Online Submissions: http://www.journaltcm.

com J Tradit Chin Med 2017 October 15; 37(5): 688-694

[email protected] ISSN 0255-2922
© 2017 JTCM. This is an open access article under the CC BY-NC-ND license.

RESEARCH ARTICLE
TOPIC

Traditional Chinese Medicine symptom pattern analysis for Parkin-

son's disease

Chen Hongzhi, He Jiancheng, Teng Long, Yuan Canxing, Zhang Zhe

aa
Chen Hongzhi, College of Basic Medicine, Shandong Uni- viewed for symptom patterns of Parkinson's dis-
versity of Traditional Chinese Medicine, Jinan 250355, China; ease and analyzed using frequency analysis, cluster
College of Basic Medicine, Shanghai University of Traditional analysis, and other methods of data extraction.
Chinese Medicine, Shanghai 201230, China
Zhang Zhe, College of Foreign Language, Shandong Univer- RESULTS: The analyses indicated that the most fre-
sity of Traditional Chinese Medicine, Jinan 250355, China
quent symptom patterns of Parkinson's disease are
He Jiancheng, Teng Long, Yuan Canxing, College of Basic
Medicine, Shanghai University of Traditional Chinese Medi-
Yin deficiency of kidney and liver, deficiency of Qi
cine, Shanghai 201230, China and blood, phlegm heat and wind stirring, blood
Supported by Surface Project of National Natural Science stasis and wind stirring, and deficiency of Yin and
Foundation of China, "TCM Compound Rehmannia Formula Yang.
Regulating Basal Ganglia Loop to Treat Parkinson's Disease"
(No. 30973722); Surface Project of National Natural Science CONCLUSION: Taken together, the analyses identi-
Foundation of China "Mechanism of TCM Compound Rehm- fied the primary symptom patterns of Parkinson's
annia Granule Regulating MAPK/ERK Signaling Pathway in disease as Yin deficiency of kidney and liver, defi-
Parkinson's Disease" (No. 81573899); Shanghai TCM Re- ciency of Qi and blood, phlegm heat and wind stir-
search and Technology Support Project "Development of
ring, and blood stasis and wind stirring.
TCM Compound Rehmannia Granule Treating Parkinson's
Disease" (No. 12401900302); Shanghai TCM Research and © 2017 JTCM. This is an open access article under the
Technology Support Project "Toxicological Research on TCM CC BY-NC-ND license.
Compound Rehmannia Granules Treating Parkinson's Dis- Keywords: Parkinson disease; Symptom complex;
ease" (No. 16401902400); Shanghai Municipal Health Bu- Cluster analysis; Data extraction
reau Scientific Research Project "Based on the Neural Plastic-
ity Compound Rehmannia Treating Parkinson's Disease"
(No. 2012J009A) INTRODUCTION
Correspondence to: Prof. He Jiancheng, College of Basic
Medicine, Shanghai University of Traditional Chinese Medi- Parkinson's disease (PD) is a degenerative disorder of
cine, Shanghai 201203, China. [email protected] the central nervous system characterized by shaking, ri-
Telephone: +86-21-51322142 gidity, slowness of movement, and gait disturbance.
Accepted: November 17, 2016 PD mainly affects middle-aged and elderly individuals.
As the population ages, PD incidence is increasing and
it is the major cause of impairment in middle-aged and
elderly people. Patients with PD can experience sub-
stantial suffering and deterioration in quality of life.
Abstract Traditional Chinese Medicine (TCM) treats PD ac-
OBJECTIVE: To use the theory of Traditional Chi- cording to symptom patterns, using TCM theory to
nese Medicine to identify the major symptom pat- identify patterns and relieve symptoms, interfere with
terns of Parkinson's disease. disease development, counteract the side effects of
chemical drugs, and improve patient quality of life.1
METHODS: Journal databases were searched for Many researchers have investigated PD symptom pat-
relevant articles in the last 30 years. Articles were re- terns theoretically, experimentally, and clinically. By

