帕金森病伴情绪障碍患者证素分布及神经递质特征初探

目的] 分析帕金森病（PD）伴情绪障碍患者的证素分布特征，初步探究PD伴情绪障碍患者的脑内神经递质特征。方法] 选择2016年1—12月就诊于本院脑病科门诊的41例PD患者，按照情绪障碍诊断标准分为PD伴情绪障碍组与PD非情绪障碍组，对纳入患者进行一般情况、中医四诊信息、汉密尔顿抑郁量表、汉密尔顿焦虑量表的测评，并对其中可配合脑电超慢涨落分析的27例PD患者进行神经递质检测。结果] PD伴情绪障碍组心神、气滞出现频次明显高于PD非情绪障碍组，差异具有统计学意义（P<0.05）；PD伴情绪障碍组心神、心、肝、热、气滞、阳亢、阴虚的分值明显高于PD非情绪障碍组，两组间差异具有统计学意义（P<0.05）。PD伴情绪障碍组与PD非情绪障碍组相比，谷氨酸（GLU）的测定值较高，5-羟色胺（5-HT）、乙酰胆碱（ACH）的测定值较低，两组间差异具有统计学意义（P<0.05）。结论] PD伴情绪障碍患者可在治疗帕金森病的基础上佐以养心安神，理气通滞之品。GLU的升高，5-HT、ACH的降低可能为PD患者发生情绪障碍的神经生化基础。

Distribution of syndrome elements and primary study of neurotransmitter characteristics in Parkinson's disease with emotional disorder

Objective] To analyze the distribution pattern of syndromes in patients with Parkinson''s disease(PD) and mood disorders,and to explore the characteristics of neurotransmitters in the brain of PD patients with mood disorders.Methods] Forty-one patients with PD who were enrolled in the department of encephalology from January to December 2016 were divided into PD with emotional disorder group and PD non-emotional disorder group according to the diagnostic criteria for emotional disorders. The four diagnostic information of TCM,the Hamilton Depression Scale,and the Hamilton Anxiety Scale were evaluated. Neurotransmitters were tested in 27 PD patients who could be used in the analysis of ultra-slow fluctuations in EEG.Results] Compared with the non-emotional disorder group,the frequency of mind and qi stagnation in emotional disorder group was higher,the difference was statistically significant (P<0.05);Compared with the non-emotional disorder group,the score of mind,heart,liver,heat,qi stagnation,yang hyperactivity,yin deficiency were higher,and the cold score was lower,the difference was statistically significant(P<0.05);Compared with the non-emotional disorder group,the determination values of glutamic acid (GLU) were higher,while those of 5-hydroxytryptamine (5-HT) and acetylcholine (ACH) were lower,the difference was statistically significant (P<0.05).Conclusions] PD patients with mood can be on the basis of the treatment of Parkinson''s disease with the drugs of nourishing the heart and calming the mind,regulating qi and promoting stagnation. The increase of glutamic acid,the decrease of 5-hydroxytryptamine and acetylcholine may be the neurobiochemical basis for emotional disorders in PD patients.