帕金森病伴周围神经病变的相关研究进展  

Research progress of Parkinson’s disease with peripheral neuropathy

作　　者：王瑞召 张伟峰[1] 张璟 杨希[2] 冯丽莎[2] WANG Ruizhao;ZHANG Weifeng;ZHANG Jing;YANG Xi;FENG Lisha

机构地区：[1]天津中医药大学,天津301617 [2]天津市中医药研究院附属医院,天津300120

出　　处：《中医临床研究》2024年第36期138-141,共4页Clinical Journal Of Chinese Medicine

摘　　要：帕金森病(Parkinson's Disease,PD)是临床常见的一种神经系统退行性疾病,在神经系统退行性疾病中发病率仅次于阿尔茨海默病。目前临床对PD的关注主要聚焦在运动症状和非运动症状,患者病程当中出现的皮肤麻木等异常表现,通常被认为是非运动症状的外在表现,而忽视了疾病进展过程中合并周围神经病变的可能。近年来,PD合并周围神经病变更多地引起人们的重视,其临床表现主要以肢体远端感觉异常为主,体征以腱反射降低、深浅感觉减退为主,发病机制主要分为药物因素与非药物因素,范围大致包括左旋多巴的应用、炎症反应、氧化应激、营养不良、机械卡压、神经衰老等。随着神经电生理技术的成熟与应用,研究发现感觉异常主要以感觉纤维轴索损害为主,但由于部位、病程的不同,并无统一的说法与标准。针对其预防及治疗主要为以下两种方法:①左旋多巴联合用药治疗;②及时补充维生素并监测相关理化指标。研究搜集近年来国内外文献,对帕金森周围神经病变的流行病学、发病机制、临床表现、神经电生理改变、角膜改变、治疗等6个方面进行分析阐述,为今后的临床工作提供参考。Parkinson’s disease is a common neurological degenerative disease in clinical practice,and its incidence is second only to Alzheimer’s disease in the category of neurological degenerative diseases.At present,clinical attention to Parkinson’s disease mainly focuses on motor symptoms and non-motor symptoms.Abnormal manifestations such as skin numbness in the course of Parkinson’s disease are usually considered as external manifestations of non-motor symptoms,while the possibility of peripheral neuropathy in the progression of the disease is ignored.In recent years,Parkinson’s disease complicated with peripheral neuropathy has attracted more attention.The clinical manifestations of Parkinson’s disease are mainly paresthesia in the distal extremity,and the physical signs are mainly reduced tendon reflex and decreased deep and shallow sensation.According to the current clinical development data and related literature,its pathogenesis is mainly divided into drug factors and non-drug factors,and its scope roughly includes the application of levodopa,inflammatory response,oxidative stress,malnutrition,mechanical entrapage,and neuroaging,etc.With the maturity and application of neuroelectrophysiological technology,it has been found that paresthesia is mainly related to the damage of sensory fiber axons.However,due to the difference in its location and course of disease,there is no unified statement and standard.The prevention and treatment mainly include the following two methods:1.Levodopa combined therapy;2.Timely vitamin supplementation and monitoring of relevant physical and chemical indexes.By collecting literatures at home and abroad in recent years,this paper analyzes and elaborates the epidemiology,pathogenesis,clinical manifestations,neuroelectrophysiological changes,corneal changes,treatment and other six aspects of Parkinson’s peripheral neuropathy,so as to provide reference for the future clinical work.

关 键 词：帕金森病 周围神经病变 发病机制 左旋多巴 治疗 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]