Objective To explore the characteristics and differencesinChinesemedicine(CM)syndrome elements among patients with different motor subtypes of Parkinson's disease(PD),and the correlations between CM syndrome eleme...Objective To explore the characteristics and differencesinChinesemedicine(CM)syndrome elements among patients with different motor subtypes of Parkinson's disease(PD),and the correlations between CM syndrome elements and the postural instability and gait difficulty(PICD)subtype.Methods Clinical data and CM syndrome elements information were collected from 96 primary PD patients at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine,over the period from August 2022 to December 2023.The patients were assigned to two groups:PIGD type(43 cases)and non-PIGD type(53 cases).During the research,T-tests,U-tests,X tests,or Fisher's exact tests were used to analyze differences in CM syndrome elements between the groups.Besides,Binary logistic regression was employed to assess the correlations between CM syndrome elements and the PIGD phenotype.Results Compared with the non-PIGD group,individuals with PIGD exhibited a higher prevalence of freezing of gait(FOG)(P<0.001),lower scores on Montreal Cognitive Assessment(MoCA)(P=0.042),and higher levodopa equivalent daily doses(P=0.009).The predominant CM syndrome elements in the PIGD group were Shen deficiency(40/43,93.0%),qi deficiency(35/43,81.4%),Pi deficiency(34/43,79.1%),yin deficiency(29/43,67.4%),and blood deficiency(27/43,62.8%).Compared with the non-PIGD group,the incidence of Shen deficiency(P=0.022),Pi deficiency(P<0.001),qi deficiency(P=0.006),and blood deficiency(P=0.001)was significantly higher in the PIGD group,whereas the incidence of Gan wind was significantly lower(P<0.001).Regression analysis revealed a positive correlation between blood deficiency(OR=5.383,P=0.037)and the PICD subtype,while Gan wind was negatively correlated with it(OR=0.016,P<0.001).Conclusion There are differences in the distribution of CM syndrome elements among different motor subtypes of PD.The PIGD subtype is mainly characterized by deficiencies in Shen,qi,Pi,yin,and blood.Blood deficiency exhibits a positive correlation with the PICD phenotype,whereas Gan wind shows a negative correlation.展开更多
Background:The surgical spinal degenerative pathology mainly concerns the herniated intervertebral disks.Surgery is indicated when the pain becomes chronic and intense,and when motor signs appear.The results are posit...Background:The surgical spinal degenerative pathology mainly concerns the herniated intervertebral disks.Surgery is indicated when the pain becomes chronic and intense,and when motor signs appear.The results are positive in about 90%of cases,leading to the solution of the problem.However,an estimated percentage of 4%to 20%reported residual pain and postural instability after the surgical treatment of discectomy.Method:We have examined a sample of patients,retrospectively registered,undergoing surgical treatment for degenerative lumbar disease.Some of them developed postural instability.They were subjected to cycles of postural gymnastics.Postural gymnastics has proved to be a tool capable of solving unstable post-surgical posture.It included an exercise of breathing,one or two of muscular distension,one of muscular reinforcement,and one of postural correction.We used an evaluation form we created in agreement with the physiatrist for postural exercises that was based on some basic parameters such as muscle and respiratory function.At each cycle,a score was attributed to the performance of muscular and respiratory exercise to evaluate the function and therefore the degree of instability(1–3=mild,4–7=medium,8–10=severe).Results:Results were satisfactory,with return to normal posture.The improvement of postural instability has been demonstrated both by the score of the evaluation forms that have highlighted the transition from a state of severe intensity to one of normality and by a clinical aspect,concerning the static and dynamic posture.Conclusions:The postural instability has a multifactorial genesis,and different mechanisms are involved:the vertebral bone structures and the pelvis,the paraspinal muscular structures,and the nerve structures.These structures are altered after surgery due to predisposing factors,and for the action of conditions acquired as obesity.展开更多
文摘Objective To explore the characteristics and differencesinChinesemedicine(CM)syndrome elements among patients with different motor subtypes of Parkinson's disease(PD),and the correlations between CM syndrome elements and the postural instability and gait difficulty(PICD)subtype.Methods Clinical data and CM syndrome elements information were collected from 96 primary PD patients at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine,over the period from August 2022 to December 2023.The patients were assigned to two groups:PIGD type(43 cases)and non-PIGD type(53 cases).During the research,T-tests,U-tests,X tests,or Fisher's exact tests were used to analyze differences in CM syndrome elements between the groups.Besides,Binary logistic regression was employed to assess the correlations between CM syndrome elements and the PIGD phenotype.Results Compared with the non-PIGD group,individuals with PIGD exhibited a higher prevalence of freezing of gait(FOG)(P<0.001),lower scores on Montreal Cognitive Assessment(MoCA)(P=0.042),and higher levodopa equivalent daily doses(P=0.009).The predominant CM syndrome elements in the PIGD group were Shen deficiency(40/43,93.0%),qi deficiency(35/43,81.4%),Pi deficiency(34/43,79.1%),yin deficiency(29/43,67.4%),and blood deficiency(27/43,62.8%).Compared with the non-PIGD group,the incidence of Shen deficiency(P=0.022),Pi deficiency(P<0.001),qi deficiency(P=0.006),and blood deficiency(P=0.001)was significantly higher in the PIGD group,whereas the incidence of Gan wind was significantly lower(P<0.001).Regression analysis revealed a positive correlation between blood deficiency(OR=5.383,P=0.037)and the PICD subtype,while Gan wind was negatively correlated with it(OR=0.016,P<0.001).Conclusion There are differences in the distribution of CM syndrome elements among different motor subtypes of PD.The PIGD subtype is mainly characterized by deficiencies in Shen,qi,Pi,yin,and blood.Blood deficiency exhibits a positive correlation with the PICD phenotype,whereas Gan wind shows a negative correlation.
文摘Background:The surgical spinal degenerative pathology mainly concerns the herniated intervertebral disks.Surgery is indicated when the pain becomes chronic and intense,and when motor signs appear.The results are positive in about 90%of cases,leading to the solution of the problem.However,an estimated percentage of 4%to 20%reported residual pain and postural instability after the surgical treatment of discectomy.Method:We have examined a sample of patients,retrospectively registered,undergoing surgical treatment for degenerative lumbar disease.Some of them developed postural instability.They were subjected to cycles of postural gymnastics.Postural gymnastics has proved to be a tool capable of solving unstable post-surgical posture.It included an exercise of breathing,one or two of muscular distension,one of muscular reinforcement,and one of postural correction.We used an evaluation form we created in agreement with the physiatrist for postural exercises that was based on some basic parameters such as muscle and respiratory function.At each cycle,a score was attributed to the performance of muscular and respiratory exercise to evaluate the function and therefore the degree of instability(1–3=mild,4–7=medium,8–10=severe).Results:Results were satisfactory,with return to normal posture.The improvement of postural instability has been demonstrated both by the score of the evaluation forms that have highlighted the transition from a state of severe intensity to one of normality and by a clinical aspect,concerning the static and dynamic posture.Conclusions:The postural instability has a multifactorial genesis,and different mechanisms are involved:the vertebral bone structures and the pelvis,the paraspinal muscular structures,and the nerve structures.These structures are altered after surgery due to predisposing factors,and for the action of conditions acquired as obesity.
