基层帕金森病中西医结合诊疗专家共识

Consensus on Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Parkinson’s Disease at the Primary Care Level

  • 摘要: 帕金森病为中老年高发神经退行性病变,人口老龄化背景下患病率日趋增加,基层诊疗普遍存在识别不足、治疗手段单一等难题。本共识在系统检索和证据评价的基础上,经多学科专家多轮研讨及意见征集形成。参照国内外权威诊断标准,依托H-Y分级开展疾病分期,确立痰热风动证等五类中医证型;以“辨识兼顾,防治并举”为原则,构建西医规范用药联合中药辨证、针灸功法及四季膳食调养的一体化方案,细化运动症状、非运动症状及并发症的分层处置,建立上下级双向转诊机制。该方案可为基层帕金森病全周期规范化管理提供实用诊疗参考。

     

    Abstract: Parkinson’s disease is a prevalent neurodegenerative disorder in the elderly. Due to population aging, primary care is faced with insufficient identification and limited therapeutic options. This consensus was developed on the basis of systematic evidence retrieval and appraisal, followed by multidisciplinary expert discussions and consultation. It adopts authoritative diagnostic criteria and H-Y staging, and defines five traditional Chinese medicine (TCM) syndrome types, including the phlegm-heat stirring wind syndrome. Guided by the principle of “integrating identification and recognition, balancing prevention and treatment”, an integrated regimen combining standardized western medication, syndrome-based herbal medicine, acupuncture, traditional exercise and dietary conditioning is established, with hierarchical treatment for motor symptoms, non-motor symptoms and complications, as well as a two-way referral system. The feasible regimen is suitable for primary care promotion to standardize whole-course Parkinson’s disease management.

     

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