参麻益智方治疗轻中度血管性痴呆气虚血瘀阳亢型患者的临床观察  

Shenma Yizhi Recipe Treated Mild and Moderate Vascular Dementia Patients with Qi Deficiency and Blood Stasis Induced Gan-yang Hyperactivity

作　　者：吴琼 韦云[1] 刘剑刚[1] 裴卉[1] 方军艳[1] 张帅 吴佳慧 刘美霞 付静[3] 沈泽 刘方 李浩[1] WU Qiong;WEI Yun;LIU Jian-gang;PEI Hui;FANG Jun-yan;ZHANG Shuai;WU Jia-hui;LIU Mei-xia;FU Jing;SHEN Ze;LIU Fang;LI Hao(Institute of Geriatrics,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091;Department of Ophthalmology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing,100029;Beijing Tcmages Pharmaceutical Co.,Ltd.,Beijing,101301)

机构地区：[1]中国中医科学院西苑医院老年医学研究所,北京100091 [2]北京中医药大学东方医院眼科,北京100029 [3]北京康仁堂药业有限公司,北京101301

出　　处：《中国中西医结合杂志》2020年第5期554-559,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81603616);北京市科技计划课题“十病十药”研发项目资助(No.Z171100001717016)。

摘　　要：目的观察参麻益智方治疗气虚血瘀阳亢型轻中度血管性痴呆(VD)患者的临床疗效。方法选取64例轻、中度VD患者,采用随机数字表法分为试验组和对照组,每组各32例,观察期间脱落病例4例,每组完成试验各30例。两组均进行健康教育及一般生活方式干预,在此基础上试验组口服参麻益智颗粒,每次5 g,1日2次;对照组口服银杏叶片19.2 mg/次,1日3次。共服用3个月。观察两组简易智能状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力评分量表(ADL)、临床神经功能缺损量表(NIH-SS)、中医证候积分量表和血清乙酰胆碱(ACh)、乙酰胆碱酯酶(AChE)、超氧化物歧化酶(SOD)、丙二醛(MDA)、白细胞介素-6(IL-6)、谷胱甘肽过氧化物酶(GSH-Px)、肿瘤坏死因子-α(TNF-α)水平变化。结果与治疗前比较,试验组和对照组MMSE、MoCA、ADL、NIHSS、中医证候积分量表评分均有改善(P<0.01),且MMSE、ADL、NIHSS、中医证候积分量表评分改善水平试验组优于对照组(P<0.05)。两组血清ACh、AChE、SOD、MDA、IL-6、GSH-Px水平均有改善(P<0.05),且血清ACh、AChE、TNF-α改善水平试验组优于对照组(P<0.05)。结论参麻益智方治疗轻、中度VD,可改善认知功能,提高日常生活能力,缓解神经功能缺损症状,改善气虚血瘀阳亢证的中医证候,临床疗效优于银杏叶片。Objective To observe the clinical effect of Shenma Yizhi Recipe(SMYZR)on mild to moderate vascu-lar dementia(VD)patients with qi deficiency and blood stasis induced Gan-yang hyperactivity(QDBS-GYH).Methods Totally 64 mild to moderate VD patients with QDBS-GYH were assigned to the treatment group and the control group by ran-dom digit table,32 cases in each group.Four cases dropped out or were rejected,and 30 patients finished the trial in each group.All patients were involved in healthy education and general lifestyle intervention.Patients in the treatment group addi-tionally took SMYZ Granules,5 g each time,twice per day.Those in the control group additionally took Ginkgo biloba Leaves Extract Tablets,19.2 mg each time,3 times per day.The treatment course for all was 3 months.After treatment changes of Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Activity of Daily Living Scale(ADL),National Institute of Health Stroke Scale(NIHSS),integrals of TCM syndromes,acetylcholine(Ach),acetylcholine esterase(AchE),superoxide dismutase(SOD),malondialdehyde(MDA),IL-6,glutathione peroxidase(GSH-Px),and tumor necrosis factor-alpha(TNF-α)were observed in the two groups.Results Compared with before treatment,scores of MMSE,MoCA,ADL,NIHSS,and integrals of TCM syndromes were improved significantly in the two groups(P<0.01).Besides,the improvements of MMSE,ADL,NIHSS,and integrals of TCM syndromes were superior in the treatment group than in the control group(P<0.05).The serum levels of AChE,ACh,SOD,MDA,IL-6,and GSH-Px were improved in the two groups(P<0.05).Moreover,the improvements of ACh,AChE and TNF-αwere superior in the treatment group than in the control group(P<0.05).Conclusions SMYZR was superior to Ginkgo biloba Leaves Extract Tablets in treatment of mild to moderate VD patients with QDBS-GYH.It improved cognitive function and ADL,relieved symptoms of neurological defi-cits,and improved TCM syndromes of QDBS-GYH.

关 键 词：参麻益智方 血管性痴呆 气虚血瘀阳亢 认知功能 胆碱能系统 氧化应激 炎症反应 

分 类 号：R277.7[医药卫生—中医学]