帕金森病自主神经功能障碍中西医结合诊治专家共识(2020)

帕金森病自主神经功能障碍中西医结合诊治专家共识写作组

doi:10.14148/j.issn.1672-0482.2021.0006

帕金森病自主神经功能障碍中西医结合诊治专家共识(2020)

doi: 10.14148/j.issn.1672-0482.2021.0006

帕金森病自主神经功能障碍中西医结合诊治专家共识写作组

基金项目:

国家重点研发计划 2017YFC1310300

详细信息

中图分类号: R277.7
计量
- 文章访问数: 454
- HTML全文浏览量: 256
- PDF下载量: 568
- 被引次数: 0
出版历程
- 收稿日期: 2020-08-19
- 网络出版日期: 2021-12-21
- 刊出日期: 2021-01-10
- 发布日期: 2021-01-15

Consensus among Experts on the Integration of Chinese and Western Medicine for Autonomous Neurofunctional Disorders Induced by Parkinson's Disease (2020)

Writing Group of Consensus among Experts on the Integration of Chinese and Western Medicine for Autonomous Neurofunctional Disorders Induced by Parkinson's Disease

摘要

摘要: 帕金森病(Parkinson's disease, PD)自主神经功能障碍是常见的非运动症状之一，贯穿疾病始终，其临床表现复杂，个体差异性大，严重影响患者生活质量，是PD治疗的重点与难点。治疗上西医多遵循指南，但证据有限，重在对症处理；而中医的整体观念和辨证论治可以多症兼顾，临床经验积累较多，是对西医治疗的有效补充，中西医结合则可更有效地改善PD自主神经功能障碍。国内PD领域的中、西医专家秉承“病证结合，诊治协同”的理念，综合各自优势，形成PD自主神经功能障碍中西医结合诊治专家共识，以期为临床医师对PD自主神经功能障碍的诊疗提供参考。
- 帕金森病 /
- 自主神经功能障碍 /
- 中西医结合 /
- 专家共识
Abstract: Autonomous neurofunctional disorders induced by Parkinson's disease (PD) is one of the common non-motor symptoms that patients have to bear throughout the disease. The complex clinical manifestations, significant differences between individuals, severe effect on the patients' life quality are the emphases and difficulties of PD treatment. As for the treatment, in Western medicine, the focus is to deal with the symptoms with few evidences under the guideline while traditional Chinese medicine (TCM) applied the holism, treatment based on syndrome differentiation and extensive experience to deal with several symptoms, which is supplementary to Western medicine. The integration of Chinese and Western medicine can effectively improve autonomous neurofunctional disorders induced by PD. Domestic experts on the integration of Chinese and Western medicine adhere to the thought of "combination of disease and symptoms, integration of diagnosis and treatment" and make full use of their respective advantages to achieve consensus on the combination of Chinese and Western medicine for autonomous neurofunctional disorders induced by PD, thus providing reference for the diagnosis and treatment of autonomous neurofunctional disorders induced by PD for doctors.
- Parkinson's disease /
- autonomous neurofunctional disorders /
- integration of Chinese and Western medicine /
- experts' consensus

HTML全文

参考文献(47)

