黄连温胆汤加味治疗老年轻度认知障碍痰浊阻窍证的临床研究  

Effect of Modified Huanglian Wendan Decoction in Treating Senile Patients with Mild Cognitive Impairment of Turbid-phlegm Blocking Orifice Syndrome GUO Ren-zhen,ZHOU Wen-quan,LUO Zeng-gang,et al

作　　者：郭仁真[1] 周文泉[1] 罗增刚[2] 李浩[1] 崔玲[1] 刘方[1] 刘剑刚[1] 

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]中国中医科学院

出　　处：《中国中西医结合杂志》2010年第1期33-36,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：中国中医科学院基本科研业务费自主选题项目(No.ZZ2006077)

摘　　要：目的探讨黄连温胆汤加味治疗老年轻度认知障碍(mild cognitive impairment,MCI)痰浊阻窍证的临床疗效。方法采用区组随机、双盲双模拟、对照的设计原则,将2007年12月—2009年2月入选64例患者随机分为治疗组和对照组,每组32例。同时筛选出老年健康者15名设为健康对照组,治疗组口服黄连温胆汤加味汤剂,每次200 mL,每天2次,同时服用模拟胶囊;对照组给予口服茴拉西坦胶囊,每次0.2 g(70岁以上0.1 g),每天3次,同时服用模拟汤剂。两组均用药3个月。观察患者中医证候、认知能力[简易精神状态检查(MMSE)]、实验指标[乙酰胆碱(Ach)、超氧化物转化酶(SOD)、丙二醛(MDA)]及相关安全性指标。结果两组治疗后MMSE分均提高,治疗组增高幅度大于对照组,差异有统计学意义(P<0.01)。对照组治疗后智能减退(健忘)、头沉或头昏不清、肢体困重积分降低,治疗组治疗后除痰多吐涎外,其余各中医症状积分值均降低,且明显低于对照组,差异均有统计学意义(P<0.01,P<0.05)。两组治疗后血清Ach、SOD均提高,MDA均降低,治疗组Ach高于对照组,差异有统计学意义(P<0.01)。安全检测显示本研究所用方药未见不良反应。结论黄连温胆汤加味在改善老年轻度认知障碍痰浊阻窍证患者的症状、认知能力、提高Ach含量方面疗效优于茴拉西坦胶囊;在提高血清SOD活性、降低MDA含量方面与茴拉西坦胶囊疗效近似。Objective To observe the clinical efficacy of modified Huanglian Wendan Decoction （HWD） in treating senile mild cognitive impairment （ MCI） of turbid-phlegm blocking orifice syndrome. Methods With a block randomized, double-blinded and controlled design adopted, the 64 patients of MCI selected from December 2007 to February 2009 were randomly and equally assigned to two groups. The treatment group was treated with HWD in dose of 200 mL, twice a day; the control group was given Aniraectam 0.2 g （for patients over 70 years old, 0. 1 g） three times a day. And the illusive medicine in dosage-form of capsule/decoction simulated to that used in the opposite group was applied. The medication and observation lasted for three months. Chinese medicine syndrome, cognition capacity （by MMSE）, laboratory indexes E acetylcholine （Ach）, superoxide dismutase （SOD）, malondialdehyole （MDA） ] and safety related indexes in patients were observed. Results After treatment, MMSE score increased in both groups, but the increment in the treatment group was significantly higher than that in the control group （ P 〈 0. 01 ） ; Chinese medine syndrome estimated by scoring showed that after treatment, all scores of syndromes, excepting the expectoration, were improved in the treatment group with the post-treatment scores significantly lower than those in the control group respectively （ P 〈 0. 05 or P 〈 0.01 ） ; while in the control group, lowering of scores only showed in some symptoms such as poor memory, heavy head or dizziness, and heavy sensation in limbs and body. Serum levels of Ach and SOD decreased and MDA increased in both groups after treatment, but the change of Ach was more significant in the treatment group （ P 〈 0.01 ）. No obvious adverse reactions were found during the treatment. Conclusion For treatment of MCI, HWDshows effects in improving patients＇ symptoms, cognition that of Aniraectam; and with effects for raising SOD activ tam. capacity and elevating serum Ach content bett

关 键 词：轻度认知障碍 痰浊阻窍证 黄连温胆汤加味 

分 类 号：R277.7[医药卫生—中医学]