中医辨证治疗方案改善阿尔茨海默病患者生活质量的临床研究  

Clinical Study on Treatment Based on Syndrome Differentiation for Improving Quality of Life of Patients with Alzheimer's Disease

作　　者：俞璐[1] 林水淼[1] 周如倩[1] 黄品贤[2] 董英[2] 王健[1] 

机构地区：[1]上海市中医老年医学研究所,上海200031 [2]上海中医药大学基础医学院,上海201203

出　　处：《上海中医药大学学报》2012年第4期41-45,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家"十一五"科技支撑计划资助项目(2006BAI04A11-2)

摘　　要：目的:研究中医辨证治疗方案对阿尔茨海默病(Alzheimer’s disease,AD)患者生活质量的改善作用。方法:纳入AD患者181例,其中轻中度131例,随机分为中药组66例和西药组65例;重度50例,随机分为中药组25例和西药组25例。中药组每4周进行中医辨证1次,心气虚证给予调心方,肾精不足证给予补肾方,挟痰、挟瘀者分别加用礞石滚痰丸、血府逐瘀胶囊治疗;西药组给予盐酸多奈哌齐治疗。疗程均为48周。观察并比较两组患者治疗前后ADL量表和POD量表评分的变化。结果:治疗后,两组患者的ADL量表评分较治疗前均无显著差异(P>0.05)。轻中度患者治疗24周、48周后,两组患者的POD量表评分较治疗前均显著降低(P<0.001,P<0.05);重度患者治疗后,仅西药组患者在治疗24周后其评分较治疗前显著下降(P<0.01)。结论:中医辨证治疗方案对改善AD患者的生活质量、延缓其病情进展具有一定的积极作用。Objective ： To explore the effects of treatment based on syndrome differentiation for improving the quality of life of patients with alzheimer＇ s disease （ AD ）. Methods： One hundred and eighty-one patients with AD were selected, 131 patients with mild to moderate AD were randomly divided into Chinese medicine group （n = 66 ） and western medicine group （ n = 65 ） , and 50 patients with severe AD were randomly divided into Chinese medicine group （ n = 25 ） and western medicine group （ n = 25 ）. The patients in the Chinese medicine group were treated with treatment based on syndrome differentiation ： the patients of heart-qi deficiency were treated with ＂Tiaoxin Recipe＂ and the patients of kidney-essence deficiency with ＂Bushen Recipe＂, and the patients with phlegm and blood stasis were added with ＂ Mengshi Guntan Pellet＂ and ＇＂ Xuefu Zhuyu Capsule＂ respectively. The patients in the western medicine group were treated with donepezil. The therapeutic course was 48 weeks. The scores of Activities of Daily Living Scale （ADL） and Pfeffer Outpatient Disability Questionnaire （POD） were evaluated. Results： There was no statistical difference on ADL scores between before and after treatment in both groups （ P 〉 0.05 ）. Twenty-four weeks and forty-eight weeks after treatment, the POD scores of mild to moderate patients significantly decreased in both groups （ P 〈 0. 001, P 〈 0.05 ） ; twenty-four weeks after treatment, the POD scores of severe patients obviously decreased only in western medicine group （ P 〈 0.01 ）. Conclusion ： The treatment based on syndrome differentiation has positive effects for improving the quality of life of patients with AD and slowing down the progress of AD.

关 键 词：阿尔茨海默病 生活质量 辨证治疗 中医 

分 类 号：R277.7[医药卫生—中医学]