平肝潜阳法治疗肝肾阴虚型帕金森病疗效观察

Clinical observation on the treatment of Parkinson's disease with liver and kidney Yin deficiency syndrome by the method of calming liver and hiding Yang

目的 在“辨证论治”诊疗原则指导下,以平肝潜阳为治法,运用体针及中药汤剂结合疗法治疗肝肾阴虚型帕金森病患者,评价平肝潜阳法的疗效。方法 选取2019年10月至2022年3月于温州市中心医院神经内科住院部接受治疗的66例患者,采用随机数字表法分为治疗组和对照组,每组各33例。对照组单用口服抗帕西药,治疗组在对照组基础上加服镇肝熄风汤及“平肝潜阳”法针刺治疗,共治疗4周。治疗前后行帕金森病综合评分量表(unified Parkinson’s disease rating scale,UPDRS)、中医证候疗效评定量表、治疗副作用评估量表(treatment emergent symptoms scale,TESS)、帕金森生存质量量表(the 39-item Parkinson’s disease questionnaire,PDQ-39)评估,综合评定其疗效。结果 治疗4周后,两组的UPDRS评分分别较治疗前明显降低,且治疗组明显低于对照组(P<0.01);两组的PDQ-39评分分别较治疗前明显降低,且治疗组明显低于对照组(P<0.01);治疗组的肝肾阴虚主症、次症评分较治疗前显著下降(P<0.01),而对照组未见降低(P>0.05),治疗组的肝肾阴虚主症、次症评分明显低于对照组(P<0.05);治疗4周时,两组的TESS评分与治疗2周时比较,差异无统计学意义(P>0.05)。结论 以平肝潜阳为治法,运用体针及中药汤剂结合疗法,不良反应少,疗效确切,能显著改善帕金森病患者的生活质量,特别在改善肝肾阴虚症候方面具有明显的优势,为临床治疗帕金森病提供新的治疗方法及思路。

Objective Through collecting cases,under the guidance of the diagnosis and treatment principle of "differentiation of symptoms and signs",the treatment of Parkinson's disease patients with Yin deficiency of liver and kidney was evaluated by using the method of calming the liver and latent Yang as the treatment method,and the combination of body acupuncture and traditional Chinese medicine decoction.Methods A randomized and controlled clinical study was used 66 patients who were treated in the Department of Neurology of Wenzhou Central Hospital from October 2019 to March 2022 were selected for the study.The above patients were divided into treatment group and control group.The control group was treated with oral anti Paxil alone,while the treatment group was treated with Zhengan Xifeng decoction and acupuncture with the method of "calming the liver and hiding the Yang" on the basis of the control group for 4 weeks.Before and after the treatment,the comprehensive Parkinson's disease rating scale(UPDRS),TCM syndrome efficacy evaluation scale,TESS side effect evaluation scale and Parkinson's quality of life scale(PDQ-39) were used to comprehensively evaluate the efficacy.Results After 4 weeks of treatment,the UPDRS score of the two groups was significantly lower than that before treatment,and the UPDRS score of the treatment group was significantly lower than that of the control group(P<0.01);The PDQ-39 score of the two groups was significantly lower than that before treatment,and the PDQ-39 score of the treatment group was significantly lower than that of the control group(P<0.01);The score of primary and secondary symptoms of liver and kidney Yin deficiency in the treatment group was significantly lower than that before treatment(P<0.01),while the score of primary and secondary symptoms of liver and kidney Yin deficiency in the control group was not lower than that before treatment(P>0.05).The main and secondary symptoms of liver and kidney yin deficiency in the treatment group were significantly lower than those in the control group;At 4weeks of treatment,the TESS scores of the two groups were compared with those at 2 weeks of treatment,with no significant difference(P<0.05).Conclusion The study found that compared with the simple western medicine treatment,the combination of body acupuncture and traditional Chinese medicine decoction with the method of calming the liver and concealing Yang has no more side effects,better curative effect,and more significant improvement in the quality of life of Parkinson's patients,especially in improving the syndrome of deficiency of liver and kidney Yin.This method provides a new treatment method and thinking for the clinical treatment of Parkinson's disease.