早中期帕金森病患者自主神经功能障碍的临床及中医辨证分型特点
Clinical and TCM syndrome differentiation characteristics of autonomic dysfunction with PD patients in early and middle stages
- 上海中医药杂志 2021年55卷第6期 页码：15-20
- 作者机构：
1.．上海交通大学医学院附属新华医院崇明分院神经内科（上海 202150）
2.．上海交通大学医学院附属新华医院神经内科（上海 200092）
- 作者简介：
施德，男，副主任医师，主要从事帕金森病发病机制及中西医结合治疗的研究工作
吴娜，主治医师；E-mail：wuna@xinhuamed.com.cn
- 基金信息：国家重点研发计划资助项目(2017YFC1310300);国家自然科学基金项目(81974173;81771211;81703852;81671273);上海市卫健委中西医临床协作试点项目(ZXYXZ-201907);上海市卫健委先进适宜技术推广项目(2019SY024);上海市卫健委上海医学引导类（中医、西医）科技支撑项目(19401932100);上海市卫健委综合医院中西医结合专项(ZHYY-ZXYJHZX-202021);上海市科委科研计划项目(17401901000)
DOI：10.16305/j.1007-1334.2021.2003055
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施德, 干静, 万赢, 等. 早中期帕金森病患者自主神经功能障碍的临床及中医辨证分型特点[J]. 上海中医药杂志, 2021,55(6):15-20.
De SHI, Jing GAN, Ying WAN, et al. Clinical and TCM syndrome differentiation characteristics of autonomic dysfunction with PD patients in early and middle stages[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(6):15-20.
施德, 干静, 万赢, 等. 早中期帕金森病患者自主神经功能障碍的临床及中医辨证分型特点[J]. 上海中医药杂志, 2021,55(6):15-20. DOI： 10.16305/j.1007-1334.2021.2003055.
De SHI, Jing GAN, Ying WAN, et al. Clinical and TCM syndrome differentiation characteristics of autonomic dysfunction with PD patients in early and middle stages[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(6):15-20. DOI： 10.16305/j.1007-1334.2021.2003055.
摘要
目的,2,探讨早中期帕金森病（PD）患者自主神经功能障碍的临床特点及中医辨证分型特点。,方法,2,使用PD自主神经功能障碍量表（SCOPA-AUT）确定自主神经症状的发生频率，将PD患者分为SCOPA-AUT评分低分组、高分组，对6类23个自主神经功能症状进行分析。同时，对PD患者进行中医辨证分型，分析各型自主神经功能障碍的特点。,结果,2,SCOPA-AUT低分、高分组两组之间消化系统症状、泌尿系统症状、心血管系统症状、体温调节、瞳孔调节出现的频率差异均有统计学意义（,P,<,0.05）。其中，消化系统、泌尿系统、心血管系统症状差异最大。SCOPA-AUT的23个症状中，排便费力、夜尿增多和便秘发生频率最高。伴随自主神经症状数量越多的PD患者，PD综合评分量表（UPDRS）评分(总分、Ⅰ评分、Ⅱ评分和 Ⅳ评分)、 汉密尔顿抑郁量表（HAMA）评分、汉密尔顿焦虑量表（HAMD）评分、PD患者生活质量问卷（PDQ-39）评分越高。PD患者肝肾不足型患者最多，各种中医分型中，痰热动风型患者消化系统症状分数最高。,结论,2,早中期PD患者自主神经功能障碍的发生率高，且常伴有多种自主神经症状，排便费力、夜尿增多和便秘最为常见，影响患者的生活质量。
Abstract
Objective,2,To investigate the clinical characteristics and TCM syndrome differentiation of autonomic dysfunction with Parkinson’s disease (PD) patients in early and middle stages.,Method,2,Scales for outcomes in Parkinson’s disease-autonomic dysfunction(SCOPA-AUT) was used to determine the frequency of autonomic symptoms. All PD patients were divided into two groups: low SCORA-AUT group and high SCORA-AUT group. Six categories of autonomic symptoms and twenty-three items were analyzed. Correspondingly, the PD patients were classified according to TCM syndrome differentiation to further analyze the characteristics of various types of autonomic dysfunction.,Results,2,There were significant differences in the frequency of digestive symptoms, urinary symptoms, cardiovascular symptoms, thermo-regulation and pupil regulation between the low and high SCOPA-AUT groups (,P,<,0.05). Among them, gastrointestinal, urinary and cardiovascular symptoms had the greatest difference. The top three frequency among 23 items of SCOPA-AUT were defecation, nocturia and constipation. The greater number of autonomic symptoms PD patients had, the higher the UPDRS score (total score, Ⅰ score, Ⅱ score and Ⅳ score), HAMA score, HAMD score and PDQ-39 score they had. According TCM differentiation, PD patients with liver and kidney deficiency were the most, and the score of digestive symptoms was the highest in patients with phlegm heat and wind.,Conclusion,2,The prevalence of autonomic dysfunction was high in early and middle stages of PD accompanied with variety of symptoms. Among these symptoms, defecation, nocturia and constipation were the most common, which seriously affected the quality of life of patients.
关键词
帕金森病自主神经功能障碍中医辨证分型临床特点
Keywords
Parkinson’s diseaseautonomic dysfunctionTCM syndrome differentiationclinical characteristics
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