摘要
目的:观察"健脑散"联合多奈哌齐治疗阿尔茨海默病的临床疗效并初步探讨其作用机制。方法:将50例阿尔茨海默病患者且中医诊断为痴呆肾虚血瘀证型者,采用随机单盲法分为治疗组25例,对照组25例。对照组给予安理申(盐酸多奈哌齐),治疗组在对照组基础上同时给予健脑散,两组疗程均为12周,治疗期间禁用其他胆碱酯酶抑制剂及其他促智药,治疗前后检测及观察以下指标:(1)中医证候积分。(2)脑脊液Aβ42水平。(3)脑脊液tau蛋白和磷酸化tau蛋白水平。(4)简易智能状态量表(MMSE)评分。(5)长谷川智力改良量表(HDS-R)评分。(6)日常生活能力量表(Ability of daily living scale,ADL)评分。结果:治疗组的总有效率为80%,显著高于对照组的68%(P <0.05)。两组患者治疗后中医证候积分、MMSE、HDS-R、ADL评分与治疗前比较明显改善,除HDS-R评分外,其余指标治疗组改善较对照组显著(P <0.05)。两组患者治疗后脑脊液Aβ42、Tau蛋白和磷酸化Tau蛋白水平与治疗前比较明显降低,治疗组降低较对照组显著(P <0.05)。结论:"健脑散"联合多奈哌齐治疗阿尔茨海默病可显著改善患者的认知功能及精神行为状态,提高患者的生活能力,这可能与其能影响患者脑脊液中Aβ42、Tau蛋白和磷酸化Tau蛋白含量,降低患者神经元缠结数量,延缓脑内淀粉样斑块形成有关。
Objective:To observe the effect of Jiannao Powder(健脑散)combined with donepezil in treating patients with Alzheimer's disease(AD)and discuss the function mechanism of Jiannao Powder(健脑散).Methods:Fifty patients with Alzheimer’s disease who were also diagnosed as Dementia with kidney deficiency and blood stasis syndrome by TCM were divided by random single blind method into two groups:The control group(n=25)was treated with donepezil and the treatment group(健脑散)(n=25)was treated with Jiannao Powder combined with donepezil.The course of treatment was of 12 weeks.Other cholinesterase inhibitors and other agents were forbidden during the treatment.The scores of TCM symptom,level of Aβ42 protein in cerebrospinal fluid,level of Tau protein and Phosphorylated Tau protein in cerebrospinal fluid,Mini-Mental State Examination(MMSE)scale,HDS-R scale and Ability of daily living(ADL)scale were observed before and after treatment respectively.Results:The total clinical curative rate of the treatment group was 81%,which was significantly higher than that of the control group,68%(P<0.05);The scores of TCM symptom,MMSE,HDS-R and ADL in both group were improved than that before treatment,the efficacy of the treatment group was more significant than that of the control group(P<0.05),while the score of HDS-R was of no statistical significance(P>0.05).The level of Aβ42 protein,Tau protein and Phosphorylate Tauprotein were decreased in both group than that before treatment,the reduction of the treatment group was more significant than that of the control group(P<0.05).Conclusion:Jiannao Powder(健脑散)combined with donepezil could improved the patient's cognitive function,the state of mental and behavior and the living ability.The mechanism may be that it reduced the level of Aβ42 protein,Tau protein and Phosphorylate Tau protein,decreased the number of tangle in patient's neuron and delay the amyloid plaque in the brain.
出处
《中医临床研究》
2018年第27期9-12,共4页
Clinical Journal Of Chinese Medicine
基金
南通市卫计委青年科研基金项目WQ2016052
