基于圆运动思维探讨嗅觉减退、便秘在帕金森病中的治未病意义  

Significance of Hyposmia and Constipation in Preventive Treatment of Parkinson′s Disease Based on Circular Motor Theory

作　　者：余婷 林宇栋 甘露 张亚 王长德 YU Ting;LIN Yu-dong;GAN Lu;ZHANG Ya;WANG Chang-de(Clinical Faculty of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203;Shanghai Traditional Chinese Medicine Integrated Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200082)

机构地区：[1]上海中医药大学市中西医结合临床医学院,上海201203 [2]上海中医药大学附属上海市中西医结合医院,上海200082

出　　处：《世界中西医结合杂志》2025年第3期607-610,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市中医诊疗模式创新试点建设项目(ZY[2018-2020]-FWTX-6013);上海市“国医强优”三年计划行动(HGY-YSZK-2018-10)。

摘　　要：帕金森病(Parkinson′s disease,PD)是神经系统主要致残性疾病之一,发病呈渐进加重,故对早期非运动症状的识别有重要的意义。嗅觉减退、便秘是PD非运动症状中具有前驱诊断意义的两大临床症状,路易体病理学初始在嗅球或胃肠道中发现,故胃肠道及嗅球可能是帕金森病的始动环节。圆运动思维认为嗅觉减退、便秘病位为太阴湿土、阳明燥金,PD运动症状责之于厥阴肝木之风动,今金土先病,知其传木,则知肝木风动不远也;据此传变规律提出PD相关的嗅觉减退、便秘早期治疗以大柴胡汤类降金、疏肝达木;中期以增液承气汤类加减滋水涵木、健脾养肝;后期以肉苁蓉汤、阿胶麻仁汤、温脾汤等滋阴助阳、补土养肝。Parkinson′s disease(PD)is one of the main disabling diseases of the nervous system.PD′s onset is gradually aggravated,so it is significant to identify the early non-motor symptoms.Hyposmia and constipation are the two major clinical symptoms with prodromal diagnostic significance among the non-motor symptoms of PD.In relevant research,the pathology of Lewy bodies is initially found in the olfactory bulb or gastrointestinal tract,which may consequently be the initial link to PD.According to Circular Motor theory,the location of the disease of hyposmia and constipation is greater yin damp earth,and yang brightness dry gold.The PD motor symptoms are caused by the stirring wind of the reverting yin and liver wood.Disease in gold and earth may be transmitted to wood,with liver wood and stirring wind in development.Based on this law of transmission,it is proposed that the early treatment of PD-related hyposmia and constipation should be Dachai Hu decoction to descend gold and soothe the liver.In the middle stage,the Zengye Chengqi decoction should be added to nourish water to moisten wood,strengthen the spleen,and nourish the liver.In the later stage,Roucongrong decoction,Ejiao Maren decoction,and Wenpi decoction should be used to nourish yin,yang,earth,and liver.

关 键 词：嗅觉减退 胃肠功能障碍 圆运动 帕金森病 治未病 

分 类 号：R339.12[医药卫生—人体生理学] R442.2[医药卫生—基础医学]