帕金森病伴吞咽障碍的康复及中医治疗研究进展

Progress in traditional Chinese medicine and rehabilitation for dysphagia in Parkinson’s disease

帕金森病(Parkinson’s disease,PD)伴吞咽障碍发病率高,早期症状隐匿,识别率低,易导致吸入性肺炎和营养不良等并发症,影响患者生活质量。使用有效的筛查工具和客观的仪器检查有助于及早识别吞咽损害模式,为PD伴吞咽障碍患者制定包括药物、手术和康复的个体化治疗方案提供依据。中医以整体观、辨证辨病相结合以及经络腧穴等理论为基础,治疗PD伴吞咽障碍具有一定的优势。综合康复技术和中医疗法进行协同治疗,可使PD伴吞咽障碍患者获得优化治疗。本文对PD伴吞咽障碍的诊断与评估、治疗与康复以及中医治疗的进展进行综述,以期为神经科医师、言语及吞咽治疗师及其他相关临床医师在管理PD伴吞咽障碍的临床实践中提供帮助。

Dysphagia in Parkinson’s disease(PD)is characterized by high incidence rate,hidden early symptoms,and low recognition rate,which can easily lead to complications such as aspiration pneumonia and malnutrition,affecting patients’quality of life.The use of effective screening tools and objective instrument examinations is helpful for early identification of swallowing damage patterns,and provides the basis for individualized treatment including drug therapy,surgery and rehabilitation for dysphagia in PD.Based on the theory of holism,syndrome differentiation and disease differentiation,and meridian and acupoint theory,traditional Chinese medicine has certain advantages in the treatment of dysphagia in PD.Comprehensive rehabilitation and traditional Chinese medicine therapy are combined to optimize the treatment.This paper reviews the diagnosis,evaluation,treatment and rehabilitation of dysphagia in PD and the progress in treatment with traditional Chinese medicine,in order to provide help for neurologists,speech and swallowing therapist and other clinicians in the management of dysphagia in PD in clinical practice.