JTCM | www. journaltcm. com 688 October 15, 2017 | Volume 37 | Issue 5 |
 Chen HZ et al. / Research Article

collecting, standardizing, and summarizing ancient and and were read for further screening. There were 67, 6,
modern literature, researchers can examine the trends and 5 relevant research papers from the CNKI, VJIP,
and directions of PD research and provide a firm basis and CBMdisc databases, respectively (total = 78).
for further clinical and experimental study.
This study aimed to use TCM theory to identify the Data standardization
major symptom patterns of PD to provide better guid- Standardization of patterns terms was based on TCM
ance for PD treatment in TCM practice. Terms.4 Terms not in TCM Terms were classified ac-
cording to the Standard of TCM Pattern5 and TCM
Diagnosis.6 For example, deficiency of liver and kidney,
METHODS insufficiency of liver and kidney, asthenia of liver and
kidney, and Yin deficiency of liver and kidney were all
Diagnostic standards standardized as Yin deficiency of liver and kidney.
We followed the standards for PD diagnosis of the Na- There was one term that we were unable to classify and
tional Extrapyramidal Diseases Symposium,2,3 the Chi- this term was reserved.
nese Society of Neurology, and the Chinese Medical As- Standardization of symptom terms was based on TCM
sociation. Terms4 and TCM Diagnosis.6 Some symptoms were
Inclusion criteria separated before classification; for example, circumgyra-
We included articles with definite PD pattern classifica- tion was separated into vertigo and dizziness; tongue
tions, whether or not they mentioned symptoms/signs, coating and pulse were further divided into the small-
treatments, and medicines. est units (e.g., yellow and greasy tongue coating was di-
vided into yellow tongue coating and greasy tongue
Exclusion criteria coating, and thin and rapid pulse was divided into thin
We excluded (a) single case reports, (b) literature re- pulse and rapid pulse). Symptoms with similar mean-
views, (c) re-published research papers and re-cited lit- ings were combined into one classification (e.g., poor
erature and (d) other studies that failed to meet the in- sleep, disturbed sleep, and bad sleep were all standard-
clusion criteria. ized as insomnia).
Literature retrieval Statistical analysis
Articles were obtained from China Knowledge Re- SPSS 17.0 software, version 17.0 (SPSS Inc. Chicago,
source Integrated Database (CNKI), China Science IL, USA) was used to conduct frequency and descrip-
and Technology Journal Database (VIP) Journal Inte- tive statistical analyses on the symptom and diagnoses
gration Platfrom (VJIP), and China Biology Medicine data. Data for the four diagnostic information were
disc (CBMdisc). processed for cluster analysis and based on TCM
We used computer-aided and manual retrieval. The Re- knowledge to summarize the diagnostic protocol of
trieval formats were as follow: (a) Format of CNKI common patterns in PD patients.
(keywords): Parkinson's disease (paralysis agitans) and
pattern (pattern, pattern differentiation); duration:
1911-1979, 1980-2012. This produced 816 papers. RESULTS
(b) Format of VJIP (keywords): Parkinson's disease (pa-
ralysis agitans)* pattern (pattern, pattern differentia- TCM symptom patterns in PD patients
tion); duration: 1989-2011. This produced 131 pa- The 78 research papers contained 293 records of pat-
pers. (c) Format of CBMdisc (keywords): Parkinson's terns; there were 185 original patterns and 79 standard-
disease (paralysis agitans) * pattern (pattern, pattern dif- ized patterns (with additional accompanying patterns).
ferentiation); duration: 1978-2012. This produced 285 Thirty-six patterns were selected more than twice, and
papers. In total, we retrieved 1232 papers. the accompanying patterns were divided into 29 stan-
dardized patterns. The total number of patterns was
Evaluating and screening 277; Table 1 shows the six patterns with the highest fre-
The title, author, journal name/year/issue of the re- quency.
trieved papers were imported into Excel software (Mi-
crosoft Corp., Redmond, WA, USA) to determine the Data analysis of symptoms
relevant papers. When there were several similar re- The 78 research papers contained 50 papers and 193
search papers, only one paper was included. The title records involving TCM symptoms. After analysis of
and abstract of each paper were read to exclude non-rel- the symptoms, there were 147 symptoms and 2652
evant papers, based on the inclusion and exclusion cri- pieces of information on the four diagnoses. There
teria. There were 129, 14, and 14 relevant research pa- were 61 symptoms and 2306 pieces of information
pers from the CNKI, VJIP, and CBMdisc databases, re- that occurred more than 10 times (Table 2).
spectively (total = 157). After the preliminary screen- There were 86 symptoms that occurred less than 10
ing, the full text of each paper was read. Non-full text times, including Qi deficiency, tiredness of speech,
papers in paper version were retrieved in the library mouth bitterness, sluggish speech, night sweats, and

