[이데일리 이순용 기자] Parkinson’s disease is the most common degenerative brain disease along with dementia. The prevalence rate in Korea is estimated to be about 225 per 100,000 people and is increasing every year as the population ages. According to the National Health Insurance Corporation, the number of Parkinson’s disease patients in Korea has nearly doubled in 10 years, from 61,565 in 2010 to 116,504 in 2021. Parkinson’s disease is a disease in which a variety of symptoms are common, ranging from tremors, muscle stiffness and postural instability to pain, depression, anxiety and sleep disturbances, significantly reducing quality of life. With the help of Professor Seongwook Park of the Oriental Internal Medicine Department of Gangdong Kyung Hee University Hospital, we learn about the current status of Parkinson’s disease and the step-by-step treatment methods in Oriental medicine.
◇ Destruction of neurons in the midbrain substantia nigra resulting in abnormal dopamine secretion
Parkinson’s disease occurs when dopamine-secreting neurons in the substantia nigra of the midbrain are gradually destroyed. When nerve cells in the substantia nigra are destroyed and dopamine is not secreted, the body shakes at rest, muscles stiffen, movement slows down, and posture becomes unstable, making walking difficult. As these motor symptoms of Parkinson’s disease progress, it becomes difficult for patients to maintain independent daily living and they are limited in social activities. Additionally, non-exercise-related symptoms, such as pain, depression, anxiety, cognitive impairment, sleep disturbances, constipation, and orthostatic hypotension, are common, and patients’ quality of life is reduced.
◇ Incurable disease, improving the quality of life is the top priority
Parkinson’s disease is a disease that so far cannot be cured and aims to improve the quality of life of patients by controlling symptoms. In this regard, levodopa supplementation therapy is also used, which is currently used as standard therapy for the treatment of Parkinson’s disease. However, there are many uncontrolled symptoms such as postural instability, frozen walking, slurred speech, fatigue, pain and autonomic nervous disorder, and there are many cases where drugs cannot be used for a long time due to drug side effects. Reflecting this situation, it has been reported that many Parkinson’s disease patients around the world are using various complementary and alternative therapies in addition to conventional drug treatment. Of these, the most widely used treatments worldwide are oriental medicine treatments, including acupuncture and herbal medicine.
◇ Oriental medicine treatment to delay disease progression and improve symptoms
Considering the therapeutic tradition of oriental medicine and the latest research findings, the role of oriental treatment in the management of Parkinson’s disease is 1) to delay the progression of the disease, 2) to improve the motor and non-motor symptoms of Parkinson’s disease, 3) It can be summarized as an improvement in the quality of life of patients by showing a synergistic effect when used simultaneously with dopamine.
First, oriental medicine treatment delays the progression of Parkinson’s disease by preventing the destruction of dopaminergic neurons present in the substantia nigra of the midbrain. In fact, according to the results of a five-year study of Parkinson’s disease patients, patients who received acupuncture together had delayed progression of Parkinson’s disease compared with patients who received drug therapy alone. Various herbal medicines such as bee venom acupuncture, wonji, cheonma, astragalus, galgeun, golden, peony and ginseng and prescriptions such as cheonghyeoldan, eokgansan and cheonggantang have also been shown to inhibit the progression of Parkinson’s disease by protecting the brain neurons.
Secondly, the quality of life can be improved by improving various symptoms of Parkinson’s disease patients through the treatment of oriental medicine. Through the study, it was confirmed that acupuncture and pharmacopuncture treatment improved motor function, daily living skills, balance, and walking speed. In particular, falls, which occur 46 to 68% per year due to balance and gait disturbances, have a significant impact on decreasing quality of life and increasing mortality in Parkinson’s disease patients . Furthermore, herbal treatments such as Army Ja-tang and Banhahu-bak-tang have been reported to relieve various non-motor symptoms such as digestive disorders, swallowing disorders, cognitive dysfunction, depression, and sleep disturbances.
Third, dopamine, a standard treatment for Parkinson’s disease, and oriental medicine treatment can exert a synergistic effect. According to a recently published study, if you take dopamine and are simultaneously receiving acupuncture treatment or oriental medicine treatment such as Chunma or Cheonggantang, you can expect the same degree of symptomatic improvement with a small amount of dopamine. It has been confirmed that side effects can also be reduced. This means that in the case of receiving oriental treatment together, the same effect can be achieved even with a small amount of dopaminergic drug, so that drug treatment is possible for a long time and the side effects caused by the drug can be reduced.
◇ Step by step herbal treatment for Parkinson’s disease
In this way, the herbal treatment for Parkinson’s disease progresses for each patient, from suppressing the progression in the initial state, to controlling the various symptoms afflicting the patient, to improving the condition in which balance control or of walking becomes difficult as the disease progresses further. It can be applied effectively according to the grade. Therefore, in order to effectively manage Parkinson’s disease, an appropriate plan must be established and implemented for each patient considering the individual patient’s disease status, daily living patterns, and quality of life. The step-by-step herbal treatment for the management of Parkinson’s disease patients according to the progress is as follows.
Phase 1: Target patients whose symptoms are well controlled through dopamine supplementation therapy, which is the standard treatment, or whose symptoms are not severe. Visitor treatment is done once every 1-2 weeks and treatment focuses on suppressing disease progression and managing symptoms.
Phase 2: It is aimed at patients suffering from symptoms such as tremors, stiffness, constipation, fatigue, lethargy and pain caused by Parkinson’s disease. Treatment is conducted 2-3 times a week and the aim is to relieve discomfort through active improvement of symptoms.
Stage 3: Patients with impaired gait due to impaired balance control and risk of falling are eligible. Inpatient intensive care is required. After hospitalization, treatment is given to improve balance and walking function.
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