中医药治疗肝肾阴虚型帕金森病的研究进展

摘要 帕金森病是一种常见的老年病，其病程长且并发症多，难以根治，临床上，长期服用多巴胺等西药会出现药效减退、精神障碍及异动症等不良反应。中医辨证论治帕金森病，认为肝肾亏虚是本病的发病基础，且与风、痰、瘀相关。治疗上注重培补肝肾、平肝熄风、补肾活血等，从整体角度调节帕金森病，对帕金森病运动症状和非运动症状均有着良好的疗效且无明显不良反应。近年来，中医治疗帕金森病更加注重从辨证的角度来调节非运动症状。现将近5年中医治疗肝肾阴虚型帕金森病的临床研究进行归纳整理，综述如下。

关键词 帕金森病;中医药;肝肾阴虚;运动症状;非运动症状;抑郁;睡眠障碍;自主神经功能紊乱;综述

Research Progress of Parkinson′s Disease with Liver and Kidney Yin Deficiency by Chinese Medicine

Wang Fen，Shen Rui，Chen Zhaoshan，Li Shanshan，Cao Yan，Cheng Rongqi

（Shanghai Municipal Hospital of Traditional Chinese Medicine，Shanghai University of Traditional Chinese Medicine，Shanghai 200071，China）

Abstract Parkinson′s disease（PD）is a common geriatric disease. It has a long course and many complications，which is difficult to cure. Clinically，long-term use of western medicine such as dopamine may cause adverse effects，such as hypothermia，mental disorders and dyskinesia. According to the TCM syndrome differentiation，the liver and kidney deficiency is the basis of the PD，which is related to wind，phlegm，and blood stasis. The treatment of TCM focuses on nourishing liver and kidney，calming liver and eliminating wind，invigorating kidney and promoting blood circulation. Chinese medicine treatment has good curative effects on the motor symptoms and non-motor symptoms of PD without obvious side effects. In recent years，Chinese medicine treatment of Parkinson′s disease has paid more attention to regulating non-motor symptoms from a dialectical point of view. The research progress on Parkinson′s disease with liver and kidney yin deficiency by Chinese medicine in the past 5 years was summarized as follows.

Key Words Parkinson′s Disease; Traditional Chinese medicine; Liver and kidney yin deficiency; Motor symptom; Non-motor symptom; Depression; Sleep disorder; Autonomic dysfunction; Review

中圖分类号：R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2019.04.058

帕金森病（Parkinson′s Disease，PD）是一种常见的神经退行性疾病，其发病率仅次于老年痴呆，而患病率随年龄增长而上升。有研究表明，我国PD患者总数已逾200万[1]。PD临床表现主要包括静止性震颤、运动迟缓、肌张力增髙、姿势步态异常等运动症状[2]，以及便秘、抑郁、嗅觉减退和夜尿症等非运动症状[3]，是世界公认的难治性疾病之一，严重威胁中老年人身心健康。目前，西医临床常用美多芭、金刚烷胺、雷沙吉兰等药物，然而长期服用会出现药效减退以及多系统障碍、精神障碍和异动症等不良反应[4]，严重影响患者生命质量。因此，越来越多的PD患者开始选择运动疗法、中草药、针灸等无不良反应的替代疗法[5]。研究表明，中医辨证论治帕金森病可以提高西医常规用药的临床疗效，延缓疾病进展，且能降低抗帕金森药物治疗带来的不良反应[6]。而中医证候研究显示[7]，帕金森病中医基本证候以肝肾阴虚为主，现整理了近五年中医治疗肝肾阴虚型帕金森病的研究进展，以期为临床提供借鉴。

1 病因病机

中医认为本病主因当属年老肝肾阴虚，而与风、火、痰、湿、瘀等多种因素相关。《素问》曰：“…七八，肝气衰，筋不能动，天癸竭，精少，肾脏衰…”，说明了帕金森病发病与老年肝肾亏虚有着重要关系。随着年龄增长，机体“阴气自半，起居衰矣”，肝脏阴血亏虚日久则筋脉失于濡养，筋急不柔则会出现筋脉拘挛的表现;肾阴亏虚则不能滋养脑髓、肝脏在内的各脏腑，导致机体失于濡养而拘挛颤动，遂发本病。随着病情发展，更可出现痰瘀交织等虚实夹杂的复杂情况，故帕金森病发病多责之于肝肾。

推荐访问： 阴虚 研究进展 中医药 肝肾 治疗

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