JTCM | www. journaltcm. com 689 October 15, 2017 | Volume 37 | Issue 5 |
 Chen HZ et al. / Research Article

Table 1 Most frequent symptom patterns

No. Pattern Frequency Frequent percentage (%) Accumulated frequent percentage (%)
1 Yin deficiency of liver and kidney 53 19.13 19.13
2 Deficiency of Qi and blood 52 18.77 37.91
3 Phlegm heat and wind stirring 32 11.55 49.46
4 Blood stasis and wind stirring 21 7.58 57.04
5 Qi stagnation and blood stasis 15 5.42 62.45
6 deficiency of Yin and Yang 10 3.61 66.06

yellow expectoration. These were not included in the Group 3: spasm of limbs, limb pain, limb numbness,
research. gait disturbance, stiff neck, headache, dark complex-
The 61 symptoms with an accumulated frequency of ion, dark tongue, purple tongue, blue and purple sub-
2360 accounted for 88.99% of the symptoms men- lingual vessel, ecchymosis on the tongue, choppy pulse.
tioned in the articles. Table 2 shows that of the 61 Group 4: dyspnea, listlessness, lassitude, vertigo, dizzi-
symptoms (except tongue and pulse symptoms), the ness, palpitations, lusterless complexion, spontaneous
three most frequent symptoms were tremor (6.18% ), sweating, abdominal distension, poor appetite, aver-
vertigo (4.00% ), and dizziness (2.41% ). The three sion to cold, loose stool, puffy tongue, pale tongue,
symptoms with the lowest frequency (except tongue tongue with teeth marks, thin tongue coating, white
and pulse symptoms) were abdominal distension tongue coating, thin pulse, deep pulse, and weak pulse.
(0.45% ), dark urine (0.41% ), and bad temper Patterns derived from the cluster analysis. According to
(0.38%). There were 14 tongue-related symptoms. The TCM diagnosis and pattern identification, each cluster
three most frequent were red tongue (3.17% ), dark was identified as one pattern. Each pattern could ac-
tongue (2.60% ), and pale tongue (2.19% ); the three count for at least 80% of the related symptoms. There
symptoms with the lowest frequency were purple were four patterns: phlegm heat and wind stirring, Yin
tongue (0.79% ), thin tongue (0.64% ), and blue and deficiency of liver and kidney, blood stasis and wind
purple sublingual vessel (0.41% ). There were seven stirring, and deficiency of Qi and blood. The results of
pulse-related symptoms. The three most frequent were the cluster analysis conformed to the clinical pattern
thin pulse (4.75% ), stringy pulse (3.51% ), and rapid identification.
pulse (1.89%); the three symptoms with the lowest fre-
quency were slippery pulse (1.51% ), choppy pulse
(1.06%), and weak pulse (0.72%). DISCUSSION
Data extraction-cluster analysis TCM contains no term for PD, but classifies it accord-
We used hierarchical cluster analysis to summarize and ing to its character and clinical manifestations. In
classify the symptoms and then (based on TCM TCM, PD corresponds to Chan Zheng (tremor), Chan
knowledge) identified TCM patterns. A be- Zhen (shaking), and Dong Feng (wind stirring). TCM
tween-groups linkage cluster analysis was used. Pear- treatment of PD is based on a long history of pattern
son correlations were used to determine the correla- identification. In addition, many modern TCM ex-
tion matrix for the cluster analysis (the correlation perts have developed treatments for PD and have ad-
matrix indicates the similarities between variables; vanced the study of PD patterns.
larger correlation coefficients indicate greater correla-
tion between variables) to classify the data. During PD pattern nomenclature
the cluster analysis, TCM knowledge was used to de- In the TCM classics, records of PD consist mainly of
termine the number of clusters. descriptions of symptoms, such as Diao, Diao Xuan,
Cluster analysis results. The cluster analysis produced and Qiang Zhi. In Huang Di Nei Jing,7 there are re-
3-6 groups (Table 3). After TCM analysis, four groups cords of tremor, stiffness, spasm of the four limbs, slow-
were extracted based on clinical practice. ness of movement, gait disturbance, and other symp-
Group 1: tremor, slowness of movement, dementia, toms of PD. The Su Wen Zhi Zhen Yao Da Lun8 states
head tremor, sputum expectoration, epigastric oppres- that all stiffness pertains to the wind, all wind and verti-
sion, drooling, dark urine, dry stool, thirst, yellow go symptoms pertain to the liver, and all cold and
tongue coating, slippery pulse, rapid pulse. spasm symptoms pertain to the kidney. The symptoms
Group 2: stiff limbs, movement disorder, soreness and of stiffness, tremor, and spasm mentioned in the classi-
weakness of back and knees, feverish sensation in the cal texts are similar to the symptoms of PD. The Su
five centers, tinnitus, insomnia, dreaminess, amnesia, Wen Mai Yao Jing Wei Lun9 states that the head is the
emaciation, bad temper, thin tongue, red tongue, little house of the eyes, and when the head leans, the spirit
tongue coating, stringy pulse. will disappear; the back is the house of the chest, and

