血管性帕金森综合征的中医与西医发病机制及治疗研究进展^*

Research progress in the pathogenesis and treatment of vascular parkinsonism: insights from traditional Chinese medicine and Western medicine

摘要

血管性帕金森综合征(VP)是一种由脑血管病变引发的继发性帕金森综合征。随着人口老龄化进程加快及脑血管病发病率持续攀升,VP的疾病负担日益加重。VP病理机制可能涉及脑血管病变与神经退行性变的交互作用,其临床特征主要取决于脑血管病变的部位及严重程度,目前尚缺乏特异性治疗方案。中医学将VP归属“颤证”范畴,认为其病机以肝肾亏虚、气血不足为本,风、火、痰、瘀为标,通过辨证运用中药和针灸可改善运动及非运动症状。本文分别从现代医学与中医学角度系统梳理VP的发病机制及治疗研究进展,以期为深化病机认识与优化临床干预策略提供参考。

Abstract

Vascular parkinsonism (VP) is a secondary parkinsonian syndrome caused by cerebrovascular disease. As the population ages rapidly and the prevalence of cerebrovascular disease increases, the disease burden of VP continues to rise. The pathophysiology of VP may involve the interaction between cerebrovascular pathology and neurodegenerative processes. The clinical manifestations mainly depend on the location and severity of cerebrovascular lesions. Currently, no specific therapeutic strategy has been established. In traditional Chinese medicine (TCM), VP is classified as a type of “tremor syndrome”(Chan Zheng). The pathophysiology is attributed to deficiencies in the liver and kidneys, along with insufficiencies of qi and blood, while wind, fire, phlegm, and blood stasis are identified as key pathogenic factors. Interventions based on syndrome differentiation, such as herbal medicine and acupuncture, have been shown to improve both motor and non-motor symptoms. This review comprehensively summarizes the current progress in the pathogenesis andtreatmentof VP from the perspectives of Western medicine and TCM, with the aim of providing a reference for the further clarification of disease mechanisms and optimizationof clinical management strategies.

关键词

血管性帕金森综合征 / 脑血管病 / 发病机制 / 辨证论治

Key words

Vascular parkinsonism / Cerebrovascular disease / Pathogenesis / Syndrome differentiation and treatment

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基金资助

^*国家自然科学基金项目(82104995);国家中医针灸临床医学研究中心开放课题(NCRCOP2024017);天津市教委科研计划项目(2022ZD045);河北省中医药管理局科研计划项目(T2025091)