六经辨证葛根舒筋汤论治血管性帕金森综合征的临床研究

A clinical study on treating vascular Parkinson’s syndrome with the Gegen Shujin decoction based on Six meridians differentiation

目的:探讨葛根舒筋汤在改善血管性帕金森综合征(Vascular Parkinson’s syndrome,VP)患者日常生活及运动方面的作用,及能否改善微循环。方法:随机将117例VP患者分为对照组、饮片治疗组、颗粒治疗组三组。对照组给予常规脑梗死治疗及多巴胺治疗,行肢体功能康复训练。饮片型治疗组在对照组治疗基础上,给予中药葛根舒筋汤治疗。颗粒型治疗组在对照组的基础上,将单颗粒型的葛根舒筋汤混合成剂治疗。三组均以4周为一个疗程。治疗前后观察统一帕金森氏病评分量表(Unified Parkinson’s Disease Rating Scale,UPDRS)Ⅰ-Ⅲ评分、39项帕金森病调查表(The 39-item Parkinson’s Disease Questionnaire,PDQ-39)、中医证候评分、同型半胱氨酸(Homocysteine,Hcy)、经颅多普勒超声(Transcranial Doppler,TCD)。结果:治疗后,三组的UPDRS Ⅰ-Ⅲ评分、PDQ-39、中医证候评分、Hcy、TCD对比差异有统计学意义。结论:葛根舒筋汤的饮片和颗粒剂在改善VP患者症状及中医证候方面均有较明显的优势,且Hcy的减少和TCD中大脑动脉血流速度改变提示葛根舒筋汤对血管损害因子有抑制作用,对血管痉挛有改善作用。

Objective:To investigate the effect of the Gegen Shujin decoction(葛根舒筋汤)in improving daily life and exercise in vascular parkinson(VP)patients,and whether it can improve microcirculation.Methods:A total of 117 patients with VP were randomly divided into three groups namely the control group,the decoction group and the granules group.The control group was given routine cerebral infarction treatment plus dopamine treatment,and received limb function rehabilitation training.The decoction group was given additionally the Gegen Shujin decoction more compared with the control group.The granules group received granular dosage form of the Gegen Shujin decoction more compared with the control group.The three groups all took 4 weeks as a course of treatment.Results:After treatment,there were differences in unified Parkinson’s disease rating scale(UPDRS)Ⅰ-Ⅲ score,the 39-item Parkinson's disease questionnaire(PDQ-39),TCM syndrome score,Hcy and TCD among the three groups.Conclusion:The decoction piece dosage form and granules form of the Gegen Shujin decoction both have obvious advantages in improving the clinical symptoms and TCM symptoms of VP patients.The reduction of Hcy and the change of blood flow velocity of middle cerebral artery in TCD suggest that the Gegen ShuJin decoction has an inhibitory effect on vascular damage factors and can improve vasospasm.