JTCM | www. journaltcm. com 690 October 15, 2017 | Volume 37 | Issue 5 |
 Table 2 Most frequently occurring symptoms
Frequent Accumulated Frequent Accumulated
No. Symptom Frequency percentage frequent No. Symptom Frequency percentage frequent
(%) percentage (%) (%) percentage (%)
1 Tremor 164 6.18 6.18 32 Dry stool 32 1.21 68.06
2 Thin pulse 126 4.75 10.94 33 Tongue with teeth mark 30 1.13 69.19
3 Vertigo 106 4.00 14.93 34 head tremor 29 1.09 70.29
4 Stringy pulse 93 3.51 18.44 35 Choppy pulse 28 1.06 71.34
5 Red tongue 84 3.17 21.61 36 Amnesia 26 0.98 72.32

JTCM | www. journaltcm. com

6 Dark tongue 69 2.60 24.21 37 Lassitude 26 0.98 73.30
7 Dizziness 64 2.41 26.62 38 Epigastric oppression 24 0.90 74.21
8 Pale tongue 58 2.19 28.81 39 Aversion to cold 23 0.87 75.08
9 Stiff limbs 57 2.15 30.96 40 Stiff neck 23 0.87 75.94
10 Spasm of limbs 55 2.07 33.03 41 Spontaneous sweating 23 0.87 76.81
11 White tongue coating 54 2.04 35.07 42 Slowness of movement 22 0.83 77.64
12 Soreness and weakness of back and knees 51 1.92 36.99 43 Feverish sensation in the five centers 21 0.79 78.43
13 Rapid pulse 50 1.89 38.88 44 Purple tongue 21 0.79 79.22
14 Insomnia 49 1.85 40.72 45 Headache 19 0.72 79.94

691
15 Puffy tongue 48 1.81 42.53 46 Weak pulse 19 0.72 80.66
16 Lassitude 47 1.77 44.31 47 Dark complexion 18 0.68 81.33
17 Yellow tongue coating 46 1.73 46.04 48 Sputum expectoration 18 0.68 82.01
18 Greasy tongue coating 46 1.73 47.78 49 Pale complexion 17 0.64 82.65
Chen HZ et al. / Research Article

19 Thin tongue coating 45 1.70 49.47 50 Thin tongue 17 0.64 83.30

20 Tinnitus 44 1.66 51.13 51 Limb pain 16 0.60 83.90
21 Ecchymosis on the tongue 44 1.66 52.79 52 Emaciation 16 0.60 84.50
22 Deep pulse 44 1.66 54.45 53 Lusterless complexion 16 0.60 85.11
23 Dementia 40 1.51 55.96 54 Drooling 16 0.60 85.71
24 Little tongue coating 40 1.51 57.47 55 Loose stool 16 0.60 86.31
25 Slippery pulse 40 1.51 58.97 56 Palpitation 14 0.53 86.84
26 Limb numbness 39 1.47 60.44 57 Dyspnea 13 0.49 87.33
27 Movement disorder 37 1.40 61.84 58 Abdominal distension 12 0.45 87.78
28 Thirst 35 1.32 63.16 59 Dark urine 11 0.41 88.20
29 Gait disturbance 33 1.24 64.40 60 Blue and purple sublingual vessel 11 0.41 88.61
30 Poor appetite 33 1.24 65.6 61 Bad temper 10 0.38 88.99
31 Dreaminess 32 1.21 66.86