[1]	ARNAO V, CINTURINO A, VALENTINO F, et al. In patient's with Parkinson disease, autonomicsymptoms arefrequent and associated with other non-motor symptoms[J]. ClinAuton Res, 2015, 25(5) : 301-307. http://congress.wooky.it/web/eventi/NEURO2015/poster/pdf/pst27.pdf
[2]	SEPPI K, RAY CHAUDHURI K, COELHO M, etal. Update on treatments for nonmotor symptoms of Parkinson's disease: An evidence-based medicine review[J]. Mov Disord, 2019, 34 (2) : 180-198. doi: 10.1002/mds.27602
[3]	中华医学会神经病学分会帕金森病及运动障碍学组, 中国医师协会神经内科分会帕金森病及运动障碍学组. 帕金森病非运动症状管理专家共识(2020)[J]. 中华医学杂志, 2020, 100 (27) : 2084-2091. doi: 10.3760/cma.j.cn112137-20200407-01106
[4]	PALMA JA, KAUFMANN H. Epidemiology, diagnosis, and management of neurogenic orthostatic hypotension[J ]. Mov Disord Clin Pract, 2017, 4(3) : 298-308. doi: 10.1002/mdc3.12478
[5]	RAFANELLI M, WALSH K, HAMDAN MH, etal. Autonomic dysfunction: Diagnosisand management[J]. Handb Clin Neurol, 2019, 167: 123-137. http://www.sciencedirect.com/science/article/pii/B978012804766800008X
[6]	陈施吾, 窦荣花, 王玉凯, 等. 帕金森病血压管理专家共识[J]. 内科理论与实践, 2020, 15(3) : 176-183. https://www.cnki.com.cn/Article/CJFDTOTAL-NKLL202003012.htm
[7]	刘小利, 陈益丹, 舒勤奋, 等. 针灸治疗体位性低血压的临床疗效观察[J]. 心脑血管病防治, 2018, 18(2) : 163-164, 171. doi: 10.3969/j.issn.1009-816x.2018.02.026
[8]	KNUDSEN K, FEDOROVA TD, BEKKER AC, et al. Objective colonic dysfunction is far more prevalent than subjective constipationin Parkinson's disease: A colon transit and volume study[J]. J Parkinsons Dis, 2017, 7(2) : 359-367. doi: 10.3233/JPD-161050
[9]	PABLO- FERNANDEZ ED, PASSANANTI V, ZARATE- LOPEZ N, et al. Colonic transit, high- resolution anorectal manometryand MRIdefecographystudyofconstipationin Parkinson's disease[J]. Parkinsonism Relat Disord, 2019, 66 (8) : 195-201.
[10]	DROSSMAN DA. Functional gastrointestinal disorders: History, pathophysiology, clinicalfeatures, and Rome Ⅳ[J]. Gastroenterology, 2016, 150(6) : 1262-1279. doi: 10.1053/j.gastro.2016.02.032
[11]	TERNENT CA, BASTAWROUS AL, MORIN NA, et al. Practice parametersfortheevaluationand managementofconstipation[J]. Dis Colon Rectum, 2007, 50(12) : 2013-2022. doi: 10.1007/s10350-007-9000-y
[12]	BARICHELLA M, PACCHETTI C, BOLLIRI C, et al. Probiotics and prebioticfiberfor constipation associated with Parkinsondisease: An RCT[J]. Neurology, 2016, 87(12) : 1274- 1280. doi: 10.1212/WNL.0000000000003127
[13]	卢璐, 袁晓蕾, 张艳, 等. 帕金森病人便秘与运动症状以及中医证型分布的关系探讨[J]. 中西医结合心脑血管病杂志, 2019, 17(21) : 3299-3303. doi: 10.12102/j.issn.1672-1349.2019.21.009
[14]	李金容, 陈倩, 陶文强. 二白汤治疗帕金森病相关便秘的临床疗效观察[J]. 河北中医, 2017, 39(9) : 1337-1339. doi: 10.3969/j.issn.1002-2619.2017.09.015
