中国中西医结合杂志2025，Vol.45Issue(11)：1343-1349,7.DOI:10.7661/j.cjim.20251014.024
帕金森病异动症中医证候要素与量表评分特征
Characteristics of Chinese Medical Syndrome Elements and Scale Scores of Parkinson's Disease with Levodopa-induced Dyskinesia
摘要
Abstract
Objective To explore the characteristics of Chinese medical(CM)syndrome elements and scale scores of Parkinson's disease(PD)patients with Levodopa-induced dyskinesia(LID).Methods A total of 224 PD patients were assigned to two groups:the LID group(38 cases)and the non-LID group(186 cases).General information and scores of the following scales were collected:Parkinson's Disease CM Syndrome Elements Scale(PD-PES-13),MDS Unified Parkinson's Disease Rating Scale(MDS-UPDRS),Hoehn-Yahr(HY)staging,39-item Parkinson's Disease Questionnaire(PDQ-39),Non-Motor Symptoms Scale for PD(NMSS),Hamilton Rating Scale for Depression(HAMD),Parkinson's Disease Sleep Scale(PDSS-2),and Scales for Outcomes in Parkinson's Disease-Autonomic(SCOPA-AUT).Data were analyzed using R and SPSS 26.0.Results Compared with the non-LID group,the LID group showed a younger age of onset(P=0.002),longer disease duration(P＜0.001),and higher daily equivalent dose of levodopa(P＜0.001).The top three CM syndrome elements in both groups,ranked by frequency from high to low,were marrow reduction(81.58％vs.54.84％),qi deficiency(68.42％vs.42.47％)and Gan-wind(52.63％vs.37.63％).The frequencies of marrow reduction,qi deficiency,internal heat,Shen deficiency,and yang deficiency were significantly higher in the LID group than in the non-LID group(all P＜0.05).The combination patterns of CM syndrome elements were more complex(P＜0.001).Additionally,the LID group showed significantly higher scores in MDS-UPDRS Parts Ⅰ,Ⅱ,and Ⅳ,as well as in PDQ-39,NMSS,HAMD,and PDSS-2(all P＜0.05).In terms of motor subtype distribution,the tremor-dominant(TD)subtype was associated with a lower risk of dyskinesia(OR 0.16,95％CI:0.04-0.71).Overall,a significant positive correlation was observed between the CM syndrome elements and the Western medicine scale(P＜0.05).Conclusions The core CM syndromes elements of PD are marrow reduction,qi deficiency and Gan-wind.The pathogenesis of LID may involve marrow reduction,qi deficiency,internal heat,Shen deficiency,and yang deficiency.Patients with LID exhibit a worse quality of life.The total score of CM syndrome elements positively correlates with several Western medicine scales,offering valuable insights for guiding integrative medicine in PD management.关键词
帕金森病/异动症/中西医结合/证候要素/病因病机/复合证候/阳虚风动Key words
Parkinson's disease/Levodopa-induced dyskinesia/integrative medicine/syndrome elements/etiology and pathogenesis/composite syndrome/Yang deficiency generating wind引用本文复制引用
邹丽萍,刘卫国,吴天晨,陆艳..帕金森病异动症中医证候要素与量表评分特征[J].中国中西医结合杂志,2025,45(11):1343-1349,7.基金项目
国家自然科学基金资助项目(No.81804022) （No.81804022）
2022年李果烈全国名老中医药专家传承工作室建设项目(No.LGL-2022-GJ) （No.LGL-2022-GJ）
江苏省研究生科研与实践创新计划(No.SJCX22-0822) （No.SJCX22-0822）