October 15, 2017 | Volume 37 | Issue 5 |

 Chen HZ et al. / Research Article

Table 3 Results of the cluster analysis of symptoms from the literature (n)
Symptom 6 Clusters 5 Clusters 4 Clusters 3 Clusters
Tremor 1 1 1 1
Stiff limbs 2 2 2 1
Spasm of limbs 3 3 3 2
Limb pain 3 3 3 2
Limb numbness 3 3 3 2
Movement disorder 2 2 2 1
Slowness of movement 4 4 1 1
Gait disturbance 5 3 3 2
Dementia 4 4 1 1
Aversion to cold 6 5 4 3
Soreness and weakness of back and knees 2 2 2 1
Stiff neck 5 3 3 2
Head tremor 1 1 1 1
Headache 5 3 3 2
Vertigo 6 5 4 3
Dizziness 6 5 4 3
Tinnitus 2 2 2 1
Insomnia 2 2 2 1
Dreaminess 2 2 2 1
Amnesia 2 2 2 1
Emaciation 2 2 2 1
Feverish sensation in the five centers 2 2 2 1
Palpitation 6 5 4 3
Dyspnea 6 5 4 3
Listlessness 6 5 4 3
Lassitude 6 5 4 3
Lusterless complexion 6 5 4 3
Pale complexion 6 5 4 3
Dark complexion 5 3 3 2
Bad temper 2 2 2 1
Spontaneous sweating 6 5 4 3
Sputum expectoration 4 4 1 1
Epigastric oppression 4 4 1 1
Abdominal distension 6 5 4 3
Poor appetite 6 5 4 3
Drooling 4 4 1 1
Dark urine 4 4 1 1
Dry stool 4 4 1 1
Loose stool 6 5 4 3
Thirst 4 4 1 1
Puffy tongue 6 5 4 3
Thin tongue 2 2 2 1
Pale tongue 6 5 4 3
Dark tongue 3 3 3 2
Red tongue 2 2 2 1
Purple tongue 3 3 3 2
Blue and purple sublingual vessel 3 3 3 2
Ecchymosis on the tongue 3 3 3 2
Teeth mark on the tongue 6 5 4 3
Little tongue coating 2 2 2 1
Thin tongue coating 6 5 4 3

JTCM | www. journaltcm. com 692 October 15, 2017 | Volume 37 | Issue 5 |
 Chen HZ et al. / Research Article

Table 3 Results of the cluster analysis of symptoms from the literature (n) (continuted)
Symptom 6 Clusters 5 Clusters 4 Clusters 3 Clusters
White tongue coating 6 5 4 3
Yellow tongue coating 4 4 1 1
Greasy tongue coating 4 4 1 1
Stringy pulse 2 2 2 1
Thin pulse 6 5 4 3
Slippery pulse 4 4 1 1
Rapid pulse 4 4 1 1
Deep pulse 6 5 4 3
Weak pulse 6 5 4 3
Choppy pulse 3 3 3 2

