Masuda Takuya, Egawa Kenichiro, Takeshita Yu, Tanaka Koichiro
Division of General Internal Medicine & Rheumatology, Mitsui Memorial Hospital, Tokyo, JPN.
Department of Traditional Medicine, Toho University, Tokyo, JPN.
Cureus. 2024 Oct 4;16(10):e70860. doi: 10.7759/cureus.70860. eCollection 2024 Oct.
Parkinson's disease (PD) is a common progressive neurodegenerative disease. The management of PD including Pisa syndrome (PS), a postural deformity in PD characterized by reversible lateral bending of the trunk on the side, is often challenging. Recently, acupuncture has been a recognized intervention for treating motor or non-motor symptoms in PD management. However, very few of these studies or cases have been reported from Japan. A 58-year-old man with a four-year history of PD (Hoehn and Yahr Scale: Stage 2) presented to the acupuncture department of our hospital with dysphasia, bradykinesia, forward posture, and newly appeared right-side bending of the trunk after he increased the dose of rotigotine delivered via skin patches six months earlier. There was no change in the right-sided bending of the trunk two months after the withdrawal of the dopaminergic agents. A traditional Japanese acupuncture and moxibustion treatment, , was started. According to the Oriental medical diagnosis, he was categorized with "liver depression," "kidney deficiency," and "dampness" patterns. The treatment was administered once a week, and only one or two needles were used. The acupoints, such as Ququan (LR8) or Houxi (SI3), were selected according to the Oriental medical diagnosis and the findings of the acupoint examination. At first, the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) score was 34 points, and the Parkinson's Disease Questionnaire (PDQ-39) score was 42 points; the Cobb angle was 45°. After 10 weeks, he could walk smoothly and almost upright. MDS-UPDRS-3 and PDQ-39 scores improved to 12 points and 34 points, respectively, while the Cobb angle improved to 32°. Changes (improvements) in his gait and posture are shown in the videos included in this case report. We present a case of PD bradykinesia, forward posture, and drug-induced PS alleviated with traditional Japanese acupuncture. This case report suggests that acupuncture using this Japanese method would achieve similar efficacies to those achieved in conventional case reports or clinical trials, and it could be one of the optional treatments available for PD. Further studies, such as the long-term effect of acupuncture on PD patients or improved outcomes of PD patients with early-phase intervention, are required.
帕金森病（PD）是一种常见的进行性神经退行性疾病。帕金森病的管理，包括 Pisa 综合征（PS），一种以躯干向一侧可逆性侧弯为特征的帕金森病姿势畸形，通常具有挑战性。最近，针灸已成为帕金森病管理中治疗运动或非运动症状的一种公认干预措施。然而，日本报道的此类研究或病例非常少。一名 58 岁男性，有 4 年帕金森病病史（Hoehn 和 Yahr 分级：2 期），6 个月前增加经皮贴片给予的罗替戈汀剂量后，出现吞咽困难、运动迟缓、前倾姿势以及新出现的躯干右侧弯曲，遂到我院针灸科就诊。停用多巴胺能药物两个月后，躯干右侧弯曲情况无变化。开始采用传统日本针灸和艾灸治疗。根据中医诊断，他被归类为“肝郁”“肾虚”和“湿”证型。治疗每周进行一次，仅使用一到两根针。根据中医诊断和穴位检查结果选择穴位，如曲泉（LR8）或后溪（SI3）。起初，运动障碍协会赞助的统一帕金森病评定量表（MDS-UPDRS）评分为 34 分，帕金森病问卷（PDQ-39）评分为 42 分；Cobb 角为 45°。10 周后，他能够平稳行走且几乎直立。MDS-UPDRS-3 和 PDQ-39 评分分别改善至 12 分和 34 分，而 Cobb 角改善至 32°。本病例报告所附视频展示了他步态和姿势的变化（改善情况）。我们报告一例帕金森病运动迟缓、前倾姿势及药物诱导的 Pisa 综合征经传统日本针灸缓解的病例。本病例报告表明，采用这种日本方法的针灸可取得与传统病例报告或临床试验相似的疗效，且可能是帕金森病可用的可选治疗方法之一。需要进一步开展研究，如针灸对帕金森病患者的长期影响或早期干预帕金森病患者的改善结果。
