从“郁”论治帕金森病抑郁

Treating Parkinson’s Disease with Depression from the Perspective of “Depression Syndrome”

摘要: 抑郁是帕金森病最常见的非运动症状之一，相较于单纯帕金森病患者，帕金森病抑郁患者的疾病进展更速，认知下降更著，依从性更差，致残率更高，照料起来更困难。然该病西医发病机制尚不明确，治疗效果欠佳，副作用多，遂从中医寻求诊治该病的理论支持。笔者认为，此病乃颤拘病与郁病合病，“郁证”为其核心病机。本文通过分析“郁证”与帕金森病抑郁的联系，阐述了从郁论治帕金森病抑郁的理论基础，认为郁证分为气血津液郁滞与情志抑郁，前者发为颤拘病，后者发为郁病，二者合而发为帕金森病抑郁。颤拘病与郁病发病不分先后，可相互影响，加速病程进展。治疗上应以调和气血、疏肝解郁为治则，兼顾心理疏导。

Abstract: Depression is one of the most common non-motor symptoms of Parkinson’s disease. Compared with patients with Parkinson’s disease alone, patients with Parkinson’s disease depression have faster disease progression, more pronounced cognitive decline, poorer adherence, higher disability rate, and more difficulty in care. However, the pathogenesis of the disease in Western medicine is still unclear, and the treatment effect is poor with many side effects, so we seek theoretical support from Chinese medicine to diagnose and treat the disease. In the author’s opinion, this disease is a combination of Parkinson’s disease and depression, and the core pathogenesis of the disease is the “depression syndrome”. In this paper, we analyzed the connection between “depression syndrome” and Parkinson’s disease with depression, and explained the theoretical basis of treating Parkinson’s disease with depression from “depression syndrome”. The onset of Parkinson’s disease and depression is not sequential, but can affect each other and accelerate the progression of the disease. The treatment should be to harmonize the qi and blood, dredge the liver and relieve depression as the treatment, taking into account psychological relief.