中医杂志

总结周绍华教授“病、症、证结合”分期论治帕金森病的临证经验。认为肾精亏虚为发病之本，痰瘀蕴毒为恶化之关键。将帕金森病分为前驱期、早期及中晚期。前驱期治疗以补肾填髓为本，选用左归丸或右归丸，并针对便秘、快速眼动睡眠行为障碍等非运动症状随症加减；早期辨证分为肝肾阴虚风动、脾肾阳虚、痰浊壅盛三型，主张“治风先治血”，分别以大定风珠、右归丸、金水六君煎为基础方，合用四物汤养血熄风；中晚期补肾固元与解毒化浊并举，加鹿角胶、龟甲等血肉有情之品，联合黄连解毒汤清热解毒化浊、攻补兼施，重视体位性低血压、吞咽困难等非运动症状的中西医协同调治。

This paper aims to summarize Professor ZHOU Shaohua's clinical experience in treating Parkinson's disease(PD) based on the "disease-symptom-syndrome integration" approach. It is believed that kidney essence deficiency is the root cause of the disease, and phlegm-stasis accumulating toxin is the key factor for its deterioration. PD could be divided into the prodromal stage, early stage and middle-late stage. In the prodromal stage, treatment focuses on tonifying the kidney and replenishing marrow, choosing Zuogui Pill （左归丸） or Yougui Pill （右归丸） to prescribe with modifications according to accompanying non-motor symptoms such as constipation and rapid eye movement sleep behavior disorder. For the early stage, the disease is differentiated into three syndromes, liver-kidney yin deficiency with stirring wind, spleen-kidney yang deficiency, and excessive phlegm turbidity, then following the principle of "calming wind by regulating blood first", the basic prescriptions of Dading Fengzhu Pill （大定风珠）, Yougui Pill （右归丸） and Jinshui Liujun Decoction （金水六君煎） are applied respectively, combined with Siwu Decoction （四物汤） to nourish blood and extinguish wind. For the middle-late stage, therapies of tonifying the kidney and consolidating original qi are combined with detoxifying and resolving turbidity, prescribing fleshy and nourishing medicinals such as deer-horn glue(Cervus nippon Temminck) and turtle shell glue(Colla Carapacis et Plastri Testudinis), together with Huanglian Jiedu Decoction （黄连解毒汤） to clear heat, detoxify and resolve turbidity, implementing simultaneous tonification and elimination. Integrated traditional Chinese and western medicine intervention is emphasized for nonmotor symptoms including orthostatic hypotension and dysphagia.