Parkinson’s disease has become the “third killer” for the middle-aged and the elderly, with 1.7 million of the world’s 4 million patients in China. Parkinson’s patients tend to be younger, “adolescent Parkinson’s disease” patients accounted for 10% of the total number of people. The disease is related to ageing, genetics, environmental toxins (industrial and agricultural pollution, pollution, cell phones, computer radiation may cause disease) exposure and other factors. 20% of the patients due to environmental pollution or chemical toxins erosion “hit”. Adolescents with Parkinson’s tend to have a family genetic background for Parkinson’s. A recent epidemiologic study confirmed this. A recent epidemiologic study confirms that intellectuals do have a higher rate of Parkinson’s disease than the rest of the population. Many people think of shaky hands when they think of Parkinson’s disease, and it is true that most people with Parkinson’s disease have shaky hands, but there are a number of exceptions. Early recognition of Parkinson’s disease is important. Hand tremors are not the only symptom of Parkinson’s disease, but slow movements and slow hands and feet are common in Parkinson’s patients. Here’s an overview of the past and present of Parkinson’s disease. Parkinson’s disease (PD) is a common neurodegenerative disease that mainly affects middle-aged and elderly people, and develops after the age of 60. Its lesions are located in a part of the human brain called the midbrain. There is a group of nerve cells called substantia nigra neurons. When more than 80% of these substantia nigra neurons degenerate and die, the neurotransmitter dopamine in the brain decreases to the point where it cannot maintain the normal function of the nervous system and the symptoms of Parkinson’s disease appear. Clinical manifestations of Parkinson’s disease The clinical symptoms of Parkinson’s disease mainly include motor symptoms and non-motor symptoms. Its motor symptoms mainly include involuntary tremor of hands, head or mouth at rest, muscle stiffness, slow movement and postural balance disorders, resulting in an inability to take care of oneself. As people’s understanding of Parkinson’s disease deepens, non-motor symptoms are increasingly recognized. Non-motor symptoms mainly include mood disorders (depression and anxiety are common), mild cognitive impairment and visual hallucinations in some patients, and hypersecretion of glands such as sebaceous glands, persistent constipation due to vegetative nerve dysfunction, and upright hypotension in some patients. The diagnosis of Parkinson’s disease mainly relies on medical history, clinical symptoms and signs. General auxiliary examinations are mostly without abnormal changes. Treatment of Parkinson’s disease Early stage of Parkinson’s disease is recommended to use physical therapy and sports therapy, etc., to strive for the cooperation of the patient’s family and encourage the patient to take more initiative to exercise, and try to postpone the time of drug treatment. When the disease affects the patient’s daily life and work, drug treatment is needed. Pharmacotherapy is currently the most important treatment for Parkinson’s disease. Levodopa preparation is still the most effective drug. Surgery is an effective complement to medication. Rehabilitation, psychotherapy and good nursing care can also improve symptoms to some extent. Although the currently applied treatments can only improve the symptoms, cannot stop the progress of the disease, and cannot cure the disease, effective treatment can significantly improve the quality of life of patients. (I) Drug therapy The main treatment drug for Parkinson’s disease is levodopa, which is effective, yet has relatively large long-term side effects. For this reason, patients before the age of 65 are generally preferred for symptomatic relief is not very obvious, but can protect neurons can also relieve the course of the disease to a certain extent, while patients after the age of 65 can be preferred to levodopa. Drug treatment should follow the following principles: (1) start with a small dose, slowly increase, try to use a small dose to achieve satisfactory results; (2) individualized treatment plan; (3) do not blindly increase the drug, do not suddenly stop taking the drug, and need to take the drug for a lifetime; (4) the effect of single-drug treatment is unsatisfactory should be combined with the appropriate drug. Tips for taking levodopa (1) It should be taken on an empty stomach. If the drug is taken together with protein, the effectiveness of the drug will be greatly reduced. Therefore, it is recommended to take the drug one hour before or one and a half hours after a meal. (2) It is not recommended to drink milk or eat other protein-containing foods while taking the medicine. Many elderly people have the habit of drinking milk for breakfast, but milk containing protein will also affect the effectiveness of the drug. If you experience the following during levodopa treatment: fluctuation of symptoms (including three forms of efficacy reduction, switch phenomenon, freezing phenomenon, etc.), movement disorders (also known as anisotropia, often manifested as chorea-like – tardive dyskinesia involuntary movements or monotonous and stereotyped involuntary movements, etc.), mental symptoms, etc., it is considered that there may be a side effect of levodopa, so please consult a neurologist in a timely manner to adjust the levodopa dosage for you. Please consult your neurologist to adjust the dosage of levodopa for you. Other commonly used drugs for Parkinson’s disease include anticholinergic drugs (Antan, Kemacrine, etc.), amantadine, dopamine agonists (bromocriptine, Pergolide, Tysudan Extended-Release Tablets, etc.), monoamine oxidase B inhibitors, and catechol-oxygen-methyltransferase inhibitors, which should be customized by your specialist. (ii) Surgical treatment Surgical treatment may be considered when medication fails, is