摘要
目的探讨原发性帕金森病的关键中医证候。方法招募的108例原发性帕金森病患者中85例完成经颅黑质超声检查,测量黑质强回声区面积(SN)。应用帕金森病证候量表进行中医证候评分,将85例病例进行中医证候诊断,辨证为髓减证、阴虚证、肝风证、气虚证、内热证、肾虚证、脾虚证、阳亢证、痰浊证、血虚证、阳虚证、血瘀证、气滞证,并分为证候阳性组和证候阴性组。比较两组间黑质强回声区异常扩大(SN+)病例比例的差异,应用偏相关及Spearman相关分析中医证候与黑质强回声区面积的相关性。结果髓减证患者SN+占79.7%,高于非髓减证患者的36.4%(P=0.002);肾虚证患者SN+占84.6%,高于非肾虚证患者的65.2%(P=0.042)。髓减证(r=0.276,P=0.011)、肾虚证(r=0.279,P=0.011)、痰浊证(r=0.277,P=0.011)证候积分与最大侧黑质强回声区面积(SN_L)呈正相关;髓减证(r=0.297,P=0.006)、肾虚证(r=0.242,P=0.026)证候分布与SN_L呈正相关。结论髓减证、肾虚证、痰浊证是PD的关键证候,一定程度上反映了原发性帕金森病颅内黑质区的神经病理改变。
Objective To explore the key traditional Chinese Medicine(TCM) syndromes of primary Parkinson′s disease(PD). Methods A total of 108 patients with primary Parkinson′s disease were recruited and detected by transcranial substantia nigra ultrasound echo(TCS) in 85 patients to measure strong echo area of substantia nigra(SN). The Parkinson′s Disease Syndrome Scale was used to give scores TCM syndromes, and 85 cases were diagnosed with TCM syndromes. The syndrome differentiation include syndrome of marrow reduction, syndrome of yin deficiency, syndrome of liver wind, syndrome of qi deficiency, syndrome of internal heat, syndrome of kidney deficiency, syndrome of spleen deficiency, syndrome of hyperactivity of yang, syndrome of phlegm turbidity, syndrome of blood deficiency, syndrome of yang deficiency, syndrome of blood stasis, and syndrome of qi stagnation, and they were divided into syndrome positive group and syndrome negative group. The difference in the proportion of cases of abnormal enlargement of substantia nigra echo area(SN+) between the 2 groups were compared, and partial correlation and Spearman correlation were used to analyze the correlation between TCM syndromes and the area of substantia nigra echo area. Results The SN+ ratio in patients with the marrow reduction(79.7%) was higher than that in the patients with non-marrow reduction(36.4%, P= 0.002). The SN+ ratio in patients with kidney deficiency(84.6%) was higher than that in the non-kidney deficiency group(65.2%, P= 0.042). Syndrome scores of marrow reduction syndrome(r=0.276, P= 0.011), kidney deficiency syndrome(r=0.279, P= 0.011), phlegm turbidity syndrome(r=0.277, P= 0.011) were positively correlated with the largest substantia nigra echogenic areas(SN_L);the syndrome distribution of the syndrome of marrow reduction(r=0.297, P= 0.006) and kidney deficiency syndrome(r=0.242, P= 0.026) was positively correlated with SN_L. Conclusion The syndrome of marrow reduction, syndrome of kidney deficiency and syndrome of phlegm turbidity are the key syndromes of PD, which to some extent reflect the neuropathological changes in the substantia nigra of PD.
作者
李婷
田金洲
秦斌
周沪方
徐筱青
杜相宜
倪敬年
魏明清
张学凯
时晶
LI Ting;TIAN Jinzhou;QIN Bin;ZHOU Hufang;XU Xiaoqing;DU Xiangyi;NI Jingnian;WEI Mingqing;ZHANG Xuekai;SHI Jing(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100007;Beijing Hospital)
出处
《中医杂志》
CSCD
北大核心
2020年第11期971-977,共7页
Journal of Traditional Chinese Medicine
基金
首都卫生发展科研专项基金(首发2014-1-4191)
首都临床特色应用研究(Z141107002515019)
国家自然科学基金(81573824)。
关键词
帕金森病
经颅黑质超声
髓减证
肾虚证
痰浊证
Parkinson disease
transcranial substantia nigra ultrasound
syndrome of marrow reduction
syndrome of kidney deficiency
syndrome of phlegm turbidity
