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1.河南中医药大学 第一附属医院,郑州 450000
2.河南中医药大学,郑州 450046
Received:29 March 2021,
Published Online:23 December 2021,
Published:05 January 2022
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王佳彬,沈晓明,马云枝等.帕金森病中西医研究进展[J].中国实验方剂学杂志,2022,28(01):241-250.
WANG Jia-bin,SHEN Xiao-ming,MA Yun-zhi,et al.Parkinson's Disease in Traditional Chinese and Western Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(01):241-250.
王佳彬,沈晓明,马云枝等.帕金森病中西医研究进展[J].中国实验方剂学杂志,2022,28(01):241-250. DOI: 10.13422/j.cnki.syfjx.20220496.
WANG Jia-bin,SHEN Xiao-ming,MA Yun-zhi,et al.Parkinson's Disease in Traditional Chinese and Western Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(01):241-250. DOI: 10.13422/j.cnki.syfjx.20220496.
帕金森病是严重危害中老年人健康的神经系统退行性疾病,临床主要表现为运动迟缓、静止性震颤和肌强直等运动症状及便秘、精神障碍、睡眠障碍和自主神经功能障碍等非运动症状。其病因及发病机制尚未完全明确,且临床疗效不尽如人意。笔者拟通过检索近年国内外相关文献,从帕金森病的中医病因病机、中医治疗、西医病因、西医发病机制、西医治疗、中西医结合治疗等方面最新研究进行归纳总结。总的来看,肝肾不足是目前国内相关领域专家认为该病的主要病机所在,而
α
-突触核蛋白的异常聚集、氧化应激、线粒体功能障碍、泛素-蛋白酶体系统功能障碍、神经炎症、自噬、微生物-肠-脑轴调控机制、兴奋性神经毒性等与该病的发病机制密切相关。治疗上目前中医主要有辨证论治、名医验方、单味中药、针灸等治疗手段。西医仍以药物替代疗法为主,以及传统的免疫疗法、神经营养因子、脑深部电刺激疗法(DBS)等手术治疗、康复与运动疗法、科学护理等,基因疗法成为近年来治疗该病的新技术手段,此外,中西医结合治疗该病越来越被重视。该文通过对帕金森病的中西医病因及治疗进行归纳梳理,以期为该病的临床诊治提供参考。
Parkinson's disease (PD) is a neurodegenerative disease that seriously endangers the health of the middle-aged and elderly people. The main clinical manifestations include motor symptoms such as bradykinesia, static tremor, and myotonia and non-motor symptoms like constipation, mental disorders, sleep disorders, and autonomic nervous dysfunction. Its etiology and pathogenesis have not been fully understood, and the clinical efficacy is not satisfactory. By searching the relevant literature in China and abroad in recent years, this paper summarized the etiology, pathogenesis, and treatment of PD in both traditional Chinese medicine (TCM) and western medicine as well as the integrated TCM and Western medicine treatment. In general, liver and kidney deficiency is recognized by domestic experts in related fields as the main pathogenesis of PD. The abnormal aggregation of
α
-synuclein, oxidative stress, mitochondrial dysfunction, ubiquitin-proteasome system dysfunction, neuroinflammation, autophagy, microbiota-gut-brain axis regulation, and excitatory neurotoxicity are closely related to the pathogenesis of this disease. At present, treatment based on syndrome differentiation, empirical formulae from famous doctors, single Chinese herbs, and acupuncture and moxibustion are mainly adopted for the tackling of PD in TCM. Western medicine is still dominated by drug replacement therapy, supplemented by such surgical treatments as traditional immunotherapy, neurotrophic factors, and deep brain stimulation (DBS), rehabilitation and exercise therapy, and scientific nursing. Gene therapy has become a new technical means for the treatment of this disease in recent years. In addition, the combined therapy of TCM and Western medicine has received increasing importance. This paper reviewed the pathogenesis and treatment of PD in TCM and Western medicine, so as to provide reference for its clinical diagnosis and treatment.
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