针刺星状神经节联合西药治疗帕金森病体位性低血压：随机对照试验

李密密; 周立峰; 马金成

doi:10.13703/j.0255-2930.20240105-k0006

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针刺星状神经节联合西药治疗帕金森病体位性低血压：随机对照试验

临床研究 | 更新时间：2024-10-12

- 针刺星状神经节联合西药治疗帕金森病体位性低血压：随机对照试验
- Acupuncture at stellate ganglion combined with western medication for orthostatic hypotension in Parkinson's disease: a randomized controlled trial
- 中国针灸 2024年44卷第10期页码：1119-1124
- 作者机构：
  
  1.丽水市中医院神经内科，浙江丽水　323000
  2.丽水市中医院老年医学科，浙江丽水　323000
- 作者简介：
  
  ☒马金成，住院医师。E-mail：405351777@qq.com
- 基金信息：
  
  丽水市科技计划项目(2023GYX54)
- DOI：10.13703/j.0255-2930.20240105-k0006
  中图分类号：
- 收稿：2024-01-05，
  
  网络首发：2024-07-02，
  
  纸质出版：2024-10-12
- 稿件说明：
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李密密, 周立峰, 马金成. 针刺星状神经节联合西药治疗帕金森病体位性低血压：随机对照试验[J]. 中国针灸, 2024,44(10):1119-1124.

LI Mimi, ZHOU Lifeng, MA Jincheng. Acupuncture at stellate ganglion combined with western medication for orthostatic hypotension in Parkinson's disease: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(10): 1119-1124.
李密密, 周立峰, 马金成. 针刺星状神经节联合西药治疗帕金森病体位性低血压：随机对照试验[J]. 中国针灸, 2024,44(10):1119-1124. DOI： 10.13703/j.0255-2930.20240105-k0006.

LI Mimi, ZHOU Lifeng, MA Jincheng. Acupuncture at stellate ganglion combined with western medication for orthostatic hypotension in Parkinson's disease: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(10): 1119-1124. DOI： 10.13703/j.0255-2930.20240105-k0006.

摘要

目的：

观察针刺星状神经节对帕金森病（PD）体位性低血压（OH）患者的影响，探讨其作用机制。

方法：

将68例PD合并OH患者随机分为针药组(34例，脱落2例，剔除1例）和西药组（34例，剔除1例）。两组均给予稳定剂量的抗PD西药，西药组予盐酸米多君片口服，每次2.5 mg，每天2次，针药组在西药组基础上针刺双侧星状神经节，不留针，每天1次，每周5 d。两组均治疗2周。分别于治疗前后观察两组患者卧位及立位血压、体位性低血压自评量表（OHQ）评分、中医证候积分、统一帕金森病评分量表(UPDRS）评分，检测两组患者血清去甲肾上腺素（NE）含量，并评定临床疗效。

结果：

治疗后，针药组患者立位收缩压（SBP）、舒张压（DBP）均较治疗前升高（

0.01），OHQ评分、中医证候积分、UPDRS评分均较治疗前降低（

0.01）；西药组患者卧位SBP较治疗前升高（

0.05），OHQ评分较治疗前降低（

0.05）；两组患者血清NE含量较治疗前升高（

0.01）。治疗后，针药组立位SBP、DBP及血清NE含量高于西药组（

0.01，

0.05），OHQ评分、中医证候积分、UPDRS评分低于西药组（

0.05，

0.01）。针药组总有效率为87.1%（27/31），高于西药组的63.6%（21/33，

0.05）。

结论：

针刺星状神经节可升高PD合并OH患者的立位血压，改善临床症状，其机制可能与上调NE水平有关。

Abstract

Objective

To observe the effect of acupuncture at stellate ganglion on orthostatic hypotension (OH) in Parkinson's disease (PD)

and explore its action mechanism.

Methods

A total of

68 patients with OH in PD were randomly divided into a combination group (34 cases

2 cases dropped out

1 case was eliminated) and a western medication group (34 cases

1 case was eliminated). Both groups received stable dose anti-PD western medication

the western medication group received oral midodrine hydrochloride tablets

2.5 mg each time

2 times a day. The combination group was treated with acupuncture at bilateral stellate ganglion on the basis of the western medication group

without retaining needles

once a day

5 times a week. Both groups were treated for 2 weeks. Supine and orthostatic blood pressure

orthostatic hypotension questionnaire (OHQ) score

TCM syndrome score

unified Parkinson's disease rating scale (UPDRS) score before and after treatment in the two groups were observed

the level of serum norepinephrine (NE) was detected

and the clinical effect was evaluated.

Results

After treatment

orthostatic systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the combination group were increased compared with those before treatment (

0.01)

OHQ score

TCM syndrome score

UPDRS score were decreased compared with those before treatment (

0.01); supine SBP in the western medication group was increased compared with that before treatment (

0.05)

OHQ score was decreased compared with that before treatment (

0.05); the levels of serum NE in both groups were increased compared with those before treatment (

0.01). After treatment

orthostatic SBP

orthostatic DBP and the level of serum NE in the combination group were higher than those in the western medication group (

0.01

0.05)

the OHQ score

TCM syndrome score

UPDRS score were lower than those in the western medication group (

0.05

0.01). The total effective rate was 87.1% (27/31) in the combination group

which was higher than 63.6% (21/32) in the western medication group (

0.05).

Conclusion

Acupuncture at stellate ganglion can increase the orthostatic blood pressure in patients with OH in PD

improve clinical symptoms

and the mechanism may be related to the up-regulation of NE.

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