| Background:Parkinson’s disease (Parkinson’s disease, PD)and Vascular parkinsonism (vascular parkinsonism, VP) belong to senile tremor syndrome in TCM.It’s important to study the TCM syndrome characteristics of the two diseases.PD is a degenerative disease of the nervous system in the elderly over 65 years old. The main clinical manifestations are motor symptoms such as bradykinesia, resting tremor, muscle rigidity, postural reflex abnormal symptoms.There are as well as a series of non-motor symptoms. Vascular parkinsonism (vascular parkinsonism, VP) is a group of syndromes with a kind of clinical manifestations of Parkinson’s disease, and have a close relationship with cerebro vascular disease, especially the multiple lacunar infarction in the basal ganglia. The main clinical manifestations are muscle rigidity, bradykinesia, split step, resting tremor rarely. There used to be disputes whether vascular parkinsonism is an independent syndrome.With the accumulation of clinical cases, pathological studies, neuro imaging development, VPS has been confirmed by vascular brain damage, which is an independent syndrome caused by lacunar infarction and cortical arteriosclerotic encephalopathy. The prevalence of the disease is on the increase, but there is no uniform diagnostic criteria. The clinical symptoms of these two diseases are complex.There is a lack of accepted standards for clinical diagnosis. This clinical study is to focus on the real issues.Objective:This study aims to study the TCM syndromes, clinical symptoms and signs, cranial MRI, carotid ultrasound, transcranial Doppler ultrasound characteristics of VP and PD,in order to compare the two diseases.Method:65 hospitalized cases of the patients whose diagnoses were VP,PD or chanzheng in TCM in Dongzhimen Hospital, Beijing University of Chinese Medicine in the recent 9 years were included in the research.We analyzed the TCM syndromes, clinical symptoms and signs, cranial MRI, carotid ultrasound, transcranial Doppler ultrasound characteristics of VP and PD. The data we collected were processed by SPSS20.0 statistical analysis software.Results:1. the general data analysis:The maximum age of onset in VP patients were 83 years old.The minimum age of onset was 48 years old, with an average age of onset of 69.9 years old. The maximum age of onset of PD patients were 79 years old.The minimum age of onset was 42 years old, with an average age of onset of 60.54 years old. The onset ages of VP patients were older than PD patients, with a statistically significant difference. (P<0.05).The disease duration of VP patients was 2.80±2.54, PD patients The disease duration of PD patients was 6.64±6.93, with a statistically significant difference.2.The clinical symptoms:The occurrence rate of intentionality/postural tremor of VP patients was higher than the occurrence rate of PD patients (P<0.05); The occurrence rate of resting tremor of PD patients was higher than the occurrence rate of VP patients (P<0.01). The occurrence rate of gait disorders, sensory disturbances, dysarthria, pathological symptoms, romberg syndrome of VP patientswas higher than PD patients. The occurrence rate of resting tremor, muscle rigidity, depression, anxiety, memory loss in VP patients was higher than PD, muscle abnormalities, dysphagia, choking water slightly higher incidence in patients with VP, but the difference was not statistically significant.3.In terms of clinical symptoms of Chinese Medicine, The occurrence rate of constipation, frequent urination, anorexia, hot flashes (or hot and cold), dry mouth, dizziness in VP patients was higher than that of PD patients. The occurrence rate of fatigue, night sweats symptoms was slightly higher than that of PD patients. The occurrence rate of sleep disorders, palpitation, chest tightness, shortness of breath, the spontaneous symptoms in PD patients was slightly higher than that of VP patients, but the difference was not statistically significant (P> 0.05)4.In senile tremor patients the disease location syndrome factor integral order from high to low is:meridian, mind, kidney,bones and muscles, liver, heart, spleen. (P< 0.01) The frequency from high to low in turn is:the bones and muscles, meridian, liver, kidney, mind, spleen, heart. The empirical syndrome factor score from high to low in turn is phlegmy, wind, wet, cold, hyperactivity of yang, blood stasis, and qi stagnation, heat. (P< 0.01)The frequency from high to low in turn is hyperactivity of yang, phlegm, wet, wind,blood stasis, heat, cold, and qi stagnation.The deficiency syndrome factor score from high to low in turn is blood deficiency, Yin deficiency, qi deficiency, Yang