精神藥物引起巴金森氏症之中醫治療體會

The Use of Chinese Medicine to Treat Parkinson’s Disease Induced by Psychotropic Drugs

鄭淑鎂(Shu-Mei Zheng)

《台灣中醫臨床醫學雜誌》 13卷2期 (2007/06) Pp. 121-127

https://doi.org/10.6968/TJCCM.200706.0121

摘要

精神藥物主要作用為阻斷多巴胺接受器，以治療精神分裂症、躁症、妄想症等精神科疾病，但可能造成功能上多巴胺的缺失，而產生藥源性巴金森氏症。藥源性巴金森氏症，易發生在服精神藥物一周至三個月間，臨床上以抗巴金森藥物治療，有部分病人可能發生原發性巴金森氏症。依臨床觀察，藥源性巴金森氏症病人以膽鬱痰擾為主證者居多，且以溫膽湯加方依不同兼證施治效果較佳；待諸症狀改善後，視體質續調肝、脾、腎、氣血、腦髓等，以期陰平陽秘，精氣神充足，可預防原發性巴金森氏症。中醫的清熱化痰，疏肝解鬱，重鎮安神諸法，除了可解除因精神藥物對神經傳導的抑制，而產生醫源性巴金森氏症外，亦能改善神經傳導的代謝過亢，且治療精神藥物可能產生的各種副作用。

關鍵字

精神藥物 ； 多巴胺接受器 ； 藥源性 ； 巴金森氏症 ； 膽鬱痰擾 ； 溫膽湯加方

並列摘要

The primary mechanism of psychotropic medicines is the blockage of dopamine receptors in the brain. Psychotropics are used to treat various psychological disorders such as schizophrenia, mania, and delusion. However it is possible that their use may lead to a reduction in dopamine receptors, and result in drug-induced Parkinson’s disease. According to clinical observing, drug-induced Parkinson’s disease is likely to happen after taking psychotropic medication for one week to three months, while a portion of those patients who take medicines to counter the effects these Parkinson’s like symptoms may themselves develop Parkinson’s disease. According to clinical observation, the majority of those with drug-induced Parkinson’s disease manifest with constrained gallbladder qi and phlegm harassment as their primary pattern. The use of Wen Dan Tang, modified to address concurrent patterns, is most effective. Once all symptoms have shown improvement, the continuation of treatment involves regulating the liver, spleen, kidneys, qi and blood, as well as the brain and marrow. The goal is to prevent primary Parkinson’s disease by calming the yin and conceal the yang, as well as replenishing essence, spirit and qi. The various methods of Chinese medicine, such as clearing heat and transforming phlegm; coursing the liver and resolving constraint, heavily settling and quieting the spirit, not only can resolve the inhibitory effects psychotropics have on nerve conduction, but in fact improve the hyper metabolism of nerve conduction, thus treating the various side effects associated with psychotropic medicines.

並列關鍵字

psychotropic medicine ； dopamine receptor ； drug-induced parkinson’s disease ； gallbladder constraint and phlegm harassment ； modified wen dan tang