ZHUANG Lixing's Experience in Differentiating and Treating Levodopa-Induced Dyskinesia in Parkinson's Disease

XU Danghan; LI Jialing; DUAN Lining; WANG Nanbu; TU Haitao; XU Zhanqiong

doi:10.13288/j.11-2166/r.2023.21.004

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ZHUANG Lixing's Experience in Differentiating and Treating Levodopa-Induced Dyskinesia in Parkinson's Disease

更新时间：2023-10-26

- ZHUANG Lixing's Experience in Differentiating and Treating Levodopa-Induced Dyskinesia in Parkinson's Disease
- Journal of Traditional Chinese Medicine Vol. 64, Issue 21, Pages: 2179-2183(2023)
- 作者机构：
  
  1.广州中医药大学第一附属医院，广东省广州市白云区机场路16号，510405
  2.广州中医药大学第一临床医学院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2023.21.004
  CLC：
- Received：19 December 2022，
  
  Revised：2023-07-27，
  
  Published：02 November 2023
- 稿件说明：
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许铛瀚,李嘉玲,段礼宁等.庄礼兴分型论治左旋多巴引发的帕金森病异动症经验[J].中医杂志,2023,64(21):2179-2183.

XU Danghan,LI Jialing,DUAN Lining,et al.ZHUANG Lixing's Experience in Differentiating and Treating Levodopa-Induced Dyskinesia in Parkinson's Disease[J].Journal of Traditional Chinese Medicine,2023,64(21):2179-2183.
许铛瀚,李嘉玲,段礼宁等.庄礼兴分型论治左旋多巴引发的帕金森病异动症经验[J].中医杂志,2023,64(21):2179-2183. DOI： 10.13288/j.11-2166/r.2023.21.004.

XU Danghan,LI Jialing,DUAN Lining,et al.ZHUANG Lixing's Experience in Differentiating and Treating Levodopa-Induced Dyskinesia in Parkinson's Disease[J].Journal of Traditional Chinese Medicine,2023,64(21):2179-2183. DOI： 10.13288/j.11-2166/r.2023.21.004.

摘要

总结庄礼兴教授分型论治左旋多巴引发的帕金森病异动症（LID）的临证经验。认为LID以筋脉失约或失养为根本病机，临证将剂峰LID辨为肝阳化风型、肝肾不足型，肝阳化风型治当平肝熄风、舒筋止颤，方以镇肝熄风汤加石决明、珍珠母加减，肝肾不足型治当补益肝肾、育阴熄风，以大补阴丸为主方加减；将关期LID辨为痰湿中阻型、气血两虚型，痰湿中阻型治当化痰除湿、濡养筋脉，予温胆汤或二陈汤加减，气血两虚型治当补益气血、濡养筋脉，可以补中益气汤或八珍汤或参苓白术散为主方加减；将双相LID辨为少阳枢机不利型，治当和解少阳、调达枢机，予小柴胡汤加减。

Abstract

This paper summarized Professor ZHUANG Lixing's clinical experience in differentiating and treating levodopa-induced dyskinesia （LID） in Parkinson's disease. It is believed that the fundamental pathogenesis of LID lies in the disharmony or malnourishment of tendons and vessels. Based on the clinical manifestations， peak-dose LID is differentiated into two syndromes： syndrome of hyperactive liver

yang

causing wind and syndrome of deficiency of both liver and kidney. For the syndrome of hyperactive liver

yang

causing wind， the treatment focuses on calming the liver to stop the wind， and relaxing the tendons to stop tremors. The main prescription used is Z

hengan Xifeng Decoction

（镇肝熄风汤） with the addition of

Shijueming

（石决明） and

Zhenzhumu

（珍珠母）. For the syndrome of deficiency of both liver and kidney， the treatment focuses on nourishing the liver and kidneys， and replenishing

yin

to stop the wind. The main prescription used is

Dabuyin Pills

（大补阴丸） with modification. LID in the acoustic phase is differentiated into syndrome of phlegm-damp blocking middle jiao and syndrome of deficiency of both

and

yin

. For the syndrome of phlegm-damp blocking middle jiao， the treatment focuses on dissipating phlegm and eliminating dampness， and nurturing tendons and vessels.

Wendan Decoction

（温胆汤） or

Erchen Decoction

（二陈汤） with modification is used. For the syndrome of deficiency of both

and

yin

， the treatment focuses on replenishing

and nourishing blood， and nurturing tendons and vessels. The main prescriptions used are

Buzhong Yiqi Decoction

（补中益气汤） or

Bazhen Decoction

（八珍汤） or

Shenling Baizhu Powder

（参苓白术散） with modification. Biphasic LID is differentiated as the Shaoyang pivot disadvantageousness， and the treatment focuses on harmonizing Shaoyang and regulating the pivot. The main prescription used is

Xiaochaihu Decoction

（小柴胡汤） with modification.

关键词

Keywords

references

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