中西医治疗帕金森病体位性低血压的研究进展

doi:10.16138/j.1673-6087.2025.01.07

摘要/Abstract

摘要：

从跨学科的中西医结合视角出发，本文系统性回顾了帕金森病中体位性低血压（orthostatic hypotension, OH）的研究动态与进展，旨在为临床医疗实践提供坚实的理论支撑。OH作为帕金森病非运动性症状中的显著表现，其引发的晕厥和跌倒风险常成为影响患者预后的不利因素。因此，对于帕金森病OH中医与西医双重视角下的病因探究、病机分析、诊断手段以及治疗手段的全面理解，对临床医疗工作者具有重要意义。这种深入理解不仅能提升对该疾病的认识和治疗水平，还为患者提供更全面、精准且有效的诊疗策略。

关键词: 帕金森病, 体位性低血压, 中西医结合

Abstract:

From the perspective of interdisciplinary integration of traditional Chinese and Western medicine, this article systematically reviews the research trends and progress on treatment of orthostatic hypotension in Parkinson disease, aiming to provide solid theoretical support for clinical medical practice. Orthostatic hypotension, as a prominent non-motor symptom in Parkinson disease, often poses risks of syncope and falls, and becomes adverse factor affecting patient prognosis. Therefore, a comprehensive understanding of the etiology, pathogenesis analysis, diagnostic methods, and treatment methods of orthostatic hypotension in Parkinson disease from both traditional Chinese and Western medicine perspectives is of immeasurable importance to clinical medical workers. This in-depth understanding will not only enhance the understanding and treatment skills of the disease but will also help to provide patients with more comprehensive, accurate, and effective diagnosis and treatment strategies.

Key words: Parkinson disease, Postural hypotension, Integrated traditional Chinese and Western medicine

中图分类号:

R741
R25

张凤娟, 杨钊. 中西医治疗帕金森病体位性低血压的研究进展[J]. 内科理论与实践, 2025, 20(01): 34-37.

ZHANG Fengjuan, YANG Zhao. Research progress on treatment of orthostatic hypotension in Parkinson disease with integrated traditional Chinese and Western medicine[J]. Journal of Internal Medicine Concepts & Practice, 2025, 20(01): 34-37.

参考文献 25

[1]	Wieling W, Kaufmann H, Claydon VE, et al. Diagnosis and treatment of orthostatic hypotension[J]. Lancet Neurol, 2022, 21(8):735-746. doi: 10.1016/S1474-4422(22)00169-7 pmid: 35841911
[2]	Su D, Zhang X, Su Y, et al. Effects of different levodopa doses on blood pressure in older patients with early and middle stages of Parkinson’s disease[J]. Heliyon, 2023, 9(7):e17876.
[3]	Juraschek SP, Daya N, Appel LJ, et al. Orthostatic hypotension and risk of clinical and subclinical cardiovascular disease in middle-aged adults[J]. J Am Heart Assoc, 2018, 7(10):e008884.
[4]	Klanbut S, Phattanarudee S, Wongwiwatthananukit S, et al. Symptomatic orthostatic hypotension in Parkinson’s disease patients: prevalence, associated factors and its impact on balance confidence[J]. J Neurol Sci, 2018,385:168-174.
[5]	The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy[J]. Neurology, 1996, 46(5):1470.
[6]	Breeuwsma AC, Hartog LC, Kamper AM, et al. Diagnosing orthostatic hypotension with continuous and interval blood pressure measurement devices[J]. J Hum Hypertens, 2018, 32(12):831-837. doi: 10.1038/s41371-018-0091-9 pmid: 30108291
[7]	许翊坂. 六味地黄丸加减中药膏方治疗肝肾阴虚型帕金森病效果及对其运动和非运动症状的影响观察[J]. 中国医药指南, 2019, 17(31):179-180.
[8]	刘金玉, 刘春花, 吴思敏, 等. 益气养阴通络方联合康复训练治疗气阴两虚型帕金森病临床研究[J]. 新中医, 2023, 55(10):27-31.
[9]	王亚辉, 郝淑芹, 赵保礼, 等. 腹针加艾灸联合地黄饮子治疗帕金森病体位性低血压的疗效观察[J]. 时珍国医国药, 2019, 30(6):1410-1411.
[10]	刘帅. 温阳疏肝汤治疗肾阳亏虚兼肝郁型帕金森病非运动症状的临床疗效观察[D]. 兰州: 甘肃中医药大学, 2024.
[11]	Goldstein DS, Holmes C, Sullivan P, et al. Cardiac noradrenergic deficiency revealed by 18F-dopamine positron emission tomography identifies preclinical central Lewy body diseases[J]. J Clin Invest, 2024, 134(1):e172460.
[12]	Chen Z, Li G, Liu J. Autonomic dysfunction in Parkinson’s disease: Implications for pathophysiology, diagnosis, and treatment[J]. Neurobiol Dis, 2020,134:104700.
[13]	Braak H, Del Tredici K. Neuropathological staging of brain pathology in sporadic Parkinson’s disease: separating the wheat from the chaff[J]. J Parkinsons Dis, 2017, 7(s1):S71-S85.
[14]	Perez-Lloret S, Rascol O. Efficacy and safety of amantadine for the treatment of L-DOPA-induced dyskinesia[J]. J Neural Transm (Vienna), 2018, 125(8):1237-1250.
[15]	Tsuboi T, Satake Y, Hiraga K, et al. Effects of MAO-B inhibitors on non-motor symptoms and quality of life in Parkinson’s disease: a systematic review[J]. NPJ Parkinsons Dis, 2022, 8(1):75.
[16]	沈琳, 张潇文, 吴璐一, 等. 针灸治疗帕金森病自主神经功能障碍的临床研究进展[J]. 世界中医药, 2023, 18(13):1932-1937.
[17]	马喆, 陈奕奕, 刘慧荣, 等. 针灸治疗帕金森病运动症状的临床研究述评[J]. 上海针灸杂志, 2020, 39(7):943-954.
[18]	何顺清, 周凯, 张镇群, 等. 大定风珠联合西药治疗髓海不足型帕金森病临床观察[J]. 山西中医, 2024, 40(9):25-26.
[19]	梅可夫. 补中益气丸联用米多君在症状性神经源性体位性低血压的疗效及安全性观察[D]. 郑州: 郑州大学, 2019.
[20]	王克先, 曹利民, 李红琴, 等. 镇肝熄风汤合黄连阿胶汤加减治疗帕金森病失眠肝肾阴虚证36例[J]. 浙江中医杂志, 2022, 57(12):880-881.
[21]	李华兴, 刘爱武, 丘伟贤, 等. 镇肝熄风汤加减联合美多芭对老年帕金森病患者自主神经的改善效果分析[J]. 中医临床研究, 2020, 12(20):64-67.
[22]	吴文涛, 张秋池, 朱元, 等. 补中益气汤联合盐酸米多君治疗帕金森病直立性低血压疗效研究[J]. 陕西中医, 2018, 39(6):713-716.
[23]	吴晓丹, 肖萌, 翁陈怡. 补肾活血疏肝汤联合西药治疗帕金森病临床研究[J]. 新中医, 2024, 56(20):48-52.
[24]	胡娅娜, 章雄英, 陈衍. 裘氏滋阴息风汤联合多巴丝肼片治疗肝肾不足型早中期帕金森病临床研究[J]. 浙江中西医结合杂志, 2024, 34(10):924-927.
[25]	王爱芳, 王冬. 镇肝熄风汤加减联合西药治疗老年帕金森病患者的临床效果[J]. 慢性病学杂志, 2024, 25(8):1194-1196.