[15]	孙明广, 王芳, 王冬慧, 等. 王永炎院士诊治帕金森病学术思想探析[J]. 现代中医临床, 2019, 26(1) : 34-37. doi: 10.3969/j.issn.2095-6606.2019.01.010
[16]	沈利荣, 王厹东, 沈丽萍, 等. 针灸治疗中晚期帕金森病便秘的临床疗效及对患者用药依从性的影响[J]. 上海中医药杂志, 2019, 53(3) : 63-66. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZZ201903021.htm
[17]	彭婷婷, 刘从秀. 艾灸治疗帕金森病便秘的临床疗效研究[J]. 中医药临床杂志, 2019, 31(9) : 1702-1704. https://www.cnki.com.cn/Article/CJFDTOTAL-AHLC201909029.htm
[18]	MUKHERJEE A, BISWAS A, DAS SK. Gut dysfunctionin Parkinson's disease[J]. World J Gastroenterol, 2016, 22 (25) : 5742-5752. doi: 10.3748/wjg.v22.i25.5742
[19]	秦晓凌, 辛在娥, 李雪, 等. 帕金森病患者消化系统相关症状及影响因素分析[J]. 中华神经科杂志, 2019, 52(8) : 607-612. doi: 10.3760/cma.j.issn.1006-7876.2019.08.002
[20]	PASRICHA PJ, PARKMAN HP. Gastroparesis: Definitions and diagnosis[J]. Gastroenterol Clin North Am, 2015, 44(1) : 1-7. doi: 10.1016/j.gtc.2014.11.001
[21]	彭随风, 杨家耀, 时昭红. 电针改善功能性消化不良胃动力、自主神经功能及心理状态[J]. 世界华人消化杂志, 2008, 16 (36) : 4105-4109. doi: 10.3969/j.issn.1009-3079.2008.36.016
[22]	MAO CJ, XIONG YT, WANG F, et al. Motor subtypes and otherriskfactorsassociated withdroolingin Parkinson'sdisease patients[J]. Acta Neurol Scand, 2018, 137(5) : 509-514. doi: 10.1111/ane.12893
[23]	LLORET SP, PIRÁN AG, ROSSI M, et al. Validation of a newscaleforthe evaluation ofsialorrheain patients with Parkinson's disease[J]. Mov Disord, 2007, 22(1) : 107-111. doi: 10.1002/mds.21152
[24]	谢朝艳, 丁雪萍, 高吉祥, 等. 帕金森病患者流涎与吞咽困难的关系研究[J]. 中华神经科杂志, 2016, 49(11) : 856-863. doi: 10.3760/cma.j.issn.1006-7876.2016.11.007
[25]	冯庆玲, 程元元, 刘培培, 等. 发声训练对帕金森病流涎严重程度的影响[J]. 中国现代神经疾病杂志, 2019, 19(11) : 891-896. doi: 10.3969/j.issn.1672-6731.2019.11.014
[26]	周海艳, 丁佳媛, 刘绍能. 多涎症证治探讨[J]. 现代中医临床, 2018, 25(4) : 46-48, 57. doi: 10.3969/j.issn.2095-6606.2018.04.012
[27]	陈叶萍, 孙秀萍. 温针灸法配合功能训练改善老年帕金森病患者吞咽功能障碍分析[J]. 辽宁中医药大学学报, 2019, 21 (1) : 200-202. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB201901058.htm
[28]	BADRI AV, PUROHIT RS, SKENAZYJ, et al. Areview of lower urinarytract symptomsin patients with Parkinson's disease[J]. Curr Urol Rep, 2014, 15(9) : 435-443. doi: 10.1007/s11934-014-0435-0
[29]	JAIN S. Multi-organ autonomic dysfunctionin Parkinson disease[J]. Parkinsonism Relat Disord, 2011, 17(2) : 77-83. doi: 10.1016/j.parkreldis.2010.08.022
[30]	ZONG H, MENG F, ZHANG Y, et al. Clinical study of the effects of deep brainstimulation on urinary dysfunctionsin patients with Parkinson's disease[J ]. Clin Interv Aging, 2019, 14: 1159-1166. doi: 10.2147/CIA.S204368
