帕金森病药物治疗研究进展

Research advances in pharmacotherapy for Parkinson's disease

摘要:

目前帕金森病（Parkinson’s disease，PD）药物治疗依然是以多巴胺替代治疗为主线的症状治疗，长期用药带来的运动并发症及神经精神症状、平衡步态障碍等问题限制了很多中晚期患者的治疗效果。近年来PD药物治疗领域也取得一些进展。在症状治疗方面，一批左旋多巴制剂新剂型和多巴胺受体激动剂新剂型，新型单胺氧化酶-B和儿茶酚胺氧位甲基转移酶抑制剂，多种非多巴胺能药物陆续进入临床或即将进入临床。目前虽然尚无疾病修饰治疗药物在临床使用，但一批针对不同PD发病机制靶点疾病修饰治疗药物正在开展早期临床试验研究，有些药物显示较好的应用前景。一些已在临床使用的药物被再开发用于PD治疗。本文对该领域新进展做一综述。

Abstract:

Symptomatic dopamine replacement therapy has dominated the pharmacotherapy of Parkinson's disease （PD）. However，long-term use of dopaminergic drugs can induce a variety of problems，such as motor complications，neuropsychiatric dysfunctions，and balance and gait disturbances，which greatly compromise the treatment outcome of patients with PD at an advanced stage. In recent years，substantial progress has been made in pharmaceutical treatment for PD. For symptomatic treatment，novel levodopa formulations，novel dopaminergic agonist formulations，new monoamine oxidase B inhibitors，new catechol-O-methyltransferase inhibitors，and multiple non-dopaminergic drugs have been approved or on the horizon. Although there are no clinically available disease-modifying medications at present，a variety of such drugs targeting various pathological mechanisms have been in early clinical trials，and some of them have achieved promising results. In addition，some medications for treating other conditions are being re-developed for PD treatment. Here，we provide a review on new advances in this field.