A Study On The Correlation Between Non-motor Symptoms Of Parkinson’s Disease And Six-meridian Differentiation In Parkinson’s Disease Patients

Objective: Non-motor symptoms of Parkinson’s disease(PD)involve multiple systems of the body,physiological mechanisms are complex,and multiple symptoms are often combined with attacks.The six-meridian differentiation of Treatise on Febrile Diseases has the characteristics of strong generalization and wide applicability,and its original texts have strong contact with constipation,depression,and insomnia in non-motor symptoms of PD.In this paper,the theory of six-meridian differentiation is summarized,and through the way of clinical observation,the correlation between non-motor symptoms of PD and syndromes of six-meridian differentiation is explored and analyzed in order to provide reference for the clinical differentiation and treatment of non-motor symptoms of PD in TCM.Methods: Eighty patients with PD who met the inclusion criteria were enrolled in this study.Information about six-meridian collection form,Parkinson’ s Disease Nonmotor Symptom Evaluation Scale(NMSS),Pittsburgh Sleep Quality Index(PSQI),Constipation Severity Scale(CSS),Hamilton Depression Rating Scale(HAMD),and Hoehn-Yahr(H-Y)grading scale were collected.The six-meridian syndromes were determined based on the six-meridian outline syndromes and the Handout of Jingfang.SPSS software was used for statistical analysis to study the distribution characteristics of six-meridian syndrome of PD,and to explore the relationship between the distribution of each syndrome and gender,age and each scale.Association rule analysis was performed using R4.2.1 and Rstudio software to explore the association between the six-meridian syndromes and non-motor symptoms of PD(constipation,insomnia,depression)..Results:1.A total of 12 six-meridian syndromes occurred in 80 patients in this study,including 6 single meridian syndromes and 6 combined meridian disease,of which Taiyin disease found in 18 patients as the most common one accounting for 22.5%.2.There were 51 cases of single meridian syndrome,accounting for63.75% of all patients.Taiyin disease had 18 cases accounted for the highest proportion of single meridian disease about 35.3%.Sanyin disease(Taiyin,Shaoyin,Jueyin)accounted for a higher proportion about 68.6% of single meridian disease;Sanyang disease(Taiyang,Shaoyang,Yangming)accounted for a relatively low proportion about 31.4%.There were 29 cases of combined syndromes of the two meridians,accounting for 36.3% of all patients.Among them,Shaoyin Taiyin combined disease and Shaoyang Yangming combined disease had 8 cases in each group accounting for the highest proportion about27.59% of the percentage of the two meridians combined disease.3.In age,sex and past history,there was no significant difference in the distribution of six-meridian(P>0.05).There was no significant difference in H-Y grade between the six-meridian(P>0.05).There was no statistical difference in sleep score and sleep rating between the six-meridian(P>0.05).4.There were significant differences in constipation scores among the six-meridian(P<0.05).There was a significant difference in constipation rating between the six-meridian(P<0.01).There were significant differences in depression score and depression rating between the six-meridian(P<0.01).The distribution of six-meridian syndrome was significantly different in NMSS scores(P<0.01).5.In the correlation analysis,the items with strong correlation between the six-meridian and symptoms are: Taiyang disease-no depression,no constipation;Yangming disease,Shaoyang Yangming disease,Shaoyin and Yang disease-constipation;Shaoyin disease,Shaoyin Taiyin disease-depression,mild or moderate depression,no constipation,very poor sleep;Taiyin disease-sleep well,diagnosis of depression.Conclusions:1.In the six-meridian differentiation of PD patients,the syndrome of Sanyin disease is significantly more than that of Sanyang disease,and the most common syndrome is Taiyin disease.2.The six-meridian syndrome with the strongest association with Parkinson’ s disease constipation is Yangming disease and Shaoyang Yangming disease.3.The six-meridian syndrome with the strongest association with PD depression is Taiyin disease,Shaoyin disease and Shaoyin Taiyin disease.4.Insomnia may occur in Parkinson’ s disease patients with each sixmeridian syndrome.