内科理论与实践

内科理论与实践 >

2025 , Vol. 20 >Issue 01: 50 - 53

DOI: https://doi.org/10.16138/j.1673-6087.2025.01.10

综述

帕金森病疼痛的中西医治疗研究进展

  • 孙倩 ,
  • 林诗雨 ,
  • 夏梦婕 ,
  • 周海燕 ,
  • 王秀薇
展开
  • 1.复旦大学附属闵行医院神经内科，上海 201199
    2.广州中医药大学第一附属医院 针灸推拿康复中心，广东 广州 510405
    3.上海交通大学医学院附属瑞金医院神经内科，上海 200025
    4.上海中医药大学附属龙华医院脑病科，上海 200032

收稿日期: 2024-07-08

  网络出版日期: 2025-04-30

收起

Research progress on treatment of Parkinson disease-related pain with traditional Chinese and Western medicine

  • SUN Qian ,
  • LIN Shiyu ,
  • XIA Mengjie ,
  • ZHOU Haiyan ,
  • WANG Xiuwei
Expand
  • 1. Department of Neurology, Minhang Hospital, Fudan University, Shanghai 201199,China
    2. Department of Acupuncture and Rehabilitation, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
    3. Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    4. Department of Neurology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China

Received date: 2024-07-08

  Online published: 2025-04-30

Fold

摘要

疼痛作为帕金森病最常见的非运动症状之一，其发病机制复杂，临床分类多样。目前西医治疗以多巴胺能替代疗法为主，但仅能缓解部分疼痛症状，且长期治疗存在不可避免的运动并发症和药物不良反应，疗效存在明显局限性。中医在疼痛治疗领域具独特优势。本文总结近年中西医治疗帕金森病疼痛的相关文献，旨在为中西医结合治疗该病提供科学参考及治疗思路。

关键词： 帕金森病; 疼痛; 中西医结合治疗; 研究进展

本文引用格式

孙倩 , 林诗雨 , 夏梦婕 , 周海燕 , 王秀薇 . 帕金森病疼痛的中西医治疗研究进展[J]. 内科理论与实践, 2025 , 20(01) : 50 -53 . DOI: 10.16138/j.1673-6087.2025.01.10

Abstract

Pain is one of the most common non-motor symptoms of Parkinson disease, with complex pathogenesis and clinical classification. The current treatment in Western medicine for pain in Parkinson disease mainly focuses on dopamine replacement therapy, which can only solve a portion of the pain issues. However, long-term use of Western medications inevitably leads to motor complications and drug side effects, making the effect of treatment often insufficient. Traditional Chinese medicine has unique advantages in pain management. Therefore, this article summarizes recent literature on the treatment of Parkinson disease pain with Western and traditional Chinese medicine, aiming to provide scientific references and therapeutic strategies for the integrated treatment of the disease with traditional Chinese and Western medicine.

Key words： Parkinson disease; Pain; Integrated traditional Chinese and Western medicine; Research progress

