基于五脏论治帕金森病的研究近况

Recent research on treating Parkinson’s disease based on the five Zang organs

帕金森病是一种慢性进展性神经系统变性疾病,临床上主要表现为运动迟缓、静止性震颤、肌强直、姿势平衡障碍的运动症状以及睡眠障碍、嗅觉、自主神经等非运动症状。对患者的生理、心理造成了严重的影响,也给社会带来沉重的负担,目前我国帕金森病患者众多,且伴随着人口老龄化的加重,帕金森病患者的数量呈现增加的趋势。目前临床上多采取复方左旋多巴、多巴胺受体激动剂等药物治疗以及手术治疗等疗法以控制患者的运动症状,对于非运动症状多采取临时对症处理的方法,在临床上取得的效果有限,甚至在疾病的中后期会加重患者的运动及非运动症状,故应积极发挥中医药在帕金森病中的治疗作用。中医认为帕金森的基本病因病机为肝风内动,筋脉失养,病位在筋脉,与肝、脾、肾三脏密切相关,总体病理性质属本虚标实。人体是以五脏为中心的一个有机整体,五脏之间相互影响,相互克制,其运动症状及非运动症状在病因病机上也着相似之处,文章从五脏分别归纳总结帕金森疾病的病因病机以及近些年来中医治疗帕金森病的概况,并根据疾病的不同发展阶段、病邪性质以及正气亏损情况采取不同的治则治法,以寻求中医更规范化、系统化地诊治帕金森病。

Parkinson’s disease is a chronic progressive deform disease of the nervous system.The main clinical manifestations are motor symptoms such as motor retardation,static tremor,myotonia,postural balance disorders and non-motor symptoms such as sleep disorders,olfaction,autonomic nervous system.It has a serious impact on the physiology and psychology of patients,and also brings a heavy burden to society.At present,there are a large number of patients with Parkinson’s disease in our country,and with the aggravation of population aging,the number of patients with Parkinson’s disease shows an increasing trend.At present,compound levodopa,dopamine receptor agonists and other drug therapy as well as surgical therapy are usually used to control patients’motor symptoms.For non-motor symptoms,temporary symptomatic treatment is usually adopted,which has limited clinical effect and even exacerbates patients’motor and non-motor symptoms in the middle and late stages of the disease.Therefore,we should play the role of TCM medicine in the treatment of Parkinson’s disease.TCM believes that the basic etiology and pathogenesis of Parkinson’s disease is the internal movement of liver wind,the loss of muscles,the disease location is in the muscles,and it is closely related to the three viscera of liver,spleen and kidney,and the overall pathological nature is the primary deficiency and the symptom of solid.The human body is an organic whole centered on the five Zang(五脏)organs,which influence each other and control each other.The motor symptoms and nonmotor symptoms are similar in etiology and pathogenesis.This paper summarizes the etiology and pathogenesis of Parkinson’s disease from the five Zang organs and summarizes the general situation of TCM treatment of Parkinson’s disease in recent years.And according to the different stages of development of the disease,the nature of pathogenic factors and the deficiency of healthy Qi(气)to take different treatment methods,in order to seek a more standardized and systematic diagnosis and treatment of Parkinson’s disease.