Research On The Clinical Characteristics Of Parkinson's Disease Fatigue And The Characteristics Of TCM Syndrome Elements

Objective:To explore the relationship between fatigue and common non-motor symptoms of Parkinson's disease(PD)and the characteristics of Traditional Chinese Medicine(TCM)syndrome elements,so as to provide dialectical basis for further clinical treatment.Method:1.All subjects were from patients who were admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine and Beijing Hospital of Ministry of Health from September 2017 and January 2019.A total of 106 subjects were enrolled in the study,whose age were between 40 and 90 years old.All subjects met the MDS Clinical Diagnostic Criteria for Parkinson's disease(2015)and the standard of excretion,and they were able to cooperate well with each other.The subjects were grouped according to the mean points of Parkinson's Fatigue Scale(PFS-16),whose mean points?3.3were classified as fatigue group,and the rest were into the non-fatigue group.A cross-sectional study was used to record the general information of all patients,and we evaluate the scores of non-motor by Hamilton Depression scale(HAMD17),Hamilton anxiety scale(HAMA 14),Mini Mental State Examination Scale(MMSE)and Parkinson's Disease Sleep Disorder Scale(PDSS).And we collect the data of Traditional Chinese Symptoms by Parkinson's disease syndrome element scale-13(PD-PES-13).2.We use SPSS20.0 for statistical analysis:(1)Demographic data:gender was tested by chi-square test;age was measured by two independent samples t-test;the duration of disease and Hoehn-Yahr grades(H-Y grades)were tested by two independent samples of nonparametric test;(2)The integral values of non-motor symptoms between the two groups were compared by nonparametric test of two independent samples;(3)The non-parametric test of two independent samples was used to compare the integrals of the two groups of syndrome elements;(4)The difference of distribution frequency of syndrome elements between the two groups was tested by chi-square test;(5)The gender difference of TCM syndrome elements distribution in PD fatigue group was tested by chi-square test;(6)The correlation between PD fatigue and other non-motor symptoms(depression,anxiety,cognitive function,sleep status),the correlation between TCM syndrome elements and H-Y grades,the correlation between TCM syndrome elements and the course of disease in PD subjects were analyzed by Spearman correlation analysis.The significant level of all kinds of tests was p<0.05.Results:1.Among the 106 subjects enrolled,43(41%)were PD fatigue subjects and 63(59%)were non-fatigue subjects.There was no significant difference in age,onset age and gender between the two groups(p>0.05).There was a significant difference in the course of disease and H-Y grades between the two groups(p<0.05);2.The scores of HAMD,HAMA,MMSE and PDSS in PD fatigue group were significantly higher than those in non-fatigue group(p<0.05);Spearman correlation analysis showed that the PD fatigue was significantly correlated with HAMD,HAMA,MMSE and PDSS(p<0.05);3.The score of the medullary degenerative was the highest in PD fatigue group and non-fatigue group.The scores of qi deficiency,blood deficiency and medullary reduction were significantly different between the two groups(p<0.05).The frequency of spleen deficiency,qi deficiency and myeloid reduction in the fatigue group was significantly higher than that in the non-fatigue group(p<0.05);4.The level of H-Y grades in PD subj ects was significantly correlated with kidney deficiency,spleen deficiency,qi deficiency,blood deficiency,pulp reduction and liver wind(p<0.05),and the level of H-Y grades in PD subjects with fatigue was significantly correlated with kidney deficiency and pulp reduction(p<0.05).The course of disease in PD subjects was significantly correlated with kidney deficiency and medullary reduction(p<0.05);5.The integral values of qi deficiency,blood deficiency and pulp reduction in PD simple fatigue group were significantly higher than those in simple non-fatigue group(p<0.05).Conclusion:1.The course of Parkinson's disease with fatigue is longer and the condition is more serious;2.Parkinson's disease fatigue is significantly correlated with non-motor symptoms such as depression,anxiety,sleep disorder and cognitive impairment;3.With the aggravation of the disease and the prolongation of the course of disease,the manifestations of kidney deficiency and medullary reduction were more obvious in patients with PD;4.The syndrome elements of myeloreduction is the most obvious manifestation in the patients with Parkinson's disease;and the patients with fatigue have more obvious manifestations of qi deficiency,blood deficiency and pulp loss compared with those without fatigue.And the distribution of syndrome factors in patients with fatigue may not be affected by non-motor symptoms such as depression,anxiety,sleep disorders and cognitive disorders.