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上海中医药大学 附属岳阳中西医结合医院,上海 200437
Received:06 April 2025,
Revised:2025-05-19,
Accepted:20 June 2025,
Online First:23 June 2025,
Published:20 May 2026
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王玉,梅家宁,赵红苹等.中西医结合辨治帕金森病疾病全周期的理论框架构建[J].中国实验方剂学杂志,2026,32(10):270-279.
WANG Yu,MEI Jianing,ZHAO Hongping,et al.Construction of A Conceptual Framework for the Integration of Traditional Chinese and Western Medicine in Evolutionary Syndrome Differentiation and Treatment Across Full-cycle of Parkinson's Disease[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(10):270-279.
王玉,梅家宁,赵红苹等.中西医结合辨治帕金森病疾病全周期的理论框架构建[J].中国实验方剂学杂志,2026,32(10):270-279. DOI: 10.13422/j.cnki.syfjx.20252097.
WANG Yu,MEI Jianing,ZHAO Hongping,et al.Construction of A Conceptual Framework for the Integration of Traditional Chinese and Western Medicine in Evolutionary Syndrome Differentiation and Treatment Across Full-cycle of Parkinson's Disease[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(10):270-279. DOI: 10.13422/j.cnki.syfjx.20252097.
帕金森病(PD)是累及多系统、多递质的复杂神经退行性疾病,由于PD的高度临床异质性,亟需建立全面和长程的中医管理模式。该文初步构建了首辨分期虚实,次辨症状脏腑的PD疾病全周期管理理论框架:基于PD蛋白沉积和递质紊乱的病理生理机制演变,纵向描述前驱期(正盛邪微)、临床早期(正消邪长)和中晚期(邪盛正衰)的3阶段证候特征;通过藏象辨证全面分析PD运动与非运动症状的病因病机,推究与之匹配的治法方药,提出主证、兼证和次证组合的模块化方案;阐释了基于框架下的运动并发症(“变证”)和PD相关的急性高热综合征(“危证”)的中医学内涵空白。该框架体现病证结合、整体恒动的特点,为中医个体化、全程管理PD提供了新的理论和研究思路。
Parkinson's disease (PD) is a complex neurodegenerative disease involving multiple systems and neurotransmitters. Due to the high clinical heterogeneity of PD,it is urgent to establish a comprehensive and long-term traditional Chinese medicine (TCM) management model. In this paper,the conceptual framework of full-cycle management of PD is preliminarily constructed:based on the evolution of the pathophysiological mechanisms of protein deposition and neurotransmitter disorder in PD,the three-stage syndrome characteristics of the prodromal stage (predominant healthy Qi with subtle pathogenic factors),the early clinical stage (declining healthy Qi with growing pathogenic factors) and the middle and late stages (overwhelming pathogenic factors with deficient healthy Qi) are longitudinally described. Through the syndrome differentiation of visceral manifestations,the etiology and pathogenesis of PD motor and non-motor symptoms were comprehensively analyzed,while the matching treatment methods and prescriptions were inferred,and the modular scheme of the combining main symptoms,accompanying symptoms and secondary symptoms was proposed. The conceptual gap of TCM regarding motor complications ('variable syndrome') and PD-related hyperpyrexia syndrome ('critical syndrome') was explained. This framework reflects the characteristics of combination of disease and syndrome and overall constant motion,and provides new theories and research ideas for individualized and whole-process management of PD in TCM.
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