中医药研究论丛

211.7 帕金森氏症之中医辨证论治的回顾性文献探讨
TJ TCM.21(1) : 71-84, 2018
帕金森氏症之中医辨证论治的回顾性文献探讨
Retrospective Study of Discussion on Syndrome Differentiation of Parkinson’sDisease in Traditional Chinese Medicine
黄靖钧1 黄义腾1 林立伟1 吴龙源1*
1 义守大学学士後中医学系,高雄,台湾
【摘要】
帕金森氏症(Parkinson’s disease,简称为PD),一种常见於老年人的运动障碍性神经退化疾病,以静止性颤抖、肌肉僵直、动作迟缓及姿态不稳四大表现为特点。目前台湾的盛行率,大约每10 万人中约有150 人,常发生於55 岁以上中老年人,65 岁以上人群患病率为1-4%,年纪越大盛行率越高。关於PD 的中医病因病机、辨证论治以及治疗新思维,尚未有系统的分析讨论。因此,我们利用中国知识资源总库及华艺线上图书馆,对PD 的现代病理研究、中医病因病机和中医治疗方法,进行收集、整理及分析讨论。本篇研究结果说明四点:一、Braak 假说可以说明PD 的病程,按现代医学病理:胃肠道症状—嗅觉障碍—情感障碍—运动障碍—精神症状,对应中医脏腑:脾—肺—肝气—肝阴—肾,对於PD 的早期预防,由中医药的角度可以从健脾益肺着手。二、PD 的中医病机本虚标实,以虚为主,即以肝、脾、肾三脏亏虚为本,以风、火、痰、瘀为标。三、方药治疗主要根据辨证论治、发生频率高低以及相关临床研究集中在补益肝肾、补气养血、清热化痰、活血化瘀四法。四、针灸治疗以头针法、体针法为主流、配合透针法或灸法的治疗体系,对PD 的症状有明确改善的效果。关於未来PD 的中医研究,我们认为若能从大脑神经学出发,以现代病理生理学为基础,搭配中医的脏腑辨证,可以提出更新的中医治疗思维,期待在临床上的中医治疗或中西医结合都能达到更好的疗效。
【关键词】帕金森氏症、中医文献、中医治疗
Ching-Chun Huang1 Yi-Teng Huang1 Li-Wei Lin1 Lung-Yuan Wu1*
1The school of Chinese Medicines for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan
【Summary】
Parkinson’s disease (PD) is a common dyskinesia neurodegenerative disease in elderly people. Static trembling, muscle stiffness, slow movement and posture instability are the four performance characteristics. At present, the prevalence of PD is about 150 people per 100,000 people in Taiwan. It is mostly happened in the middle age group over 55 years old. The prevalence rate of PD over 65 years old is 1% to 4%. The elder the patients are, the higher risk of PD would be. About PD on the etiology and pathogenesis of traditional Chinese medicine (TCM), syndrome differentiation and treatment of new thinking, there is no systematic analysis and discussion. Therefore, we use the China National Knowledge Infrastructure (CNKI) and the Airiti Library to collect the research about the PD of the modern pathology, TCM etiology and pathogenesis, TCM treatment methods for collation, analysis and discussion. The results of our study show four points. First, the Braak hypothesis can explain the course of PD, according to modern medical pathology: Gastrointestinal symptoms-olfactory disorder-affective disorder-dyskinesia-psychiatric symptoms. These symptoms could be corresponding to TCM organs: spleen-lung-liver qi-liver yin-kidney. For the early prevention of PD, the perspective of TCM can start from the spleen and lungs. Second, According to the etiology and pathogenesis of TCM, PD is characterized by deficiency in the root and excess in the branch. Deficiency was referred to liver, spleen and kidney. Excess was referred as wind, fire, phlegm and stasis. Third, TCM prescription for treating PD could be mainly based on the frequency of syndrome differentiation and focused on invigorating the liver and kidney, benefiting qi and nourishing blood, clearing away heat and dispersing phlegm, promoting blood circulation and removing blood stasis. Fourth, scalp acupuncture and body acupuncture are
the main stream. The symptoms of PD have a clear improvement after pointthrough-point acupuncture or moxibustion treatment. In the future, we believe that the TCM research of PD should start from the brain neurology, modern pathophysiology as the basis, with TCM differentiation of zang and fu. Then the new idea of TCM treatment should be updated. We look forward to the clinical treatment of TCM or integrative medicine can achieve better efficacy.
KeywordsParkinson’s disease, TCM Syndrome Differentiation, TCM treatment