction, psychosis, glaucoma and ulcer.