帕金森病排便障碍中医证候特征研究

目的]探讨帕金森病(PD)排便障碍的中医证候特征,为中医治疗PD排便障碍提供辨证论治依据。方法]将纳入的102例PD患者,依据排便障碍诊断标准分为PD排便障碍组(44例)和非排便障碍组(58例)。应用PD证候量表(PD-PES-13)对两组受试者进行中医证候评分。分析PD排便障碍的中医证候特征及其与中医证候的相关性。结果]证候积分方面,两组均以髓减积分数值为最高,排便障碍组(9.44±5.98)分,非排便障碍组(9.18±5.60)分。经卡方检验,PD排便障碍患者脾虚比例高于非排便障碍患者(P0.01)。PD排便障碍患者中,髓减证与HOEHNYAHR(HY)分级呈正相关(P0.05);髓减证、肝风证与统一帕金森病评定量表(UPDRS)积分具有相关性(P0.05或P0.01)。结论] PD可能以髓减证突出。脾虚对伴发排便障碍的PD患者可能存在影响。PD排便障碍患者HY分级越高髓减证越重。随着UPDRS积分升高,PD排便障碍患者髓减证和肝风证逐渐加重。

Study on characteristics of TCM syndrome in Parkinson's disease with defecation disorder

Objective] To investigate the characteristics of traditional Chinese medicine (TCM) syndromes of Parkinson disease (PD) in defecation disorders and to provide evidence for the treatment of PD defecation disorders in Chinese medicine.Methods] The 102 patients with PD who were included were classified into PD defecation disorder group (44 cases) and non-defecation disorder group (58 cases) according to the diagnostic criteria of defecation disorder. Patients with two groups were treated with the syndrome score of Parkinson''s disease (PD-PES-13). To analyze the features of TCM syndromes of PD defecation disorder and its correlation with TCM syndromes.Results] In terms of syndrome scores, the scores for myelination were highest in both groups (9.44±5.98) for defecation disorder group and (9.18±5.60) for non-defecation disorder group. After chi-square test, the proportion of spleen-deficiency in PD patients was higher than that of patients without defecation (P<0.01). In patients with PD defecation disorder, there was a positive correlation between declining myelin levels and HOEHN&YAHR (H&Y) scores (P<0.05). And there was a linear relationship (P<0.01) among myelination syndrome, hepatic wind syndrome, and Parkinson''s disease rating scale (Unified Parkinson''s). The scores of Disease Rating Scale (UPDRS) were correlated (P<0.05 or P<0.01).Conclusion] PD may be prominent with myeloid degeneration. Spleen deficiency may have effects on PD patients with defecation disorders. The higher the H&Y grade in patients with PD defecation disorder, the higher the marrow reduction certificate. With the increase of UPDRS scores, patients with PD defecation disorder have gradually increased their pith and hepatic wind syndrome.