| Objective:To conduct the epidemiological investigation of the distribution of Elements of Syndrome and Pathogenesis in 300 patients by developing the TCM assessment questionnaire of Parkinson’s disease,then to summarize the distribution and combination regularity of the Elements of Syndrome and Pathogenesis;and to explore the pathogenesis of Parkinson’s disease.According to the pathogenesis of deficiency of liver-kidney and wind-phlegm stagnation,we used the treatment of nourishing liver and kidney,resolving phlegm and calming wind,dredging collaterals to observe the clinical efficacy of Yishen Chuchan Decoction in treating Parkinson’s disease.Method:To survey the general condition of 300 patients with Parkinson’s disease including:age,gender,occupation,disease duration,education,past history,family history,brief case history,Hoehn&Yahr(H-Y)stage,four diagnostic information of Chinese Medicine,Western medicine treatment,through the epidemiological survey questionnaire completing the patient"Parkinson’s disease TCM questionnaire".According to the questionnaire of the four diagnostic information the the Chinese experts determined the "Elements of Syndrome and Pathogenesis",and then came to the distribution of the law and the combination of law.Eighty-six patients with Parkinson’s disease were divided into treatment group and control group according to the random number table method.Patients in treatment group were treated with Madopar and YishenChuchan Decoction,while patients in control group were given placebo and Madopar.The levels of MDRSPD,UPDRSⅢ,performance in chronograph movement(times of left and right hand movement in one minute),NMSS,PDQ-39,MMSE,SCS-PD,Parkinson’s disease TCM symptom scale were evaluated before treatment,1 month after treatment and 2 months after treatment.And the TCM symptom scale was applied for efficacy evaluation.Result:(1)There were 1180 times of eight kinds of pathogen syndrome,including yin deficiency,qi deficiency,blood deficiency,yang deficiency,wind,fire,phlegm,blood stasis.The 4 syndrome of wind,Yin,phlegm,blood stasis were the major(22.88%,22.12%,14.89%,17.54%,respectively),and the number of patients that manifested more than one syndrome was upto 32.33%.(2)Comparison of Parkinson’s Disease Exercise Rating Scale(MDRSPD):There was no statistical difference in the motor symptom scores between the two groups at 1 month and 2 months after treatment(P>0.05,2 months,P=0.0603>0.05).There was no statistical differences in control group after treated 1 month(P>0.05),but the was statistical difference after 2 months treatment(P<0.05).There was statistical difference in the treatment group after 1 month treatment(P<0.05),and there was significant statistical difference between the two groups(P<0.01).(3)Comparison UPDRS Ⅲ score:There was no statistical difference in UPDRSIII score between the two groups at 1 month(P>0.05),and there was statistical difference between the two groups after 2 months treatment(P<0.05).There was significant statistical difference after 2 months treatment in both groups(P<0.01).(4)Comparison of the number of times of exercise test:There was no statistical difference between the two groups after1 month treatment(P>0.05).There was statistical difference between the two groups after 2 months treatment(left P<0.05,right P<0.05).There was significant statistical difference after 2 months treatment(P<0.01).(5)Comparison of non-motor symptom scale(NMSS)score:There was statistical difference between the two groups after 1 month treatment(P<0.05),and there was significant statistical difference between the two groups(P<0.01).There was significant statistical difference in treatment group(P<0.01)after 2 months treatment,while there was no statistical difference at 1 month and 2 months after treatment in control group.(6)Comparison of Parkinson’s Disease Daily Life Quality Scale(PDQ-39)score:There was statistical difference between the two groups after 1 month treatment(P<0,05),and there was significant statistical difference between the two groups(P<0.01)after 2 months treatment.There was statistical difference in treatment group(P<0.05)after 1 month treatment,and there was significant statistical difference in treatment group(P<0.01)after 2 months treatment,while there was no statistical difference at 1 month and 2 months after treatment in control group.(7)Comparison of Mini-mental State Examination(MMSE)score:There was no statistical difference in the MMSE scores between the two groups at 1 month and 2 months after treatment(P>0.05);and there was no statistical difference in the MMSE scores in both two groups.(8)Comparison of Sialorrhea Clinical Scale for PD(SCS-PD):There was statistical difference between the two groups after 1 month treatment(P<0.05),and there was significant statistical difference between the two groups(P<0.01)after 2 months treatment.There was statistical difference in treatment group(P<0.05)after 1 month treatment,and there was significant statistical difference in treatment group(P<0.01)after 2 months treatment,while there was no statistical difference after treatment in control group.(9)Comparison of quantization table of Parkinson’s disease syndrome:There was no statistical difference between the two groups afterl month treatment(P>0.05).There was statistical difference between the two groups after 2 months treatment(P<0.05).There was statistical difference in the treatment group after 1 month treatment(P<0.05),and there was significant statistical differenceafter 2 months treatment(P<0.01).While there was statistical difference at 1 month and 2 months after treatment(P<0.05).(10)Comparison of the efficacy of quantization table of Parkinson’s disease syndrome:there was cured in 3 cases,markedly effective in 9 cases,effective in 18 cases,improved in 8 cases,ineffective in 2 cases,the total effective rate of 75%in the treatment group;there recovered 1 cases,markedly effective in 7 cases,effective in 19 cases,improved in 10 cases,The total effective rate was 67.5%in the control group.There was statistical difference between the two groups(P = 0.037<0.05),and the treatment group was superior to the control group.Conclusion:(1)Deficiency of liver-kidney is the pathological basis of PD and the wind-phlegm stagnation is the central pathology;the syndrome of deficiency of liver-kidney,and wind-phlegm stagnation is the main type of PD.(2)Yishen Chuchan Decoction can improve the motor symptoms of patients with Parkinson’s disease.(3)Yishen Chuchan Decoction can alleviate the non-motor symptoms and improve the life quality of patients,while improving the motor symptoms.(4)The main treatment method is nourishing liver and kidney,resolving phlegm and calming wind,dredging collaterals;Yishen Chuchan Decoction is the effective exploration of formula for the special disease for treating PD. |
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