Li Mimi, Zhou Lifeng, Ma Jincheng
Department of Neurology, Lishui Hospital of TCM, Lishui 323000, Zhejiang Province, China.
Department of Gerontology, Lishui Hospital of TCM, Lishui 323000, Zhejiang Province, China.
Zhongguo Zhen Jiu. 2024 Oct 12;44(10):1119-24. doi: 10.13703/j.0255-2930.20240105-k0006.
To observe the effect of acupuncture at stellate ganglion on orthostatic hypotension (OH) in Parkinson's disease (PD), and explore its action mechanism.
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.
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).
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.
观察星状神经节针刺对帕金森病（PD）患者直立性低血压（OH）的影响，并探讨其作用机制。
将68例PD合并OH患者随机分为联合组（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，西药组口服盐酸米多君片，每次2.5mg，每日2次。联合组在西药组基础上加用双侧星状神经节针刺治疗，不留针，每日1次，每周5次。两组均治疗2周。观察两组治疗前后的卧位及直立位血压、直立性低血压问卷（OHQ）评分、中医证候评分、统一帕金森病评定量表（UPDRS）评分，检测血清去甲肾上腺素（NE）水平，并评价临床疗效。
治疗后，联合组直立位收缩压（SBP）和舒张压（DBP）较治疗前升高（P<0.01），OHQ评分、中医证候评分、UPDRS评分较治疗前降低（P<0.01）；西药组卧位SBP较治疗前升高（P<0.05），OHQ评分较治疗前降低（P<0.05）；两组血清NE水平较治疗前均升高（P<0.01）。治疗后，联合组直立位SBP、直立位DBP及血清NE水平高于西药组（P<0.01，P<0.05），OHQ评分、中医证候评分、UPDRS评分低于西药组（P<0.05，P<0.01）。联合组总有效率为87.1%（27/31），高于西药组的63.6%（21/32）（P<0.05）。
星状神经节针刺可提高PD合并OH患者的直立位血压，改善临床症状，其机制可能与上调NE有关。
