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针刺调节肠腑功能治疗帕金森病抑郁的理论探讨
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Abstract:
目的：基于中医“肝气郁滞、腑气不通”角度，探讨针刺调节肠腑功能，干预PDD的作用机制，以期为临床治疗PDD提供可行的治疗方法。方法：通过分析帕金森发病机制及神经递质分泌水平对于抑郁情绪的影响，联系中医“颤证”和“郁证”的有关理论以及肠道菌群对于帕金森发病机制相关性的研究。结合针刺对于神经递质、肠道菌群和炎症反应的调节作用，探讨针刺调节肠腑功能对于帕金森抑郁治疗的理论支持。结果：帕金森病抑郁(Parkinson’s Disease Depression, PDD)患者常伴有胃肠失调症状，较易被忽视。肠道与中枢之间的神经联系参与胃肠道疾病和神经退行性疾病，α-突触核蛋白(α-syn)的聚集、纹状体多巴胺(DA)缺乏、5-羟色胺(5-HT)下降、去甲肾上腺素(NE)减少、神经炎症都与肠道菌群失调有关。已有的实验证明，微生物–肠–脑轴的神经内分泌网络是PDD的发病机制之一。中医治疗PDD安全、有效，且优势显著。针刺是治疗PDD的方式之一，具有增加优势菌群、减少致病菌，维持肠道内环境稳态，调节神经递质等作用。结论：脑肠轴理论为中医治疗PPD提供了思路与方法，从脑–肠相关性探究针刺治疗PDD具有实际临床意义。尽管此次研究论述了肠道菌群与帕金森病抑郁的理论联系和针刺治疗帕金森病抑郁改善肠腑功能的可行性，但对针刺治疗帕金森病抑郁缺乏临床统一的选穴配穴方案，以及具体的针刺手法的阐述。
Objective: Based on the perspective of “liver qi stagnation and fu qi obstruction” in traditional Chinese medicine, therefore, this paper discusses the mechanism of acupuncture regulating intestinal function and intervening PDD, in order to provide a feasible treatment method for clinical treatment of PDD. Methods: By analyzing the pathogenesis of Parkinson’s disease and the influence of neurotransmitter secretion level on depressive mood, the relevant theories of “fibrillation syndrome” and “depression syndrome” in traditional Chinese medicine, as well as the correlation of intestinal flora on the pathogenesis of Parkinson’s disease. Combined with the regulatory effect of acupuncture on neurotransmitters, intestinal microbiota and inflammatory response, this paper explored the theoretical support of acupuncture in regulating intestinal function for the treatment of Parkinson’s depression. Results: Depression is one of the common clinical symptoms of Parkinson’s disease. Patients with Parkinson’s disease depression (PDD) are often accompanied by symptoms of gastrointestinal disorders and are more likely to be ignored. The neural connection between the gut and the center is involved in diseases of the gastrointestinal tract and neurodegenerative diseases. Aggregation of α-synuclein (α-syn), striatal dopamine (DA) deficiency, decreased 5-Hydroxytryptophan (5-HT), decreased norepinephrine (NE), and neuroinflammation are all associated with intestinal dysbiosis. Previous experiments have shown that the neuroendocrine network of the microbiome-gut-brain axis is one of the pathogenesis of PDD. TCM treatment of PDD is safe, effective, and has significant advantages. By the
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