帕金森病中医证候特征研究

目的初步研究帕金森病的中医证候要素特征及中医证型分布规律,为中医药干预提供辨证依据。方法对118例帕金森病患者的主要症状按照术语标准化和规范化的相关要求设计《帕金森病中医证候信息采集表》,调查表主要包括患者的一般资料、既往病史、临床表现、诊断结论等,筛选出92条症状条目进行聚类分析。结果归纳出8种帕金森病常见主症：手足震颤、动作迟缓、四肢拘急、肢体麻木、表情淡漠、行走困难、步态慌张、身体僵直。病性证候要素中以髓减、气虚、阴虚、肾虚为主,阳亢、内热、痰浊次之。病位要素则同样以脑、髓为主,肾、脾、肝次之。对本病症状进行聚类分析,初步得出5种证候类型：肾虚髓减,气阴亏虚,阴虚阳亢,脾虚痰盛,气虚发热。结论帕金森病有着本虚的基础,肾虚髓减贯穿疾病的全程,气虚、阴虚在帕金森病发病机制中占重要位置,阳亢、痰浊、内热则是随着疾病的发展所占比例越来越突出,病位要素中以肾、脑、髓贯穿疾病的全程,肝、脾随疾病的发展所占比例越多。

Study of the TCM Syndrome Characteristic of 118 Patients of Parkinson＇s Disease

Objective To study TCM syndrome elements and their distribution characteristic of Parkinson＇s disease（PD）.Methods The Table of TCM Clinical Information of PD Patients based on the main symptoms and TCM syndromes of 118 PD patients was designed according to the standardization terms. It mainly included the general information, history of disease, clinical manifestations,diagnosis,etc. ninety-two symptoms were screened out for sample clustering analysis. Results Eight common symptoms of PD were generalized,i. e. tremor of hands or feet,Bradykinesia,numbness of limbs,dull facial expressions,slow movement,clumsy movement,unsteady walking,festinating gait,predisposed to pain,stiff body. Of the syndrome elements,marrow deficiency and kidney deficiency,yin deficiency and qi deficiency were mostly common. Of the location elements,marrow /brain and kidney are mainly involved,and then spleen and liver. In the syndrome classification,the four syndromes such as kidney deficiency with marrow deficiency, spleen deficiency with phlegm, both qi and yin deficiency, qi deficiency and heat were common.Conclusion PD owns a Ben-root deficiency,with kidney deficiency and marrow deficiency in the whole process of disease,yin deficiency,qi deficiency occupying large percentage in the development of disease;with brain/marrow and kidney involved in the whole process of disease,liver and spleen occupying larger and larger percentage in the development of disease.