地黄饮子联合盐酸多奈哌齐片治疗轻中度阿尔茨海默病临床研究  

Clinical study of Dihuang-Yinzi Decoction combined with donepezil hydrochloride tablets in the treatment of mild to moderate Alzheimer's disease

作　　者：惠婷[1] 林先萍 刘泓毓 Hui Ting;Lin Xianping;Liu Hongyu(Department of Traditional Chinese Medicine,the First Hospital of Yulin in Suide District,Yulin 718000,China;Department of Emergency,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,China)

机构地区：[1]陕西省榆林市第一医院绥德院区中医科,718000 [2]海南医学院第一附属医院急诊科,海口570102

出　　处：《国际中医中药杂志》2020年第8期745-749,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的评价地黄饮子联合盐酸多奈哌齐片治疗轻中度AD的疗效。方法将符合入选标准的2017年2月-2019年2月榆林市第一医院绥德院区114例轻中度AD患者按随机数字表法分为2组,每组57例。对照组口服盐酸多奈哌齐片,研究组在对照组基础上加服地黄饮子。2组均连续治疗3个月。分别采用日常生活能力量表(Activity of Daily Living Scale, ADL)、简易精神状况量表(Mini-Mental State Examination, MMSE)、AD评定量表的认知部分(Alzheimer’s Disease Assessment Scale-Cognitive section, ADAS-cog)评价患者的生活能力与认知功能;采用免疫印迹法检测血清Notch1信号蛋白、解整合素-金属蛋白酶10(a disintegrin and metalloproteinase 10, ADAM10)、β类淀粉前体蛋白内切酶1(β-amyloid precursor protein endonuclease 1, BACE1)水平,采用ELISA法检测丙烯醛水平;记录治疗期间的不良反应,评价临床疗效。结果研究组总有效率为84.2%(48/57)、对照组为64.9%(37/57),2组比较差异有统计学意义(χ2=5.596,P=0.018)。治疗后,研究组ADL、ADAS-cog评分低于对照组(t值分别为5.939、6.124,P<0.01),MMSE评分高于对照组(t=6.087,P<0.01);研究组Notch1信号蛋白[(3.43±0.58)比(1.31±0.47),t=21.440]、ADAM10[(1.86±0.23)比(1.12±0.25),t=16.446]水平高于对照组(P<0.01),BACE1[(0.62±0.15)比(0.98±0.17),t=11.988]、丙烯醛[(2.19±0.39)nmol/mg比(4.76±0.54)nmol/mg,t=12.354]水平低于对照组(P<0.01)。研究组不良反应发生率为14.7%(11/57)、对照组为14.0%(8/57),2组比较差异无统计学意义(χ2=0.568,P=0.451)。结论地黄饮子联合盐酸多奈哌齐片可有效改善轻中度AD患者的认知功能及生活能力,提高临床疗效。Objective To evaluate the efficacy of Dihuang-Yinzi Decoction combined with donepezil hydrochloride in the treatment of mild to moderate Alzheimer's disease(AD).Methods 114 patients with mild to moderate AD in the First Hospital of Yulin in Suide District from February 2017 to February 2019 were divided into two groups according to the method of random number table,with 57 cases in each group.The control group took donepezil hydrochloride tablets orally,and the study group took Dihuang-Yinzi Decoction based on the control group.Both groups were treated continuously for 3 months.The activities of daily living scale(ADL),Mini-Mental State Examination(MMSE)and the Alzheimer’s disease assessment scale-cognitive section(ADAS-cog)were used to evaluate the life ability and cognitive function of patients.The concentrations of Notch 1 signaling protein,a disintegrin and metalloproteinase 10(ADAM10)andβ-amyloid precursor protein endonuclease 1(BACE1)in serum were detected by Western blot.The levels of acrolein were detected by ELISA,the adverse reactions during the treatment were recorded,and the clinical efficacy was evaluated.Results The total effective rate was 84.2%(48/57)in the study group and 64.9%(37/57)in the control group.The difference between the two groups was statistically significant(χ2=5.596,P=0.018).After the treatment,the ADL and ADAS-cog scores of the study group were lower than those of the control group(t values were 5.939,6.124,respectively,all Ps<0.01),and MMSE scores were higher than that of the control group(t=6.087,P<0.01).The levels of Notch1 signaling protein(3.43±0.58 vs.1.31±0.47,t=21.440)and ADAM10(1.86±0.23 vs.1.12±0.25,t=16.446)in the study group were higher than those of the control group(P<0.01),and the levels of BACE1(0.62±0.15 vs.0.98±0.17,t=11.988)and acrolein(2.19±0.39 nmol/mg vs.4.76±0.54 nmol/mg,t=12.354)were lower than those of the control group(P<0.01).The adverse reaction rate was 14.7%(11/57)in the study group and 14.0%(8/57)in the control group,and there was no signi

关 键 词：阿尔茨海默病 轻中度 地黄饮子 盐酸多奈哌齐片 治疗 临床研究性 

分 类 号：R749.16[医药卫生—神经病学与精神病学]