参考文献

[1] Silverdale MA, Kobylecki C, Kass-lliyya L, et al. A detailed clinical study of pain in 1957 participants with early/moderate Parkinson’s disease[J]. Parkinsonism Relat Disord, 2018,56:27-32.
[2] Mylius V, Perez Lloret S, Cury RG, et al. The Parkinson disease pain classification system: results from an international mechanism-based classification approach[J]. Pain, 2021, 162(4):1201-1210.
[3] Raja SN, Carr DB, Cohen M, et al. The revised international association for the study of pain definition of pain: concepts, challenges, and compromises[J]. Pain, 2020, 161(9):1976-1982.
[4] Allen NE, Romaliiska O, Naisby J. Pain and the non-pharmacological management of pain in people with Parkinson’s disease[J]. J Parkinsons Dis, 2024, 14(s1):S65-S80.
[5] Broetz D, Eichner M, Gasser T, et al. Radicular and nonradicular back pain in Parkinson’s disease: a controlled study[J]. Mov Disord, 2007, 22(6):853-856.
[6] Kosek E, Cohen M, Baron R, et al. Do we need a third mechanistic descriptor for chronic pain states?[J] Pain, 2016, 157(7):1382-1386.
[7] Fitzcharles MA, Cohen SP, Clauw DJ, et al. Nociplastic pain: towards an understanding of prevalent pain conditions[J]. Lancet, 2021, 397(10289):2098-2110.
[8] Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances[J]. Lancet, 2021, 397(10289):2082-2097.
[9] Poewe WH, Lees AJ, Stern GM. Dystonia in Parkinson’s disease: clinical and pharmacological features[J]. Ann Neurol, 1988, 23(1):73-78.
[10] Battista AF, Wolff BB. Levodopa and induced-pain response[J]. Arch Intern Med, 1973, 132(1):70-74.
[11] Brefel-Courbon C, Payoux P, Thalamas C, et al. Effect of levodopa on pain threshold in Parkinson’s disease: a clinical and positron emission tomography study[J]. Mov Disord, 2005, 20(12):1557-1563.
[12] Gerdelat-Mas A, Simonetta-Moreau M, Thalamas C, et al. Levodopa raises objective pain threshold in Parkinson’s disease: a RⅢreflex study[J]. J Neurol Neurosurg Psychiatry, 2007, 78(10):1140-1142.
[13] Rascol O, Zesiewicz T, Chaudhuri KR, et al. A randomized controlled exploratory pilot study to evaluate the effect of rotigotine transdermal patch on Parkinson’s disease-associated chronic pain[J]. J Clin Pharmacol, 2016, 56(7):852-861.
[14] Raeder V, Boura I, Leta V, et al. Rotigotine transdermal patch for motor and non-motor Parkinson’s disease: a review of 12 years’ clinical experience[J]. CNS Drugs, 2021, 35(2):215-231.
[15] Hattori N, Tsuboi Y, Yamamoto A, et al. Efficacy and safety of safinamide as an add-on therapy to L-DOPA for patients with Parkinson’s disease: a randomized, double-blind, placebo-controlled, phaseⅡ /Ⅲ study[J]. Parkinsonism Relat Disord, 2020,75:17-23.
[16] Kurihara K, Mishima T, Fujioka S, Tsuboi Y. Efficacy and safety evaluation of safinamide as an add-on treatment to levodopa for parkinson’s disease[J]. Expert Opin Drug Saf, 2022, 21(2):137-147.
[17] Chaudhuri KR, Odin P, Ferreira JJ, et al. Opicapone versus placebo in the treatment of Parkinson’s disease patients with end-of-dose motor fluctuation-associated pain: rationale and design of the randomised, double-blind OCEAN (opicapone effect on motor fluctuations and pain) trial[J]. BMC Neurol, 2022, 22(1):88.
[18] Qureshi AR, Rana AQ, Malik SH, et al. Comprehensive examination of therapies for pain in Parkinson’s disease: a systematic review and meta-analysis[J]. Neuroepidemiology, 2018, 51(3-4):190-206.
