摘要
目的:分析帕金森病(PD)患者的中医辨证分型和西医临床分型,探讨PD患者的中西医临床特点。方法:纳入209例早中期PD患者,分析患者的中医辨证分型和西医临床分型,并采用相关量表对患者的运动症状、非运动症状、生活质量进行评估,同时采用多重对应分析方法分析中医辨证分型与西医临床特征的相关关系。结果:根据中医辨证分型,肝肾不足型患者最多,其次是气血不足型、气滞血瘀型,痰热动风型患者最少。根据西医分型,姿势不稳/步态障碍(PIGD)型患者最多,其次是震颤(TD)型,中间型患者最少。多重对应分析结果显示,气滞血瘀型PD患者年龄多≤55岁,以女性为主,运动症状较轻,临床上多单侧肢体受累;肝肾不足型PD患者年龄多>65岁,临床表现为姿势步态障碍,运动症状稍重,多双侧肢体受累。以上两型患者非运动症状较少,生活质量较高。痰热动风型、气血不足型PD患者生活质量稍差,可能与痰热动风型患者非运动症状较多且较重、气血不足型患者运动症状重有关。结论:早中期PD患者以肝肾不足型最常见,多表现为姿势不稳/步态障碍,治疗上应将中医辨证分型与西医分型相结合,以期提高临床疗效。
Objective:To analyze the traditional Chinese medicine(TCM)syndrome differentiation and western medicine clinical classification of patients with Parkinson’s disease(PD),and explore the clinical characteristics of PD patients in TCM and western medicine.Methods:A total of 209 patients with early and middle stage PD were included,the TCM syndrome differentiation and western medicine clinical classification of these patients were analyzed,and the motor symptoms,non-motor symptoms and quality of life were evaluated by the related scales.Meanwhile,the correlation between TCM syndrome differentiation and western medicine clinical characteristics was analyzed by multiple correspondence analysis.Results:According to the TCM syndrome differentiation,patients with syndrome of liver and kidney deficiency were the most,followed by syndrome of qi and blood deficiency and syndrome of qi stagnation and blood stasis,and patients with syndrome of phlegm heat and wind stirring were the least.According to the western medicine classification,patients with postural instability/gait disorder(PIGD)type were the most,followed by tremor dominate(TD)type,and patients with intermediate type were the least.The results of multiple correspondence analysis showed that,the age of PD patients with syndrome of qi stagnation and blood stasis was mostly not more than 55 years old,these patients were mainly female with mild motor symptoms and common unilateral limb involvement in clinic.The age of PD patients with syndrome of liver and kidney deficiency was mostly more than 65 years old,the clinical manifestations of these patients included postural and gait disorders,with slightly severe motor symptoms and common bilateral limb involvement.The patients with above two syndromes showed less non-motor symptoms and better quality of life.The life quality of PD patients with syndrome of phlegm heat and wind stirring and syndrome of qi and blood deficiency was slightly worse,which may be related to more and serious non-motor symptoms in patients with s
作者
吴娜
赵嘉豪
宋璐
万赢
干静
张煜
李琳
李文涛
刘振国
WU Na;ZHAO Jiahao;SONG Lu;WAN Ying;GAN Jing;ZHANG Yu;LI Lin;LI Wentao;LIU Zhenguo(Department of Neurology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Encephalopathy,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)
出处
《上海中医药大学学报》
CAS
2021年第5期26-31,共6页
Academic Journal of Shanghai University of Traditional Chinese Medicine
基金
国家重点研发计划“重大慢性非传染性疾病防控研究”专项项目(2017YFC1310300)
国家自然科学基金资助项目(81974173,81771211,81703852)
上海市综合医院中西医结合专项项目(ZHYY-ZXYJHZX-202021)
上海市科委生物医药领域科技支撑项目(17401901000)
上海高水平地方高校创新团队上海市卫健委先进适宜技术推广项目(2019SY024)
上海医学引导类科技支撑项目(19401932100)
上海市中西医临床协作试点项目(ZXYXZ-201907)。
关键词
帕金森病
临床分型
中医辨证分型
Parkinson’s disease
clinical classification
Chinese medical syndrome differentiation and classification
