Objective To explore the key traditional Chinese Medicine（TCM） syndromes of primary Parkinson′s disease（PD）. Methods A total of 108 patients with primary Parkinson′s disease were recruited and detected by transcranial substantia nigra ultrasound echo（TCS） in 85 patients to measure strong echo area of substantia nigra（SN）. The Parkinson′s Disease Syndrome Scale was used to give scores TCM syndromes

and 85 cases were diagnosed with TCM syndromes. The syndrome differentiation include syndrome of marrow reduction

syndrome of yin deficiency

syndrome of liver wind

syndrome of qi deficiency

syndrome of internal heat

syndrome of kidney deficiency

syndrome of spleen deficiency

syndrome of hyperactivity of yang

syndrome of phlegm turbidity

syndrome of blood deficiency

syndrome of yang deficiency

syndrome of blood stasis

and syndrome of qi stagnation

and they were divided into syndrome positive group and syndrome negative group. The difference in the proportion of cases of abnormal enlargement of substantia nigra echo area（SN+） between the 2 groups were compared

and partial correlation and Spearman correlation were used to analyze the correlation between TCM syndromes and the area of substantia nigra echo area. Results The SN+ ratio in patients with the marrow reduction（79.7%） was higher than that in the patients with non-marrow reduction（36.4%

P= 0.002）. The SN+ ratio in patients with kidney deficiency（84.6%） was higher than that in the non-kidney deficiency group（65.2%

P= 0.042）. Syndrome scores of marrow reduction syndrome（r=0.276

P= 0.011）

kidney deficiency syndrome（r=0.279

P= 0.011）

phlegm turbidity syndrome（r=0.277

P= 0.011） were positively correlated with the largest substantia nigra echogenic areas（SN

L

）; the syndrome distribution of the syndrome of marrow reduction（r=0.297

P= 0.006） and kidney deficiency syndrome（r=0.242

P= 0.026） was positively correlated with SN

L

. Conclusion The syndrome of marrow reduction

syndrome of kidney deficiency and syndrome of phlegm turbidity are the key syndromes of PD

which to some extent reflect the neuropathological changes in the substantia nigra of PD.