when the back and shoulder are twisted, the house will is best characterized by multiple (and sometimes over-
break; the waist is the house of the kidneys, and when lapping) patterns. Many researchers disagree on the
the waist is unable to twist, the kidneys will collapse; classification of its clinical patterns.
the knees are the house of the tendons, when they fail Ye14 classified PD into two types: liver Yin deficiency
to flex and people stoop when walking, the tendons and liver Qi stagnation. Xu15 classified PD into three
will become exhausted; the bones are the house of the types: phlegm and turbidity accumulating and block-
marrow, when people are unable to stand for long peri- ing, static blood blocking the collaterals, and deficien-
ods and experience tremor while walking, the bones cy of liver and kidney. Lao16 classified PD into four
will become exhausted. The above-mentioned symp- types: deficiency of liver and kidney, phlegm and
toms of head leaning, twisted back and shoulder, inabil- dampness with wind stirring, deficiency of Qi and
ity to twist, inability to flex, stooping while walking, blood, and Qi stagnation and blood stasis. Wang17 clas-
and tremor while walking, are closely related to symp- sified PD into five types: Yin deficiency of liver and
toms of PD, such as tremor, muscle rigidity, slowness kidney; Yang deficiency; Qi stagnation and blood sta-
of movement, and gait disturbance. Chao Yuanfang of sis; deficiency of Yin, Yang, Qi, and blood; and exuber-
the Sui Dynasty states in the Zhu Bing Yuan Hou Lun ance of phlegm and dampness. Song18 classified PD in-
Feng Si Zhi Ju Luan Bu De Qu Shen Hou10 that the to eight types: liver Qi stagnation, phlegm and turbidi-
Foot Jue Yin channel pertains to the liver. The liver ty accumulating and blocking, phlegm heat and wind
governs all the tendons; when the liver channel be- stirring, Qi stagnation and blood stasis, Yin deficiency
comes deficient, the wind pathogen attacks the ten- of liver and kidney, deficiency of heart and spleen, defi-
dons, causing the four limbs to spasm and fail to flex. ciency of Qi and blood, and deficiency of the sea of
Spasm of the four limbs and inability of the limbs to marrow. He proposed that, based on pattern differenti-
flex are the major symptoms of PD. Sun Yikui of the ation, TCM treatment could effectively relieve the
Ming Dynasty states in the Chi Shui Xuan Zhu11 that a symptoms of PD and reduce the side effects of chemi-
person with Chan Zhen usually manifests tremors of cal medicines.
the hand and foot that are like vibrations and the ten- As there is no standardization of pattern classification
dons fail to control or hold, like the wind stirring. In for PD, most TCM practitioners classify its patterns ac-
this text, PD is identified for the first time as Chan
cording to personal experiences, leading to inconsistent
Zhen. In 1982, Ren et al 12 suggested that Chan Zhen,
nomenclatures. The most authoritative current pattern
Zhen Zhuo, and Tou Yao were the ancient names for
classifications are as follows: Shi Yong Zhong Yi Nei Ke
PD. Zhen Chan is the modern name of PD in TCM.
Xue19 classifies PD into three types: deficiency of liver
In November 1991, the third session of the Chinese So-
and kidney, deficiency of Qi and blood, and phlegm
ciety of Geriatrics of the Chinese Medical Association
heat and wind stirring; the third session of the Chinese
established the Standard for the Diagnosis and Efficacy
Society of Geriatrics of the Chinese Medical Associa-
Evaluation of TCM Geriatric Tremor13 and PD was
tion established the Standard for the Diagnosis and Ef-
named as geriatric tremor, a classification that was ap-
ficacy Evaluation of TCM Geriatric Tremor, and classi-
proved by most researchers and experts.
fied PD into five types: phlegm heat with wind stir-
ring, blood stasis and wind stirring, deficiency of Qi
Pattern classification research
and blood, deficiency of liver and kidney, and deficien-
The pathomechanism of PD is complicated. Its onset
and development is a process that starts with deficiency cy of Yin and Yang.
and proceeds to excess. Excess then transforms into de- Research on the standardization of patterns
ficiency, producing a state in which deficiency is mixed Shi Dianbang20 called for research on the standardiza-
with excess. PD is a chronic disease that has no current tion of patterns, aiming to standardize and normalize
cure. PD does not comprise a single pattern; rather, it TCM pattern diagnosis, and eventually established a

JTCM | www. journaltcm. com 693 October 15, 2017 | Volume 37 | Issue 5 |
 Chen HZ et al. / Research Article