deficiency, jing kui, jin kui. (P> 0.05) The frequency from high to low in turn is:yin deficiency, blood deficiency, qi deficiency, Yang deficiency, jin kui and jing kui.In patients with Parkionson’s disease, the disease location syndrome factor integral order from high to low is:meridian, mind, bones and muscles, liver, kidney, heart, spleen. (P> 0.05) The frequency from high to low in turn is:the bones and muscles, meridian, liver, kidney, mind, spleen, heart. In patients with VP, the disease location syndrome factor integral order from high to low is:meridian, kidney,mind, liver,bones and muse les,sp lee n, heart. (P<0.01) The frequency from high to low in turn is:the bones and muscles, liver,meridian, kidney, mind, spleen, heart.In senile tremor patients, phlegm and wind is positively correlated with the occurrance of multiple lacunar infarctions in MRI.5.In respect ofcomorbidities:The prevalence rate of cerebral infarction, hypertension, coronary heart disease, cervical spondylosis, anxiety in VP patients was higher than that in PD patients. The prevalence rate of hyperlipidemia, diabetes, lumbar spondylosis, depression in PD patients was higher than that of VP patients. The prevalence of cerebral infarction, hypertension in VP patients was significantly higher than that in PD patients,with a statistically significant difference.6.TCM syndromes:The proportion of patients with the syndrome of blood stasis activity wind certificate or phlegm moving wind in VP patients is higher than that in PD patients. The proportion of patients with the syndrome of deficiency of liver and kidney or deficiency of qi and blood was higher than that in VP patients, with a statistically significant difference.7.The head MRI:The proportion of multiple lacunar infaction in VP patients were higher than that of PD patients, with a statistically significant difference. (P=0.007)The infarction lesions lie next to the lateral ventricles, basal ganglia, frontal cortex, the semi-oval center, corona radiata and so on. The proportion of infarction lesions lie next to the lateral ventricles in VP patients is higher than that in PD patients,with a statistically significant difference. (P=0.000)8.Carotid ultrasound:The proportion of VP patients with carotid plaque (76.2%) is slightly more than that of PD patients (72.2%); the proportion of patients with carotid artery plaque membrane thickening or with carotid plaque (90.5%)in VP patients is greater than that of PD patients (77.8%).These differences were not statistically significant. The proportion of VP patients with hypoechoic plaque or heterogeneous plaque (41.2%) is greater than that of PD patients (23.1%), but the difference was not statistically significant. The difference in the largest patch length, thickness of the two groups of patients was not statistically significant. (P>0.05)Conclusions:(1) In senile tremor patients, phlegm moving wind syndrome and cerebral infarction were positively related. Sweat is positively correlated with qi and blood deficiency syndrome, and is negatively correlated with phlegm moving wind syndrome.(2) The proportion of patients with the syndrome of blood stasis activity wind certificate or phlegm moving wind in VP patients is higher than that in PD patients. The proportion of patients with the syndrome of deficiency of liver and kidney or deficiency of qi and blood was higher than that in VP patients.(3) In senile tremor patients,the commom disease location syndrome factor is bones and muscles, meridian, liver, kidney.The common empirical syndrome factor is hyperactivity of yang, phlegmy, wet, wind.The common deficiency syndrome factor is yin deficiency, blood deficiency. There is no difference between the syndromes elements distribution between PD and VP patients. In senile tremor patients, phlegm and wind is positively correlated with the occurrance of multiple lacunar infarctions inMRI.(4) The age of onset of VP patients is older than that of PD patients.and the average duration of VP patients is shorter than PD patients. The prevalence of cerebral infarction, hypertension in VP patients was significantly higher than that in PD patients.(5)The occurrence rate of intentionality/postural tremor of VP patients was higher than the occurrence rate of PD patients.The occurrence rate of resting tremor of PD patients was higher than the occurrence rate of VP patients.(6)The proportion of multiple lacunar infarction in VP patients were higher than that of PD patients. The proportion of infarction lesions lie next to the lateral ventricles in VP patients is higher than that in PD patients.
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