Source 丨21 Healthnews21 original work
Author 丨Ji Yuanyuan
Editor 丨Xu Xu
Picture 丨 Figure worm
According to the data of the Seventh National Census, there are 260 million people aged 60 and above on the mainland, accounting for 18.7% of the population, and population aging is the basic national condition of the mainland for a long period of time to come.
11 April is World Parkinson's Day for Disease. Parkinson's disease (PD) is a chronic progressive neurodegenerative disease common in middle-aged and elderly people. The incidence of Parkinson's disease in the elderly over 65 years old in mainland China is 1.7%, according to which it is estimated that there are more than 3 million Parkinson's disease patients in China. There are 100,000 new cases every year.
On the occasion of the 26th World Parkinson's Day, how can the long-term needs of Parkinson's patients be met? In this regard, Professor Chen Shengdi of the Department of Neurology of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine said in an interview with the 21st Century Business Herald reporter that Parkinson's disease is a chronic disease, once the disease is accompanied by patients for life, and the disease will continue to worsen over time.
"At present, the diagnosis and treatment level of Parkinson's disease cannot be reversed, so that the disease has early, middle and advanced stages, but there are differences in the treatment plan at different stages, and there are individual differences according to the course of the disease, the severity of the disease, and the sensitivity of patients." Therefore, in our treatment, the treatment in the early stage should propose an optimized treatment plan to postpone him to the middle and late stage. Chen Shengdi stressed that it is of great significance to promote the integration, standardization and precision of Parkinson's diagnosis and treatment, so that the diagnostic level of doctors at all regions and levels in China can be gradually balanced, and the overall level can be improved.
Individual symptoms vary widely in patients with Parkinson's disease
Parkinson's disease (PD) is a chronic progressive neurodegenerative disease common to middle-aged and elderly people, which seriously affects the patient's ability to move and even the quality of life, and there is currently no cure. At present, there are about 3 million Parkinson's disease patients on the mainland, which is the largest number of Parkinson's disease patients in the country. According to experts from the World Health Organization, by 2030, the number of parkinson's disease patients on the mainland will reach 5 million.
Although Parkinson's disease is a common chronic disease, the increasing number of patients with the disease and the level of disease management that still need to be improved have brought certain challenges to the diagnosis and treatment of Parkinson's disease in mainland China. Studies have shown that it takes more than 1 year on average for Patients with Parkinson's disease from onset to diagnosis, and even in first-tier cities such as Beijing, Shanghai, and Guangzhou, patients often encounter difficulties in diagnosis and treatment.
Professor Wang Tao of the Department of Neurology, Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, told the 21st Century Business Herald reporter that when Parkinson's disease enters the middle and late stages, it does not mean that there is no hope, and patients can still effectively improve symptoms, reduce or avoid adverse reactions through reasonable diagnosis and treatment, and do not stop or change drugs without authorization. When symptoms fluctuate or uncontrollable involuntary movements occur, it is necessary to seek medical treatment in time and reduce the pain caused by the disease and improve the quality of life through the diagnosis and treatment of a specialist.
The individual symptoms of patients with Parkinson's disease vary greatly and vary a lot, and their standardized diagnosis and treatment is particularly complex. In recent years, although many breakthrough results have been achieved in the treatment of Parkinson's diseases in mainland China, the problem of standardized diagnosis and treatment still needs to be improved.
Professor Zhang Zhentao of the Department of Neurology of Wuhan University People's Hospital also pointed out to the 21st Century Business Herald reporter that the early symptoms of Parkinson's disease include motor symptoms and depressive symptoms, sleep disorders, decreased sense of smell, constipation and other non-motor symptoms. Among them, motor symptoms include slow movement, difficulty starting, slow walking, tremor, shaking of hands and feet, affected fine movements, muscle stiffness, tube-like or gear-like.
Once Parkinson's disease occurs, the progression of the disease gradually increases over time, and Parkinson's disease progresses faster in the early stages than in the later stages. Therefore, if Parkinson's disease is diagnosed early, patients can respond early and fight the "anti-Parsian" protracted battle, and cannot wait until the symptoms affect life before taking measures. Early diagnosis and early diagnosis can not only better improve symptoms, but also help delay the progression of the disease.
