中医药治疗左旋多巴诱发异动症的研究进展  

Research Progress of TCM in Treatment of Levodopa-Induced Dyskinesia

作　　者：秦正巍 王顺[1] 白妍 李元 QIN Zhengwei;WANG Shun;BAI Yan;LI Yuan(Heilongjiang University of Traditional Chinese Medicine,Harbin Heilongjiang China 150040;Heilongjiang Academy of Traditional Chinese Medicine,Harbin Heilongjiang China 150036)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江省中医药科学院,黑龙江哈尔滨150036

出　　处：《中医学报》2022年第5期985-990,共6页Acta Chinese Medicine

基　　金：黑龙江省自然科学基金项目(LH2021H072)。

摘　　要：中药治疗左旋多巴诱发异动症疗效显著,毒副作用小,药用靶点广泛,可根据异动症的不同病程、不同证型辨证施治,药理作用主要为抗胆碱能、发挥多巴胺能受体激动剂作用、影响纹状体多巴胺系统、抗氧化等。针灸亦可保护神经元、改善细胞凋亡、抵抗细胞自噬,有效改善异动症患者临床症状,抑制左旋多巴的不良反应。但目前的研究仍存在一些问题:异动症发病机制复杂,现有研究多侧重于突触前机制、突触后可塑性变化、GABA能神经元、非多巴胺能调节因子等方面,具体机制仍不甚清楚;研究缺乏深度,专方专药较少,缺乏大样本、多中心的临床试验研究;针灸治疗在穴位选取及手法操作方面缺乏量化和标准化。故今后需进一步加强中医药治疗异动症的机制研究,制定统一的疗效评定标准,继续开展大样本、高质量的临床试验研究。Traditional Chinese medicine has obvious curative effect in the treatment of dyskinesia,with less toxic and side effects,and has a wide range of medicinal targets.It can be treated according to the different course of dyskinesia and different syndrome types.The pharmacological effects are mainly anticholinergic and dopaminergic receptor agonists.It affects the striatal dopamine system,antioxidant and so on.Acupuncture can also protect neurons,improve cell apoptosis,resist autophagy,effectively improve the clinical symptoms of dyskinesia patients,and improve the adverse reactions of levodopa.However,there are still some problems in current research:the pathogenesis of dyskinesia is complex,and the existing research mostly focuses on presynaptic mechanisms,postsynaptic plasticity changes,GABA energetic neurons,and non-dopaminergic regulators,etc.The specific mechanism is still unclear;the research lacks depth,there are few special prescriptions and special drugs,and there is a lack of large-scale,multi-center clinical trial research;acupuncture treatment lacks quantification and standardization in acupoint selection and manipulation.Therefore,in the future,it is necessary to further strengthen the research on the mechanism of traditional Chinese medicine in the treatment of dyskinesia,formulate unified efficacy evaluation standards,and continue to carry out large-scale,high-quality clinical research.

关 键 词：异动症 帕金森病 左旋多巴 中医药 肝肾阴虚证 气血亏虚证 痰瘀动风证 阳虚风动证 

分 类 号：R277.7[医药卫生—中医学]