中医辨证治疗方案治疗对改善重度阿尔茨海默病患者认知功能的疗效  

Clinical Study on Traditional Chinese Medicine Treatment Based on Syndrome Differentia⁃tion for Improving Cognitive Function of Patients with Severe Alzheimer’s Disease

作　　者：俞璐[1] 郁志华[2] 黄品贤[3] 董英[3] 王健[2] 林水淼[2] YU Lu;YU Zhi-hua;HUANG Ping-xian;DONG Ying;WANG Jian;LIN Shui-miao(Comprehensive Department of TCM,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China;Shanghai Geriatric Institute of Chinese Medicine,Shanghai 200031,China;Department of Preventive Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属普陀医院中医综合科,上海200062 [2]上海市中医老年医学研究所,上海200031 [3]上海中医药大学预防医学教研室,上海201203

出　　处：《神经损伤与功能重建》2020年第10期567-570,共4页Neural Injury and Functional Reconstruction

基　　金：国家科技部“十一五”支撑计划项目(No.2006BAI04A 11-2);国家自然科学基金项目(No.81503370);上海市自然科学基金项目(No.19ZR1447900);上海市卫生健康委员会临床研究专项面上项目(No.202040150);上海市青年医师培养资助计划项目;上海市普陀区中医临床重点专科建设项目(No.PTZYLC ZDZK-2017003)。

摘　　要：目的:研究中医辨证治疗方案对重度阿尔茨海默病(AD)患者认知功能的干预作用。方法:纳入重度AD患者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,心气虚证予调心方,肾精不足证予补肾方,挟痰者,加用礞石滚痰丸,挟瘀者,加用血府逐瘀胶囊;西药组予盐酸多奈哌齐治疗。疗程均为48周。观察并比较2组患者治疗前、治疗24周和48周后简易智能精神状态检查量表(MMSE)、临床痴呆评定量表(CDR)、Fuld物体记忆测验(FOM)、快速词汇测验(RVR)、积木测验(BD)量表的评分变化。结果:2组MMSE、FOM分子、FOM分母、RVR、BD分值较治疗前差异无统计学意义(P>0.05),但中药组在治疗24周和治疗48周时,CDR等级均较治疗前降低(P<0.05,P<0.01);西药组在治疗48周时,CDR等级较治疗前降低(P<0.05)。结论:重度AD患者经中医辨证治疗后认知功能未发生进一步恶化,且病情程度得到一定的缓解。Objective:To explore the effects of traditional Chinese medicine(TCM)treatment based on syndrome differentiation on the cognitive function of patients with severe Alzheimer’s disease(AD).Methods:Fifty patients with severe AD were selected and randomly divided into the Chinese medicine(CM)group and western medicine(WM)group with 25 patients in each group.Patients in the CM group were treated once every 4 weeks by TCM treatment based on syndrome differentiation:the patients of heart-qi deficiency were treated with“Tiaoxin Recipe”and of kidney-essence deficiency with“Bushen Recipe”,and patients with phlegm and blood stasis were additionally given“Mengshi Guntan Pellet”and“Xuefu Zhuyu Capsule”respectively.Patients in the WM group were treated with donepezil hydrochloride.The therapeutic course was 48 weeks.The scores of the Mini-Mental State Examination(MMSE),Clinical Dementia Rating(CDR),Fuld Object-Memory Evaluation(FOM),Rapid Verbal Retrieve(RVR),and Block Design(BD)before and after treatment were observed and compared.Results:In both groups,there was no statistical difference in MMSE,FOM numerator,FOM denominator,RVR,and BD scores before and after treatment(P>0.05).However,CDR scores in the CM group decreased after 24 and 48 weeks of treatment(P<0.05,P<0.01),and CDR scores in the WM group decreased after 48 weeks of treatment(P<0.05).Conclusion:The cognitive function of patients with severe AD did not deteriorate after TCM treatment based on syndrome differentiation,and to some extent,the disease severity was reduced.

关 键 词：中医辨证 阿尔茨海默病 重度 认知功能 临床研究 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]