unified standard and system of TCM teaching, re- 5 Deng TT. Symptomatic standard of Tradition Chinese
search, and clinical practice. Medicine. Guangzhou: Guangdong Technology Publish-
This study identified relevant literature and used fre- ing House, 1990: 22-407.
quency analysis and cluster analysis to examine PD 6 Zhu WF, Yuan ZK. Diagnostics of Traditional Chinese
symptom patterns used in the last 30 years. The find- Medicine. 2nd ed. Beijing: People's Medical Publishing
ings could further understanding of the basic, common House, 2011: 153-204.
patterns of PD. Six symptom patterns were found 7 Wang B (Tang dynasty). Hunag Di Nei Jing Su Wen. Bei-
most frequently (total frequency percentage = jing: People's Medical Publishing House, 1963: 122.
8 Gao SZ (Qing dynasty). Huang Di Nei Jing Su Wen Zhi
66.06% ): deficiency of liver and kidney, deficiency of
Jie. Beijing: Beijing Science and Technology Publishing
Qi and blood, phlegm heat and wind stirring, blood
House, 1980: 656.
stasis and wind stirring, Qi stagnation and blood stasis,
9 Gao SZ (Qing dynasty). Huang Di Nei Jing Su Wen Zhi
and deficiency of Yin and Yang. The cluster analysis re-
Jie. Beijing: Beijing Science and Technology Publishing
sults indicated that the common PD patterns are
House, 1980: 113.
phlegm heat and wind stirring, Yin deficiency of liver 10 Chao YF (Sui dynasty). Edited and annotated by Ding
and kidney, blood stasis and wind stirring, and deficien- GD. Zhu Bing Yuan Hou Lun. Beijing: Peoples' Medical
cy of Qi and blood. Both sets of results were in concor- Publishing House, 2000: 18.
dance in identifying the patterns of Yin deficiency of 11 Sun YK (Ming dynasty). Chi Shui Xuan Zhu. Beijing:
liver and kidney, deficiency of Qi and blood, phlegm China Press of Traditional Chinese Medicine, 1996: 259.
heat and wind stirring, and blood stasis and wind stir- 12 Ren JX, Fang GL. Differentiation and treatment for trem-
ring. Therefore, we conclude that these four patterns or. Jiangsu Zhong Yi 1982; 4(4): 11-12, 46.
are the basic symptoms patterns of PD. 13 Long CX. The standard for the evaluation of diagnosis
In conclusion, the primary TCM symptom patterns in and treatment efficacy on geriatric tremor. Beijing Zhong
PD patients are Yin deficiency of kidney and liver, defi- Yi Xue Yuan Xue Bao 1992; 15(4): 39-41.
ciency of Qi and blood, phlegm heat and wind stirring, 14 Ye ZF. 36 cases of paralysis agitans treated with pattern dif-
and blood stasis and wind stirring. ferentiation. Sichuan Zhong Yi 2001; 19(10): 30.
15 Xu LZ. Traditional Chinese Medicine pattern of Parkin-
son's disease and its treatment. Hebei Zhong Yi 2011; 33
REFERENCES (5): 689-690.
16 Lao GP. Observation on the effect of combination of Tra-
1 Cai DF. Combined Traditional Chinese Medicine and ditional Chinese Medicine and Western Medicine to treat
Western Medicine to treat Parkinson's disease. Zhong Guo paralysis agitans. Hebei Zhong Yi 2000; 22(10): 777-778.
Zhong Xi Yi Jie He Zha Zi 2007; 27(9): 775-776. 17 Wang KQ. Traditional Chinese Medicine treatment for pa-
2 National extrapyramidal diseases symposium, Diagnostic ralysis agitans. Zhong Yi Yao Yan Jiu 1991; 3(2): 35-37.
standard and differentiation diagnosis of Parkinson's dis- 18 Song QY. Experiences on Traditional Chinese Medicine
ease. Zhong Hua Shen Jing Jing Shen Ke Zha Zhi 1986; treatment for paralysis agitans. Henan Zhong Yi 2003; 23
19(5): 256. (3): 47-48.
3 The group of movement disorder and PD, Chinese society 19 Fang YZ, Deng TT, Li KG, et al. Shi Yong Zhong Yi Nei
of psychiatry, Chinese medical association, diagnosis of PD. Ke Xue. 6th ed. Shanghai: Shanghai Technology Publish-
Zhong Hua Shen Jing Ke Zha Zhi 2006; 39(6): 408- 409. ing House, 1985: 432-438.
4 Traditional Chinese Medicine nomenclature compilation 20 Deng TT. Symptomatic standard of Tradition Chinese
committee. Zhong Yi Yao Xue Ming Ci. Beijing: Beijing Medicine. Beijing: People's Medical Publishing House,
Science Publishing House, 2005: 19-106. 2001: 1743-1746.

JTCM | www. journaltcm. com 694 October 15, 2017 | Volume 37 | Issue 5 |