血管性帕金森综合征与帕金森病中医证候的比较研究

目的:探讨血管性帕金森综合征(VPS)与帕金森病(PD)中医证候的异同点,从而阐明VPS的发病特点和中医证候特征。方法:临床收集VPS或PD病例共90例,进行临床证候学调查,并检测血糖、血脂、血液流变学指标,建立数据库,做统计学分析。结果:VPS组患者出现手部动作迟缓、颈肩僵直、步态不稳、表情呆板、智能障碍和锥体束征等临床症状和体征明显多于PD组患者(均P<0.01);VPS组中医证候中气虚、脾虚、痰证和血瘀证多于PD组(均P<0.01);VPS组复合证型中脾肾两虚、痰瘀内蕴和气虚血瘀两型明显多于PD组(均P<0.01);VPS组患者血浆粘度、血沉、TG、CHOL、LDL-C显著高于PD组患者(均P<0.01)。结论:VPS与PD在中医病因、病机及证型等方面均明显不同,应建立VPS的中医病因病机、临床证候及其中医诊断和临床疗效评定标准。

Comparative Research on Vascular Parkinson's Syndrome and Traditional Chinese Medical Syndrome of Parkinson's Disease

Objective:To explore the similarities and differences between Vascular Parkinson's Syndrome(VPS)and Traˉditional Chinese Medical Syndrome of Parkinson's disease(PD),and clarify the characteristics of VPS's onset and TCM syndrome.Methods:90cases of VPS and PD were collected to investigate the clinical symptoms and signs,and given the tests on testing blood pressure,blood sugar,blood-fat,and items of blood rheology.Then the database was established to make statistical analysis.Results:Compared to the PD group,more clinical symptoms and signs in the VPS group were observed as bradypragia of hand,rigidity of neck and shoulder,staggering gait,hypomimia,disturbance of intelligence and speech,and pyramidisign(P<0.01);TCMpatterns of middle-qi deficiency,spleen deficiency,phlegm,blood stagnaˉtion,deficiency of spleen and kidney,stagnation of blood and phlegm,and blood stagnation due to qi deficiency were much more than those in the VPS group,(P<0.01);plasmic viscosity,erythrocyte sedimentation,TG,CHOL,LDL-C were obviously higher(P<0.01).Conclusions:VPS and PD are different diseases with same syndromes,and have different TCMcauses,pathogenesis,and patterns.So the standards for VPS should be established to evaluate its TCMpathogenesis,clinical symptoms and signs,diagnosis and curative effects.