To Explore The Clinical Efficacy Of Bushen Yisui Recipe In The Treatment Of Multiple System Atrophy And Parkinson's Disease Based On The Theory Of Treating Different Diseases With The Same Treatment

Multiple System Atrophy(MSA)and Parkinson's Disease(PD)are neurodegenerative diseases.Both of them have the same pathological basis.In ultrastructure,filamentous inclusions composed of ?-synuclein can be seen.So they are often associated with Lewy bodies Dementia and are called Synuclein Disease.Because of the high rate of disability and poor prognosis in the middle and late stage,the research on the treatment of these two diseases has always been a hot issue.But there are always difficulties in the treatment of MSA and PD,Many adverse reactions brought by PD during treatment make patients more troubled,However,the treatment of MS A is difficult and all kinds of therapies have little effect,so it is urgent to seek more effective treatment means.Many doctors in traditional Chinese medicine believe that the pathogenesis of MSA and PD can be classified as deficiency of liver and kidney and deficiency of the "marrow sea".In addition,the preliminary study results of our team suggested that kidney deficiency was the main syndrome of MSA patients.Therefore,our team proposed for the first time that MSA and PD share the core pathogenesis of "kidney and marrow deficiency".Formulate prescriptions of tonifying kidney and enriching marrow.Previous studies have found that the kidney-tonifying and marrow-enriching prescription can delay the progression of MSA and PD.And it is particularly effective for non-motor symptoms.Therefore,this study intends to elucidate the core pathogenesis of "kidney deficiency and marrow deficiency".Based on the homotherapy for heteropathy theory,we on the one hand use prescriptions of tonifying kidney and enriching marrow to treat MSA and PD to verify the core pathogenesis theory.On the other hand,by means of evaluating the results of various scales,we observe the clinical effect of prescriptions of tonifying kidney and enriching marrow on MSA and PD.Objective:?By means of analyzing the changes of TCM syndrome scale scores before and after treatment to verify the core pathogenesis theory of "kidney and marrow deficiency".?Based on the homotherapy for heteropathy theory,we observe the clinical effect of the prescriptions of tonifying kidney and enriching marrow in the treatment of MSA and PD.Methods:We collected MSA and PD patients who were admitted to the outpatient department and ward of the First Department of Encephalopathy in the East Hospital of Beijing University of traditional Chinese Medicine from December 2019 to December 2020.On the basis of maintaining the patient's original medication we added the prescriptions of tonifying kidney and enriching marrow.UMSARS,MSA-NMSS and TCM syndrome scale scores were evaluated at baseline and 3 months for MSA patients.At the same time,UPDRS-?,H,NMSS,Hoehn-Yahr(H-Y)staging scale and TCM syndrome scale scores were evaluated at baseline and 3 months for PD patients.Monitor adverse reactions.Results:In this study,a total of 44 patients completed efficacy observation,including 31 MSA patients and 13 PD patients.Curative effect analysis:?Chinese medicine syndrome scale of kidney deficiency and reduced pulp:The main symptom score of TCM syndrome scale of kidney deficiency is decreased by 1.55±2.19 points in total cases,and the difference was statistically significant(P<0.05).MSA:total score,primary symptom score and secondary symptom score all decreased(P<0.05).PD:total score and primary symptom score decreased(P<0.05).All patients were relieved of fatigue,dizziness,slow thinking,weak defecation and dry knots(P<0.05).But the symptoms of walking instability were aggravated in MSA(P<0.05).There was no difference in MSA and PD main scores(P>0.05).?UMSARS:UMSARS-? had no change before and after treatment.UMSARS-?+?score and UMSARS-? score increased,while UMSARS-? score decreased slightly,and there was no statistical significance(P>0.05).The symptoms of falling and standing were significantly improved,and the posture and gait were aggravated(P<0.05).?MSA-NMSS:Score was significantly decreased(P<0.05).Fatigue,salivate symptoms,systemic symptoms,head symptoms and defecation function were improved significantly(P<0.05).?UPDRS and H-Y Staging Scores:There was no change in H-Y Staging Scores before and after treatment.UPDRS-?+? score and UPDRS-? decreased,while UPDRS-? score increased slightly,and the difference was not statistically significant(P>0.05).The rotation movement was significantly improved and the abnormal posture was aggravated(P<0.05).?NMSS:The scores were significantly decreased(P<0.05),and the sleep/fatigue symptoms were significantly improved(P<0.05).Conclusion:The prescriptions of tonifying kidney and enriching marrow can delay the progression of MSA and PD and effectively improve patients' non-motor symptoms which are mainly reflected in lack of power,dizziness,salivate symptoms,slow thinking,weak defecate,dry knot and sleep disorders and other aspects.The core pathogenesis of "kidney deficiency and marrow deficiency" was verified by prescriptions.It provides a new idea and method for the treatment of neurodegenerative diseases by traditional Chinese medicine.