恒清Ⅰ号方联合盐酸多奈哌齐对血管性痴呆患者的作用及其机制研究  

Study on the Effects ofHengqing Prescription No.1 and Donepezil Hydrochloride on Vascular Dementia and Its Mechanism

作　　者：孟胜喜[1] 付剑亮[1] 霍清萍[1] 王兵[1] 李学敏[1] 彭文波[1] 王宇新[1] 梁芳[1] 汪天湛[1] 张洪艳[1] 余忠海 刘华[1] 彭学丰 曹健美 李文涛[3] MENG Shengxi;FU Jianliang;HUO Qingping;WANG Bin;LI Xuemin;PENG Wenbo;WANG Yuxin;LIANG Fang;WANG Tianzhan;ZHANG Hongyan;YU Zhonghai;LIU Hua;PENG Xuefeng;CAO Jianmei;LI Wentao(The 6th People’s Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200233,China;Graduate College,Shanghai University of TCM;Shanghai City Hospital of Traditional Chinese Medicine)

机构地区：[1]上海交通大学附属第六人民医院,上海200233 [2]上海中医药大学研究生院 [3]上海市中医医院

出　　处：《西部中医药》2021年第1期1-5,共5页Western Journal of Traditional Chinese Medicine

基　　金：上海市科学技术委员会科研计划项目(19401932500);上海市进一步加快中医药事业发展三年行动计划(2018—2020年)项目[ZY(2018-2020)-CCCX-4010];上海交通大学医学院高水平地方高校建设中西医结合创新基金(18zxy002)。

摘　　要：目的:探讨恒清Ⅰ号方联合盐酸多奈哌齐对血管性痴呆(vascular dementia,VD)患者的作用及其机制。方法:将VD患者132例按随机数字表法分为治疗组65例及对照组67例。两组患者均给予基础治疗。对照组同时给予盐酸多奈哌齐治疗,治疗组在对照组基础上给予恒清Ⅰ号方,两组疗程均为3个月。比较治疗前后两组患者日常生活能力量表(activity of daily living,ADL)评分、长谷川痴呆量表(hasegawa dementia scale,HDS)评分、简易精神状态量表(minimum mental state examination,MMSE)评分、血液流变学指标水平(红细胞压积、血浆黏度、全血低切还原黏度与高切还原黏度)、白细胞介素6(interleukin-6,IL-6)和肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、D-二聚体(D-Dimer)水平及总有效率。结果:治疗后治疗组HDS、MMSE与ADL评分均高于对照组(P<0.01);血液流变学指标与IL-6、TNF-α水平及Hcy、hs-CRP、D-Dimer水平均低于对照组(P<0.05);总有效率治疗组为84.6%,高于对照组的68.7%,差异有统计学意义(P<0.05)。结论:恒清Ⅰ号方与多奈哌齐联用可以提高VD患者HDS、MMSE与ADL评分。其作用机制可能为改善VD患者血液流变学指标,减轻炎症反应,降低氧化损伤,改善微循环,修复神经元细胞,保护中枢神经元,从而改善VD患者的日常生活能力及认知功能。Objective:To explore the effects and the mechanism of Hengqing prescription No.1 combined with donepezil hydrochloride on the patients with vascular dementia(VD).Methods:All 132 patients were divided into 65 cases of the treatment group and 67 cases of the control group according to random number table method.Both groups accepted basic therapy,the control group were treated by donepezil hydrochloride,and the treatment group by Hengqing prescription No.1,the course was three months.To compare ADL scores,HDS scores,MMSE scores,the levels of hemorheological indexes(hematokrit,plasma viscosity,low shear reduced viscosity and high shear reduced viscosity of whole blood),the levels of IL-6,TNF-α,Hcy,hs-CRP and D-Dimer and total effective rate in two groups before and after treating.Results:After treating,HDS,MMSE and ADL scores of the treatment group were higher than these of the control group(P<0.05);the levels of hemorheological indexes,IL-6 and TNF-α,Hcy,hs-CRP and D-Dimer were lower than these of the control group(P<0.05);total effective rate of the treatment group was 84.6%,higher than 68.7%of the control group,and the difference showed statistical meaning(P<0.05).Conclusion:Hengqing prescription No.1 in combination with donepezil hydrochloride could raise HDS,MMSE and ADL scores.Its mechanism might be to perfect hemorheological indexes of VD patients,relieve inflammatory reaction,reduce oxidative stress,improve microcirculation,repair neurons and protect central neurons,therefore to enhance ADL and cognitive function.

关 键 词：血管性痴呆 认知功能 作用机制 恒清Ⅰ号方 

分 类 号：R743[医药卫生—神经病学与精神病学]