帕金森病证型分布与证候特点的研究

Study on the Distribution and Syndrome Characteristics of Parkinson’s Disease

摘要: 目的：通过研究早中期帕金森病的证型分布规律以及证候特点，希望能够进一步为中医辨证分型治疗早中期帕金森病的临床推广提供重要依据。方法：通过多中心门诊途径收集符合纳入标准的早中期帕金森病患者，进行中医证候的辨别及相关内容的调查问卷。结果：308例受试者的证型分布从多到少依次是肝肾不足(40.9%)，气血不足(29.2%)，气滞血瘀(15.6%)，痰热动风(14.3%)。性别、年龄、病程、改良Hoehn-Yahr分级、运动症状(静止性震颤、肌强直)在证型之间均无统计学差异。痰热动风证型的患者UPDRS评分最高，气滞血瘀证型最低。四种证型仅在UPDRS IV评分比较上无统计学差异，余均有统计学差异。非运动症状中伴有快动眼期睡眠行为异常症状多见于肝肾不足和气血不足。伴有便秘症状多见于肝肾不足，气血不足和痰热动风。伴有抑郁症状在证型之间无统计学差异。结论：早中期帕金森病患者以肝肾不足证型为主，总体以虚证为主，肝肾不足在帕金森病的早中期贯穿始终。痰热动风的患者UPDRS评分最高，气滞血瘀最低。伴快动眼期睡眠行为异常症状多见于肝肾不足和气血不足，伴便秘多见于肝肾不足，气血不足和痰热动风。

Abstract: Objective: by studying the distribution law and syndrome characteristics of the early and middle stage of Parkinson’s disease, we hope to provide an important basis for the clinical application of TCM syndrome differentiation in early and middle stage Parkinson’s disease. Methods: patients with Parkinson’s disease in early and middle stages who met the inclusion criteria were collected through multi-center outpatient service. Results: the syndromic types of 308 subjects were mainly liver and kidney deficiency (40.9%), qi and blood deficiency (29.2%), qi stagnation and blood stasis (15.6%), phlegm, heat and wind (14.3%). There were no statistically significant differences in gender, age, course of disease, modified Hoehn-Yahr grading, motor symptoms (quiescent tremor, myotonia) between syndromes. The UPDRS score of phlegm, heat and wind syndrome was the highest, and the qi stagnation and blood stasis syndrome was the lowest. There was no statistical difference in the UPDRS IV scores among the four syndromes, and there were statistical differences in the rest. Non-motor symptoms accompanied by rapid eye movement phase sleep behavior abnormal symptoms are more common in the liver and kidney insufficiency and insufficient blood. Companion has constipation symptom to see at liver and kidney deficiency, qi and blood deficiency and Phlegm hot wind. There was no statistically significant difference between syndromes with depressive symptoms. Conclusion: in the early and middle stage of PD, liver and kidney insufficiency is the main type, and deficiency syndrome is the main type. Liver and kidney insufficiency runs through the early and middle stage of PD. The UPDRS score was highest in phlegm, heat and wind, and lowest in qi stagnation and blood stasis. Companion has sleep behavior with rapid eye movement is more common in liver and kidney insufficiency, insufficient blood. Companion has constipation symptom to see at liver and kidney deficiency, qi and blood deficiency and Phlegm hot wind.