[31]	ZESIEWICZ TA, EVATT M, VAUGHAN CP, et al. Randomized, controlled pilottrial ofsolifenacinsuccinatefor overactive bladderin Parkinson's disease[J ]. Parkinsonism Relat Disord, 2015, 21(5) : 514-520. doi: 10.1016/j.parkreldis.2015.02.025
[32]	LUO D, LIU L, HAN P, etal. Solifenacinfor overactive bladder: a systematicreview and meta-analysis[J]. Int Urogynecol J, 2012, 23(8) : 983-991. doi: 10.1007/s00192-011-1641-7
[33]	陈义良, 冯为菊, 张小莉. 针药结合治疗帕金森病合并膀胱过度活动症[J]. 中国针灸, 2012, 32(3) : 215-218.
[34]	张敏健. 中西医结合男科学[M]. 2版. 北京: 科学出版社, 2017: 84-93.
[35]	HAND A, GRAY WK, CHANDLER BJ, etal. Sexualandrelationship dysfunction in people with Parkinson's disease[J ]. Parkinsonism Relat Disord, 2010, 16(3) : 172-176. doi: 10.1016/j.parkreldis.2009.10.007
[36]	BERNARD BA, METMAN LV, LEVINE L, et al. Sildenafil inthe treatment of erectile dysfunctionin Parkinson's disease [J]. Mov Disord Clin Pract, 2016, 4(3) : 412-415.
[37]	张家玮, 周安方, 王朝阳, 等. 周安方运用补肾泻肝法治疗阳痿验案3则[J]. 中华中医药杂志, 2015, 30(12) : 4353-4355. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201512046.htm
[38]	黄健, 徐福松. 二地鳖甲煎治疗勃起功能障碍肾阴虚证临床观察[J]. 中华男科学杂志, 2012, 18(12) : 1143-1146. https://www.cnki.com.cn/Article/CJFDTOTAL-NKXB201212026.htm
[39]	曾志华, 余海, 曾明慧. 针灸治疗男性性功能障碍疗效分析[J]. 实用中医药杂志, 2013, 29(6) : 465-466. doi: 10.3969/j.issn.1004-2814.2013.06.036
[40]	林俊钦. 神阙灸配合针刺治疗男性勃起功能障碍的临床研究[D]. 广州: 广州中医药大学, 2014: 12-18.
[41]	LETA V, WAMELEN VD, RUKAVINA K, et al. Sweating and other thermoregulatory abnormalities in Parkinson's disease: Areview[J]. Ann Mov Dis, 2019, 2(2) : 39-47. doi: 10.4103/AOMD.AOMD_2_19
[42]	FISCHER M, GEMENDEI, MARSCH WC, etal. Skinfunction and skin disorder in Parkinson's disease[J ]. J Neural Transm, 2001, 108(2) : 205-213. doi: 10.1007/s007020170088
[43]	ROMENETS SR, WOLFSON C, GALATAS C, etal. Validation ofthe non-motor symptoms questionnaire (NMS-Quest) [J]. Parkinsonism Relat Disord, 2012, 18(1) : 54-58. doi: 10.1016/j.parkreldis.2011.08.013
[44]	CHAUDHURI KR, MARTINEZ-MARTIN P, BROWN RG, et al. The metric properties of a novel non- motor symptoms scalefor Parkinson's disease: Resultsfrom aninternational pilot study[J]. Mov Disord, 2007, 22(13) : 1901-1911. doi: 10.1002/mds.21596
[45]	RZANY B, BECHARA FG, KONSTANTIN F, etal. Update ofthe S1 guidelines onthe definition andtreatment of primary hyperhidrosis[J]. J Dermatol Ges, 2018, 16(7) : 945-952. http://www.onacademic.com/detail/journal_1000040461250610_baa3.html
[46]	陈奕奕, 宗蕾, 顾侃. 针刺合谷配伍复溜治疗帕金森病多汗症状疗效观察[J]. 上海针灸杂志, 2016, 35(7) : 799-781. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZJ201607015.htm
[47]	许翊坂. 牡蛎散穴位贴敷治疗帕金森病多汗症临床观察[J]. 光明中医, 2018, 33(22) : 3364-3366. doi: 10.3969/j.issn.1003-8914.2018.22.036