帕金森病患者直立性低血压非药物干预的最佳证据总结

Summary of the best evidence on non-pharmacological interventions for orthostatic hypotension in patients with Parkinson disease

目的检索并总结帕金森病患者直立性低血压非药物干预的最佳证据。方法基于6S模型,系统检索国内外数据库中有关帕金森病患者直立性低血压非药物干预的相关指南、临床决策、证据总结、系统评价和专家共识等,检索时限为建库至2022年12月。由2名研究者独立筛选文献,对纳入的文献进行质量评价,并对符合质量标准的文献进行证据提取和总结。结果共纳入文献15篇,包括指南4篇、临床决策2篇、证据总结1篇、系统评价3篇、专家共识5篇,从目的、评估、容量干预、运动干预、体位干预、物理干预、健康教育及支持7个方面总结出24条最佳证据。结论帕金森病患者直立性低血压非药物干预的最佳证据可为临床医护人员实践提供参考,建议结合患者的病情、偏好、临床环境等有针对性地应用最佳证据,从而降低帕金森病患者直立性低血压的发生率,保障患者的安全。

Objective To search for and summarize the best evidence on non-pharmacological interventions for orthostatic hypotension in patients with Parkinson disease.Methods Based on the 6S model,the relevant guidelines,clinical decisions,evidence summaries,systematic reviews and expert consensus on non-pharmacological interventions for orthostatic hypotension in Parkinson disease patients were systematically retrieved from domestic and foreign databases.The search time was from the establishment of the database to December 2022.Two researchers independently screened the literature,evaluated the quality of the included literature,and extracted and summarized evidence that met the quality standards.Results A total of 15 articles were included,including 4 guidelines,2 clinical decision-making articles,1 evidence summary article,3 systematic evaluations and 5 expert consensus articles.A total of 24 pieces of best evidence were summarized from 7 aspects,including purpose,evaluation,capacity intervention,exercise intervention,posture intervention,physical intervention,health education and support.Conclusions The best evidence on non-pharmacological intervention for orthostatic hypotension in patients with Parkinson disease can provide a reference for the practice of clinical medical staffs.It is suggested to apply the best evidence in combination with the patient's condition,preference and clinical environment,so as to reduce the incidence of orthostatic hypotension in patients with Parkinson disease and to ensure the safety of patients.