摘要
目的:观察针刺星状神经节对帕金森病(PD)体位性低血压(OH)患者的影响,探讨其作用机制。方法:将68例PD合并OH患者随机分为针药组(34例,脱落2例,剔除1例)和西药组(34例,剔除1例)。两组均给予稳定剂量的抗PD西药,西药组予盐酸米多君片口服,每次2.5mg,每天2次,针药组在西药组基础上针刺双侧星状神经节,不留针,每天1次,每周5 d。两组均治疗2周。分别于治疗前后观察两组患者卧位及立位血压、体位性低血压自评量表(OHQ)评分、中医证候积分、统一帕金森病评分量表(UPDRS)评分,检测两组患者血清去甲肾上腺素(NE)含量,并评定临床疗效。结果:治疗后,针药组患者立位收缩压(SBP)、舒张压(DBP)均较治疗前升高(P<0.01),OHQ评分、中医证候积分、UPDRS评分均较治疗前降低(P<0.01);西药组患者卧位SBP较治疗前升高(P<0.05),OHQ评分较治疗前降低(P<0.05);两组患者血清NE含量较治疗前升高(P<0.01)。治疗后,针药组立位SBP、DBP及血清NE含量高于西药组(P<0.01,P<0.05),OHQ评分、中医证候积分、UPDRS评分低于西药组(P<0.05,P<0.01)。针药组总有效率为87.1%(27/31),高于西药组的63.6%(21/33,P<0.05)。结论:针刺星状神经节可升高PD合并OH患者的立位血压,改善临床症状,其机制可能与上调NE水平有关。
Objective To observe the effect of acupuncture at stellate ganglion on orthostatic hypotension(OH) in Parkinson's disease(PD), and explore its action mechanism. Methods A total of 68 patients with OH in PD were randomly divided into a combination group(34 cases, 2 cases dropped out, 1 case was eliminated) and a western medication group(34 cases, 1 case was eliminated). Both groups received stable dose anti-PD western medication, the western medication group received oral midodrine hydrochloride tablets, 2.5 mg each time, 2 times a day. The combination group was treated with acupuncture at bilateral stellate ganglion on the basis of the western medication group, without retaining needles, once a day, 5 times a week. Both groups were treated for 2 weeks. Supine and orthostatic blood pressure, orthostatic hypotension questionnaire(OHQ) score, TCM syndrome score, unified Parkinson's disease rating scale(UPDRS) score before and after treatment in the two groups were observed, the level of serum norepinephrine(NE) was detected, and the clinical effect was evaluated. Results After treatment, orthostatic systolic blood pressure(SBP) and diastolic blood pressure(DBP) in the combination group were increased compared with those before treatment(P<0.01), OHQ score, TCM syndrome score,UPDRS score were decreased compared with those before treatment(P<0.01);supine SBP in the western medication group was increased compared with that before treatment(P<0.05), OHQ score was decreased compared with that before treatment(P<0.05);the levels of serum NE in both groups were increased compared with those before treatment(P<0.01). After treatment, orthostatic SBP, orthostatic DBP and the level of serum NE in the combination group were higher than those in the western medication group(P<0.01, P<0.05), the OHQ score, TCM syndrome score, UPDRS score were lower than those in the western medication group(P<0.05, P<0.01). The total effective rate was 87.1%(27/31) in the combination group, which was higher than 63.6%(21/32) in the western medication group(P<0.05). Conclusion Acupuncture at stellate ganglion can increase the orthostatic blood pressure in patients with OH in PD, improve clinical symptoms, and the mechanism may be related to the up-regulation of NE.
作者
李密密
周立峰
马金成
LI Mimi;ZHOU Lifeng;MA Jincheng(Department of Neurology,Lishui Hospital of TCM,Lishui 323000,Zhejiang Province,China;Department of Gerontology,Lishui Hospital of TCM,Lishui 323000,Zhejiang Province,China)
出处
《中国针灸》
CAS
CSCD
北大核心
2024年第10期1119-1124,共6页
Chinese Acupuncture & Moxibustion
基金
丽水市科技计划项目:2023GYX54。
关键词
体位性低血压
帕金森病
针刺
星状神经节
去甲肾上腺素
随机对照试验
orthostatic hypotension
Parkinson's disease
acupuncture
stellate ganglion
norepinephrine(NE)
randomized controlled trial(RCT)