[19] Djaldetti R, Yust-Katz S, Kolianov V, et al. The effect of duloxetine on primary pain symptoms in Parkinson disease[J]. Clin Neuropharmacol, 2007, 30(4):201-205.
[20] Sidhu HS, Sadhotra A. Current status of the new antiepileptic drugs in chronic pain[J]. Front Pharmacol, 2016,7:276.
[21] Ford B. Pain in Parkinson’s disease[J]. Mov Disord, 2010,25 Suppl 1:S98-S103.
[22] Argoff CE. New analgesics for neuropathic pain: the lidocaine patch[J]. Clin J Pain, 2000, 16(2 Suppl):S62-S66.
[23] Viseux FJF, Delval A, Simoneau M, Defebvre L. Pain and Parkinson’s disease: current mechanism and management updates[J]. Eur J Pain, 2023, 27(5):553-567.
[24] 上海中西医结合学会慢性神经系统疾病专业委员会. 帕金森病运动处方专家共识[J]. 同济大学学报(医学版), 2021, 42(6):729-735.
[25] 武琪, 刘志坚, 程玲, 等. 水疗法对轻中度帕金森患者作用效果的荟萃分析[J]. 临床与病理杂志, 2021, 41(2):374-382.
[26] Yang QH, Zhang YH, Du SH, et al. Non-invasive brain stimulation for central neuropathic pain[J]. Front Mol Neurosci, 2022,15:879909.
[27] Flouty O, Yamamoto K, Germann J, et al. Idiopathic Parkinson’s disease and chronic pain in the era of deep brain stimulation: a systematic review and meta-analysis[J]. J Neurosurg, 2022, 137(6):1821-1830.
[28] Zimmers S, Robieux L, Bungener C. Towards a better comprehension and management of pain and psychological distress in Parkinson’s: the role of catastrophizing[J]. J Geriatr Psychiatry Neurol, 2023, 36(5):351-365.
[29] Pickut B, Vanneste S, Hirsch MA, et al. Mindfulness training among individuals with Parkinson’s disease: Neurobehavioral Effects[J]. Parkinsons Dis, 2015,2015:816404.
[30] 汪海芹, 蔡忠明. 大定风珠治疗帕金森病40例临床观察[J]. 世界最新医学信息文摘(连续型电子期刊), 2019, 19(26):155.
[31] 侯宇, 马效麟, 张婷, 等. 补肾养肝息风汤对肝肾阴虚型帕金森病患者综合功能的影响[J]. 湖北中医药大学学报, 2021, 23(3):66-68.
[32] 戈盾. 止颤汤合芍药甘草汤治疗帕金森病疼痛的临床疗效观察[J]. 内蒙古中医药, 2017, 36(14):44-45.
[33] 郑春叶, 吕少华, 黄强, 等. 加味桂枝加葛根汤治疗帕金森病疼痛40例临床观察[J]. 中国民间疗法, 2018, 26(11):37-38.
[34] 张秀琳, 惠振, 王苏雷, 等. 加减地黄饮子治疗帕金森病疼痛临床研究[J]. 陕西中医, 2021, 42(5):620-624.
[35] 王秀薇. 胡建华平肝熄风通络法治疗神经系统疾病[J]. 上海中医药杂志, 2006(12):9-10.
[36] Feng Z, Cui S, Yang H, et al. Acupuncture for neuropathic pain: A meta-analysis of randomized control trials[J]. Front Neurol, 2023,13:1076993.
[37] Lee SH, Lim S. Clinical effectiveness of acupuncture on Parkinson disease: a PRISMA-compliant systematic review and meta-analysis[J]. Medicine (Baltimore), 2017, 96(3):e5836.
[38] Yu SW, Lin SH, Tsai CC, et al. Acupuncture effect and mechanism for treating pain in patients with Parkinson’s disease[J]. Front Neurol, 2019,10:1114.
[39] Shaosong W, Jingqing S, Qingyin F, et al. Effectivenss of electroacupuncture for skeletal muscle pain in Parkinson’s disease: a clinical randomized controlled trial[J]. J Tradit Chin Med, 2024, 44(2):388-395.
[40] 于楠楠, 马琳, 毕海洋, 等. 浮针治疗帕金森病伴发四肢疼痛临床研究[J]. 针灸临床杂志, 2020, 36(1):37-40.
[41] Fusaro M, Bufacchi RJ, Nicolardi V, et al. The analgesic power of pleasant touch in individuals with chronic pain: recent findings and new insights[J]. Front Integr Neurosci, 2022,16:956510.
[42] Buhmann C, Wrobel N, Grashorn W, et al. Pain in Parkinson disease: a cross-sectional survey of its prevalence, specifics, and therapy[J]. J Neurol, 2017, 264(4):758-769.
[43] Deuel LM, Seeberger LC. Complementary therapies in parkinson disease: a review of acupuncture, tai chi, qi gong, yoga, and cannabis[J]. Neurotherapeutics, 2020, 17(4):1434-1455.
[44] 蔡鸣春, 顾炜萍, 王厹东, 等. 中药热熨护理对帕金森病伴发肌肉骨骼性疼痛的影响研究[J]. 现代中西医结合杂志, 2022, 31(14):2009-2011.
Options
文章导航

/

〈 〉