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Senile trembling permit four diagnostic investigation and PD with VPS Comparative Study of TCM

Author: LinLiangDa
Tutor: LiuZuo
School: Beijing University of Traditional Chinese Medicine
Course: TCM Internal Medicine
Keywords: Senile tremor syndrome Four diagnostic Parkinson Diseasee TCM syndrome
CLC: R277.7
Type: Master's thesis
Year: 2009
Downloads: 133
Quote: 1
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Abstract


Senile tremor syndrome is equal to Parkinson disease(PD) or vascular Parkinson syndrome(VPS) in terms of western medicine.In this research, essential tremor(ET) is used as a control group.Purpose:1.Conduct clinical analysis and researched syndrome of TCM by collecting patients’ clinical information and statistics of the four diagnoses.2.(1) Conduct researched syndrome of TCM between PD and VPS.(2) Conduct researched syndrome comparison of TCM between PD and VPS.(3) conduct syndrome cluster analysis between PD and VPS.Materials and methods:The information and statistics used in the analysis were collected from outpatient and inpatient objects,55 cases in total.They were patients with symptoms which satisfy the diagnostic criteria of tremor syndrome of Chinese medicine(PD,VPS),and essential tremor.By inquiring the detailed history and collecting clinical evidences,the author conducted clinical investigation of symptomatology,set up a data base for research index, analyzed and researched this syndrome by using statistical methods such as description,SPSS and so on.Results:Thisclinical investigation on senile tremor syndrome included:liver and kidney deficiency syndrome,blood stagnation stirring wind syndrome, qi and blood deficiency syndrome,phlegm heat stirring wind syndrome and yin yang deficiency syndrome.The symptoms observation was generally categorized as main symptom observation,accompanied symptom observation and symptom observed by the four diagnostic methods.The commonly seen main symptoms are trembling limbs,reduced activity,stiffness,postural balance disturbance.For accompanied symptom observation,there are types of onset,symptoms of autonomic nerve system,cognitive difficulty,sensory disability,speech, swallowing,life skills and nerve system symptoms.The symptoms observed by four diagnostic methods included clinical information collected by inspection,auscultation,olfaction,and interrogation.The results of symptomatology investigation suggested that the most common pattern of tremor syndrome is liver and kidney deficiency syndrome. Among 55 cases selected,there were 41 patients presented with this syndrome,amounted to 74.5%of the total.The second most common syndrome is blood stagnation stirring wind syndrome which was diagnosed in 32 cases, amounted to 58.2%of the total.Both qi and blood deficiency ranked the third with 25 cases which amounted to 45.5%.Eleven patients were diagnosed as phlegm heat stirring wind syndrome,amounting to 20%.Among the different types of senile tremor syndrome,the least seen syndrome is both deficiency of both yin and yang,which took up only 18.2%of the total.According to the main symptom observation of liver and kidney deficiency syndrome,the most common symptom was stiff limbs.There were 37 patients with this major symptom which took up 67.3%of the total.There were 36 patients presented symptoms such as reduced movements and slow activities,amounting to 65.5%of the total.As for the observation of accompanied symptoms,31 patients reported to experience restlessness, irritation,aggravated tremor induced by agitation,amounting to 56.4%. The second most common accompanied symptom was loss of memory,28 patients came up with this problem which amounted to 50.9%.According to information gathered by four diagnostic methods,while inspecting tongue coating, 45 cases presented with rooted coating,taking up 80%of the total.Forty four patients had agile pupils,which took up 80%.While observing patients with auscultation and olfaction,11 patients coughed with phlegm which took up 20%while 5 cases reported to have difficulty discharging phlegm and halitosis,amounting to 9.1%of the total.According to the information collected by interrogation,26 patients reported to have constipation which took up 47.3%of the total.The second most common symptom was stiffness with 22 cases.The number took up 40%of the total.Among the symptoms observed by pulse feeling and palpitation,wiry pulse was the most common symptom with 36 cases which amounted to 65.5%.Twenty patients reported to have thready pulse which took up 36.4%of the total.Among 55 cases selected,PD with 26 cases,amounted to 47.3%of the total.VPS with 16 cases amounted to 29.1%of the total.ET with 13 cases amounted to 23.6%of the total. Five types of cluster analysis were conducted on 55 cases of tremor syndrome,26 cases of PD and 16 cases of VPS respectively.The results suggested that among patients with senile tremor syndrome,there are five categories such as①onset type plus trembling movements;②static tremor;③cognition dysfunction plus balance disturbance;④pain accompanied with stiffness;and⑤accompanied symptoms plus trembling limbs.Among patients with PD,the categories are①onset type plus trembling movements;②ataxia of upper limbs;③cognition dysfunction plus numbing pain;④accompanied symptoms plus trembling limbs;⑤single limb tremor.Among the patients with VPS,there are 5 categories are①cognition dysfunction plus balance disturbance;(2) stiffness of neck and back;③nerves system disturbance plus trembling movements;④accompanied symptoms plus trembling limbs;and⑤cognitive disorder.While comparing and analyzing the statistics between the tremor diseases(in terms of western medicine such as PD and VPS) and PD、VPS、ET in terms of TCM(including deficiency syndrome,excess syndrome,and the combination of the two),P>0.05,which suggested that there’s no obvious differences between western tremor disease and TCM tremor syndrome.After comparing the statistics between the 26 cases with PD and the 16 cases with VPS,as for the part of accompanied symptoms,P values of gradual aggravation and acute or sub-acute onset are 0.011 and 0.023 respectively,which means there’ s major difference between PD and VPS regarding these two symptoms.Among the symptoms observed by inspection, P values of agile pupil and dull pupil are 0.003 and 0.016 respectively, indicating that major difference exist between PD and VPS regarding these two symptoms.Among the symptoms observed by interrogation,P values of chest stuffiness and thirsty are 0.007 and 0.034 respectively,indicating that major difference exist between PD and VPS regarding these two symptoms.Conclusion:Based on this research and statistical analysis,such conclusions can be reached:1.The most common type of tremor syndrome in terms of TCM is liver and kidney deficiency.2.The most common symptoms of tremor patients during the research were stiff limbs,slowed movements,restlessness,irritation,aggravated tremor induced by agitation and loss of memory;rooted tongue coating,agile pupils,coughing with phlegm,halitosis,constipation,wiry pulse,thready pulse,and deep pulse were also frequently seen during observation.3.after comparing the information between PD and VPS,PD patients and peculiar symptoms such as gradual aggravation,agile pupil,stuffy chest and thirsty while VPS patients of ten experience sub-acute onset of disease and dull pull.wiry and thready pulses are commonly seen by feeling the pulse.

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