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帕金森病便秘的中西医研究进展

Research progress of Chinese and Western medicine treatment of constipation in Parkinson's disease

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帕金森病(Parkinson's disease,PD)是一种在全世界范围内仅次于阿尔茨海默病的慢性中枢神经系统退行性疾病,具有不可逆且好发于中老年人的特点.便秘作为PD最常见的非运动症状之一,对患者的日常生活及工作造成严重影响,降低患者生活质量,其引发的膀胱尿道功能障碍等并发症甚至可能危及生命.因此,对PD便秘形成机制和有效治疗手段的研究讨论尤为重要.中西医对PD便秘发病机制的认知存在较大差异.西医中肠道菌群失调、α-突触核蛋白异常堆积等导致PD便秘的理论都有各自的拥趸,治疗方法主要为口服各种泄剂(以聚乙二醇4000为代表)和注射药物(以左旋多巴为代表)改善直肠肌肉张力,从而促进排便,虽然见效快但不能从根本改善病症,甚至伴有不良反应.中医则认为PD便秘是颤证和便秘合病,主要病因病机为气血亏虚、肝肾亏虚.治疗方法由此入手,通过内服汤剂以滋补肝肾、益养气血,外治配合穴位敷贴、针灸等理疗手段综合施治,从根本改善身体功能,达到长效稳定治疗目的,具有一定优越性,不足的是见效较慢且尚未形成规范的辨证及治疗标准.文章总结近年来国内外对PD便秘的研究,从中西医不同角度阐述其发病机制、治疗策略,为PD便秘的研究提供理论参考.
Parkinson's disease(PD)is a chronic degenerative disease of the central nervous system that is second only to Alzheimer's disease worldwide,and is irreversible and prone to middle-aged and elderly people.As one of the most common non-motor symptoms of PD,constipation has a serious impact on the daily life and work of patients,reduces the quality of life of patients,and may even cause complications such as vesical urethral dysfunction,which may even be life-threatening.Therefore,it is particularly important to study and discuss the mechanism of PD constipation formation and effective treatment methods.There are great differences in the cognition of pathogenesis of PD constipation between TCM and Westem medicine.In Westem medicine,the theories of intestinal flora imbalance and α-synuclein abnormal accumulation leading to PD constipation have their own supporters,The main treatment methods are oral drainage agents(represented by PEG4000)and injection drugs(representee by levodopa)to improve rectal muscle tone and promote defecation,Although the effect is fast,it can not fundamentally ameliorate the disease,and even has adverse reactions.TCM believes that PD constipation is a combination of fibrillation and constipation,and the main cause and pathogenesis are deficiency of Qi(气)and blood,deficiency of liver and kidney.The treatment method starts from this to nourish the liver and kidney,tonifying Qi and blood through the oral administration of decoction,combined with acupoint application,acupuncture and other physiotherapy methods.The fundamental improvement of the body function to achieve the purpose of long-term stable treatment has certain advantages,but the defect is that the effect is slow and has not yet formed identification and treatment standards.The paper summarizes the research on PD constipation at home and abroad in recent years,expounds its pathogenesis and treatment strategies from different perspectives of TCM and Western medicine,and provides theoretical reference for the research on PD constipation.

Parkinson's diseaseConstipationTraditional Chinese medicine and Western medicine researchReview

雷云霞、胡玉英、罗荣卿、陈秋霞

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广西中医药大学,广西 南宁,530001

广西中医药大学第一附属医院,广西 南宁,530023

帕金森病 便秘 中西医研究 综述

国家自然科学基金广西壮族自治区高等学校高水平创新团队及卓越学者计划(2020)广西中医药大学"岐黄工程"高层次人才团队培育项目广西中医药大学第一附属医院学术团队建设项目广西中医脑病临床研究中心项目

81960842桂教人才[2020]6号2018003院字[2018]146号桂科AD20238028

2024

10.3969/j.issn.1674-7860.2024.06.033

中医临床研究
中华中医药学会

中医临床研究

影响因子：0.839
ISSN：1674-7860
年,卷(期)：2024.16(6)