Parkinson’s disease non-pharmacological treatment and care regimen

  Parkinson’s disease (PD), also known as tremor palsy, is a common neurodegenerative disease of the middle-aged and elderly, clinically characterized by resting tremor, bradykinesia, myotonia, and abnormal postural gait. It is a common and frequent clinical disease. The disease belongs to the category of “senile tremor” in Chinese medicine, and is located in the brain. The clinical evidence is divided into five types: phlegm-heat-activated wind, wind-yang internal movement, yin-deficiency and blood stasis, qi-blood deficiency, and kidney essence deficiency. The non-pharmacological treatments and care regimen for Parkinson’s disease are discussed below.  Non-pharmacological treatment 1. Acupuncture acupuncture points Body acupuncture: Baihui, Taichong, Shenting, Quchi, Waiguan, Si Shencong, Fengchi, Heigu, Yanglingquan, Jigu, etc. Head acupuncture: Take the dance tremor control area of the head, located at the parallel line of the motor area moving forward 1.5cm, and stimulate strongly. According to the deficiency and reality of the disease, the corresponding tonic and diarrheal techniques are used, with the deficiency evidence using the tonic method, the reality evidence using the diarrheal method, and the deficiency and reality mixed with the flat tonic and flat diarrheal method. Once a day, 15 days for a course of treatment, interval of 5 days for the next course of treatment.  Moxibustion method: selected points such as period door, big bag, Shen Que, foot three miles. The common moxibustion method is moxibustion with moxa stick for 10 min per point, which has good effect on improving the symptoms of stiffness. For patients with Yang deficiency and phlegm stagnation, moxibustion can be applied to Shen Que and Shu San Li.  2, rehabilitation therapy (1) exercise therapy Exercise therapy is an effective adjunctive therapy for Parkinson’s disease. Used rationally with drug therapy, it can not only improve function, but also prevent secondary damage of the disease, and also delay the development of the disease to a certain extent.  Specific operations: there are basic movement training: including sitting, rising, lying down, getting up and turning over in bed. Joint range of motion training: the main parts are neck, shoulder, elbow, wrist, finger, hip, knee, active and passive movement of each joint. Training to increase muscle strength: the focus is on training the pectoral muscles, abdominal muscles, lumbar back muscles and quadriceps. Posture training: keep the torso upright and good posture of the limbs, with emphasis on training balance and coordination functions. Walking gait training: correct abnormal gait such as difficult start, low leg lift, short stride, slow turn and uncoordinated movement of upper and lower limbs. Facial movement training and speech function training: the patient is asked to speak loudly and consciously, emphasizing that every word sound should be pronounced as accurately as possible. Respiratory muscle training: repeated deep exhalation and deep inhalation, respiratory gymnastics to exercise intercostal muscles, diaphragm and respiratory auxiliary muscles, correct respiratory training is also beneficial to improve speech function.  (2) Occupational therapy Purpose: In concert with pharmacotherapy and exercise therapy, the combination of training fine movements and large movements to increase muscle strength can minimize functional impairment and reduce the disability rate.  Specific operations: mainly train hand function and daily life skills, especially practical skills such as washing face, combing hair, eating, dressing and buttoning, etc. Training methods such as clay modeling, preparation, table tennis, using typewriter and computer keyboard can be chosen.  3, care and conditioning: 1, the room should be kept fresh air, clean and quiet, temperature and humidity appropriate to prevent complications.  2, do a good job in the patient’s life care, guide the patient to participate in various forms of activities, adhere to the functional exercise of the joints of the limbs, encourage the patient to get up, dress, eat, etc., while paying attention to the safety of the patient’s activities, such as walking with a cane to help walk, the floor should be non-slip, if the patient squatting to the toilet and the difficulty in standing up, can be placed in a high stool sitting position defecation, dressing and undressing difficulties, are required to give assistance.  3, diet should be given light, easy to digest and nutritious diet, avoid eating fatty, sweet, greasy, fried products. For those who have phlegm-heat and wind, wind and yang can be given raw rhubarb as tea substitute; for yin deficiency and blood stasis type, it is appropriate to give Dendrobium cinnabarum and wolfberry as tea substitute; for deficiency of both qi and blood, cinnamon, jujube and angelica can be used to cook porridge; for deficiency of kidney essence, it is appropriate to give food with the effect of nourishing kidney and filling essence to increase nutrition.  4, with gastrointestinal motility weakness, constipation, patients should be encouraged to eat more fresh vegetables, fruits, to keep the stool smooth; swallowing difficulties, eating and choking cough, should take a sitting position to eat, the speed should be slow, to avoid choking cough; for those who can not eat should assist in feeding or nasal feeding diet.  5.Strengthen psychological care: carefully observe the changes in the patient’s condition and psychological activities, take the initiative to talk with the patient, comfort the patient, eliminate worries, depression and other adverse emotions, avoid the stimulation of adverse factors, encourage the patient to establish a correct outlook on life and maintain a balanced state of mind.  6, give rehabilitation guidance: early disease or mild symptoms, teach patients to do “Parkinson’s rehabilitation exercises”; for the more serious clinical symptoms, give passive limb functional exercise to prevent limb contracture, joint stiffness, and promote blood circulation in the limbs; for those with low voice, give language rehabilitation guidance; for those with limited mobility and abnormal posture For those with limited mobility and abnormal posture, we should prevent the occurrence of “secondary injury”.