地黄饮子干预阿尔茨海默病患者的疗效观察及作用机制探讨  

Effects and mechanisms of Dihuang Yinzi Decoction on the treatment of Alzheimer's disease patients

作　　者：张丽 汪园园[3] 周静波[4] 柯斌[2] 杨玉彬[2] 秦鉴[1,2] 黄颖娟 ZHANG Li;WANG Yuan-yuan;ZHOU Jing-bo;KE Bin;YANG Yu-bin;QIN Jian;HUANG Ying-juan(The Seventh Affiliated Hospital,SunYat-sen University,Shenzhen 518107,China;The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China;The Eastern Hospital of the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510700,China;Guangzhou Huadu Maternity and Child Health Hospital,Guangzhou 510800,China)

机构地区：[1]中山大学附属第七医院,深圳518107 [2]中山大学附属第一医院,广州510080 [3]中山大学附属第一医院东院,广州510700 [4]广州市花都区妇幼保健院(胡忠医院),广州510800

出　　处：《中华中医药杂志》2018年第11期4948-4952,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81403444);广东省社会发展领域科技计划项目(No.2014 A020221007);广东省对外科技合作项目(No.2013B051000039)~~

摘　　要：目的:观察地黄饮子治疗阿尔茨海默病(AD)患者的临床疗效并探讨其机制。方法:60例轻、中度AD患者随机分为中药组和多奈哌齐组,中药组给予地黄饮子颗粒剂口服,每日1剂,多奈哌齐组给予盐酸多奈哌齐片口服,每次5mg,每日1次,两组均治疗3个月。治疗前后采用简易智能量表(MMSE)、AD评定量表认知部分(ADAS-cog)、日常生活能力评估量表(ADL)等对患者的认知能力、日常生活能力等进行评估,同时检测患者血清中Notch1、丙烯醛及解整合素-金属蛋白酶10(ADAM10)、β类淀粉前体蛋白内切酶1(BACE1)的浓度变化。结果:与本组治疗前比较,两组患者治疗后MMSE评分、Notch1信号蛋白水平均显著升高(P<0.05),ADAS-cog评分、ADL评分、丙烯醛浓度则显著下降(P<0.05);中药组治疗后ADAM10显著上升、BACE1显著下降(P<0.05)。结论:地黄饮子能改善轻、中度AD患者的日常生活能力及认知功能,机制可能与调节Notch1、ADAM10及BACE1蛋白,降低丙烯醛浓度有关。Objective： To observe the effects of Dihuang Yinzi Decoction on the treatment of Alzheimer＇s disease（AD） patients, and to explore the potential mechanisms. Methods： Sixty mild-to-moderate AD patients were randomly allocated to Dihuang Yinzi Decoction（DYD） group or donepezil group. Patients in the DYD group received Dihuang Yinzi Decoction orally once a day, while those in the donepezil group were treated with donepezil 5 mg once a day. The interventions last for 3 months. Cognition and ability of daily life were assessed by Mini-Mental State Examination（MMSE）, Alzheimer＇s Disease Assessment Scale-Cognitive section（ADAS-cog） and Activity of Daily Living Scale（ADL）. Meanwhile, levels of Notch1, A-disitegrin and metalloprotease 10（ADAM10） and Beta-site APP-cleaving enzyme 1（BACE1） were measured. Results： After the treatments, MMSE scores and Notch1 level increased while ADAS-cog and ADL scores, acrolein level decreased significantly in both groups when compared with the baseline respectively（P0.05）, ADAM-10 level increased and BACE1 decreased in the DYD group（P0.05）. Conclusion： Dihuang Yinzi Decoction can effectively ameliorate the abilities of daily living and cognitive function of mild-to-moderate AD patients. The mechanisms might involve modulating the expressions of Notch1, ADAM10, BACE1 and scavenging of acrolein.

关 键 词：阿尔茨海默病 地黄饮子 NOTCH1 解整合素-金属蛋白酶10 β类淀粉前体蛋白内切酶1 

分 类 号：R277.7[医药卫生—中医学]