not tolerated, or when there is anisocoria, when the patient is young, and when the symptoms are predominantly tremor, tonus, and on one side of the body. Postoperative treatment with medication is still required. The most widely used surgical procedure is Deep Brain Stimulation (DBS), also known as Brain Pacemaker Therapy and Minimally Invasive Dissociative Brain Pacemaker Implantation. The therapy involves implanting a high-frequency microelectrode stimulation device into the surgical target point of Parkinson’s patients, and high-frequency electrical stimulation produces a voltage and frequency higher than that produced by the diseased neuron, thus providing an inhibitory effect. Its advantages are accurate positioning, small scope of damage, few complications, high safety and long-lasting efficacy, etc. However, it is expensive, and the U.S. FDA has approved the clinical application of DBS for the treatment of Parkinson’s disease. (III) Rehabilitation therapy Many patients with Parkinson’s disease have combined language and motor dysfunction, and often suffer from depression, anxiety and other emotional disorders. Therefore, it is very important to train and guide patients in various daily life activities, such as language, eating, walking, etc. under the care and encouragement of family members, in order to improve the quality of life of the patients. According to the patient’s functional status, select a number of patients preferred exercise training content, but need to pay attention to the amount of exercise from small to large, step by step, avoiding fatigue, and make full use of the patient’s own good visual and auditory ability to help the ability to exercise, but also to encourage the patient to actively participate in therapeutic exercise training. Bedridden patients with advanced disease should strengthen nursing care to reduce the occurrence of complications. Here are several easy to implement rehabilitation training methods for patients and their families to learn and train themselves: (1) relaxation and breathing training: close your eyes and start breathing deeply and slowly. The abdomen bulges when inhaling, and imagine that the air reaches the top of the head; when exhaling, the abdomen relaxes, and imagine that the air flows down from the top of the head, passes through the back and reaches the soles of the feet, and relaxes the muscles of the whole body. Repeat this exercise for 5-15 minutes. (2) Facial movement training: you can do frowning in front of the mirror, forcefully open and close your eyes, puff out your cheeks, show your teeth, whistle, smile, laugh, show your teeth, pout and other movements. (3) Head and neck training: up and down movement of the head, left and right rotation, side rotation, left and right swing, etc. (4) Trunk training: Rhythmic side bending movement, turning movement, sit-ups, push-ups and swallow balance training, etc., which can control trunk abdominal and dorsal muscle strength and coordination. (5) Upper limb and shoulder training: shrugging, arm lifting, back stretching and other stretching exercises, but also the use of community rings and other equipment to strengthen the mobility and flexibility of the shoulder joint. (6) Hand training: using various instruments or objects available in the family, such as towel rolls and soy beans, etc., we can repeatedly make fists and straighten them, pinch the fingers and split the fingers. (7) Lower limb training: Hip and knee joint stretching exercises can be carried out in the prone position; if the condition permits, the common bar in the community resources can also be utilized to carry out stretching exercises such as leg press. (8) Gait and balance training: in the standing position, both lower limbs can be trained to step forward and backward, trunk center of gravity control training, marching in place, crossing obstacles and even walking the “one” step training. (9) Speech disorder training: The facial training movements mentioned above, together with tongue extension and tongue-raising exercises, can improve the speech difficulties caused by the stiffness of the facial tongue muscles, and reading aloud and singing are also helpful to improve this function. In daily life, Parkinson’s disease patients should also pay attention to: (1) sleep on hard board beds to reduce muscle contracture, and maintain the physiological tension of the muscles; (2) regular eating, eating time and amount should be regular and fixed, and in the content of the diet to do low protein, high vitamin, crude fiber and other nutritious and easy to digest food; (3) to develop the habit of regular defecation; (4) to maintain the body’s correct posture of sitting and standing, and to correct the bad posture. Prognosis of Parkinson’s disease Prognosis of Parkinson’s disease Parkinson’s disease is a chronic progressive disease with no cure. There is no cure for Parkinson’s disease. The life expectancy of Parkinson’s disease patients is not significantly different from that of the general population. How can Parkinson’s disease be prevented? Prevention of Parkinson’s disease should be possible from a young age. Older people nowadays can also be prevented through activities that engage both the hands and the brain. (1) In terms of exercise, seniors can do slow exercises such as tai chi, qigong, playing the piano, walking, and playing mahjong once or twice a day. In addition, listening to music, memorizing words, and reciting Tang and Song poems can also help the elderly to move their brains more. Do not stay at home for a long time to watch TV and so on. (2) As for diet, it is important to focus on clean talk with a green diet. Women should drink and eat more soy products, such as soy milk, soy milk, etc., and eat less high-fat food. (3) Life must be regular, normal work and rest, must ensure sufficient and reasonable sleep. In addition, it can also be appropriate to carry out some Chinese medicine, acupuncture prevention.