"Early diagnosis of Parkinson's disease is a big problem because Parkinson's disease progresses to the point where patients come to see them when they have motor symptoms. In addition, patients cannot find the right doctor in the first place, and some patients will find an orthopedic department. In addition, Parkinson's disease is still difficult to diagnose, and some other auxiliary methods are needed, which requires the joint efforts of doctors, patients, families, and society, so as to improve the early diagnosis rate of patients. Zhang Zhentao said that in order to help patients achieve diagnosis as soon as possible, on the one hand, we need to establish a multidisciplinary joint diagnosis and treatment team, a one-stop Parkinson's disease diagnosis and treatment center, and integrate neurology, neurosurgery, psychiatry, rehabilitation and other departments, so that patients can get a full range of services;
On the other hand, it is necessary to continuously improve the accuracy of Parkinson's disease diagnosis and treatment with the help of medical equipment including PET and olfactory examination. In addition, since there is no method or test that can confirm Parkinson's disease, it has become our work to find some objective biomarker methods through research, or to diagnose Parkinson's disease with the help of blood draws or other tests.
There is an urgent need to create a full range of services for People with Parkinson's disease
In addition to diagnosis, according to the "White Paper on the Practice survey of Chinese neurologists", the number of neurologists in mainland China is about 100,000, which is equivalent to 1 doctor managing at least 100 Parkinson's disease patients, and how to achieve high-quality management of the disease under limited medical resources is a huge challenge facing the treatment of Parkinson's disease.
Chen Shengdi introduced that in order to help patients achieve the management goal of "full management, all-round service and comprehensive burden reduction", in 2020, the Neurologist Branch of the Chinese Medical Doctor Association launched the construction of Parkinson's Disease Specialist Center and Parkinson's Disease One-stop Diagnosis and Treatment Center. Through the network of diagnosis and treatment centers that has begun to form a large scale, a multidisciplinary diagnosis and treatment model has been established, and efforts have been made to improve the symptoms of Parkinson's disease in an all-round way. After two years of construction, 17 senior centers, 34 standard centers and 28 primary centers have been built across the country. The so-called "full management, full service, comprehensive burden reduction" specifically refers to:
Full management: that is, patient management is required in the early, middle and late stages of Parkinson's disease. Drugs are the preferred treatment for PD and an important means of full management. Early diagnosis and early treatment can effectively improve PD symptoms and delay disease progression, and after entering the middle and advanced stages of the disease, care and nursing care is also an important means of disease management.
All-round service: The establishment of the one-stop diagnosis and treatment center for Parkinson's disease in the hospital, the establishment of the payou hut outside the hospital, and the opening of online and offline drug purchase channels have helped to realize the all-round service of Parkinson's disease patients in and out of the hospital, online and offline.
Comprehensive burden reduction: The closed-loop management model can not only reduce the burden of medical treatment for patients and the burden of accompanying patients' families/nursing staff, but also reduce the pressure on the entire society and the medical system.
Parkinson's disease one-stop diagnosis and treatment center links patients, families, doctors, hospitals and medical institutions, communities, online pharmacies and other social parties to fight Parkinson's disease, patients only need to hang a number, you can get professional and standardized diagnosis and treatment in a diagnosis and treatment service area.
For Parkinson's disease, the whole process of patient management is related to multiple key links such as patients, hospitals, pharmacies, etc., and how to meet the needs of patients with out-of-hospital medication and rehabilitation management has become the key to opening up the closed loop of Parkinson's disease patient management. As an important position to open up the closed loop of management in the hospital and outside the hospital, "Payou Hut" will also gradually establish contact with the parkinson's one-stop diagnosis and treatment center hospital, forming a patient-centered "one-stop center - Payou hut" management closed-loop innovative diagnosis and treatment model - Payou can enjoy pharmaceutical services, medication guidance, consultation reminders, patient education and other services in the "Payou Hut".
"We must take a long-term view of the goal and vision of treatment, not only based on the present, but also look at the whole cycle of the disease." This is not only conducive to improving the early, middle and late stages, effectively improving symptoms, but also conducive to delaying the reduction of associated sports complications. To this end, one of the solutions we have adopted is to adopt a comprehensive treatment model, in the different stages of the patient's disease, not only the use of neurology drug treatment, but also some non-drug treatment, such as psychological counseling, strengthen the care, care, care and other multidisciplinary attention, to give patients a better optimized treatment plan. Chen Shengdi stressed that through the parkinson's disease specialty center, advanced center, standard center, through the three-level hierarchical diagnosis and treatment model, it helps to provide patients with more standardized and accurate diagnosis and treatment, so that patients can benefit.