黄精益智方联合盐酸多奈哌齐治疗老年血管性认知障碍的疗效及机制研究  

Study on Curative Efficacy and Mechanism of Huangjing Yizhi Formula(黄精益智方)Combined with Donepezil Hydrochloride in Treatment of Senile Vascular Cognitive Impairment

作　　者：赵健 王迪 袁茵 郑时嘉 杨波[4] 周忠光 ZHAO Jian;WANG Di;YUAN Yin;ZHENG Shijia;YANG Bo;ZHOU Zhongguang(Basic Medical School,Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;Department of Brain Diseases,The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150060,China;Tianwen Mountain Agriculture Comprehen sive Development Co.,Ltd.,Harbin 150300,China;Pharmacy School,Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学基础医学院,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院脑病科,黑龙江哈尔滨150060 [3]天问山农业综合开发股份有限公司,黑龙江哈尔滨150300 [4]黑龙江中医药大学药学院,黑龙江哈尔滨150040

出　　处：《山东中医杂志》2022年第8期835-840,852,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：黑龙江省应用技术研究与开发计划项目(编号:GA20C017);黑龙江中医药大学附属第二医院孙申田青年人才基金项目(编号:2020KY-11)。

摘　　要：目的:基于细胞色素C(Cyt-C)/胱天蛋白酶(Caspase)信号通路探讨黄精益智方治疗老年血管性认知障碍的效果及相关机制。方法:选择老年血管性认知障碍患者97例,按照随机数字表法分为常规治疗组48例和中医治疗组49例。两组患者均行基础对症治疗,并口服盐酸多奈哌齐片,中医治疗组在此基础上加用黄精益智方。两组均以1个月为1个疗程,连续治疗3个疗程,治疗结束后评价两组临床疗效,并比较两组患者治疗前后的中医症状积分、蒙特利尔认知评估(MoCA)得分、血浆同型半胱氨酸(Hcy)含量及血清Caspase-3、Caspase-9、Cyt-C含量。结果:治疗后,中医治疗组疗效分级情况明显优于常规治疗组(P<0.05);两组患者各项中医症状积分及中医症状总分较治疗前均下降(P<0.05),且中医治疗组低于常规治疗组(P<0.05);两组患者MoCA得分较治疗前均升高(P<0.05),且中医治疗组高于常规治疗组(P<0.05);两组患者血浆Hcy含量及血清Caspase-3、Caspase-9、Cyt-C含量较治疗前均降低(P<0.05),且中医治疗组明显低于常规治疗组(P<0.05)。结论:黄精益智方治疗老年血管性认知障碍疗效较好,能明显改善患者的临床症状和认知功能,其机制可能是通过降低Hcy含量以阻止神经元坏死或凋亡,并通过抑制Cyt-C/Caspase信号通路以减少神经细胞凋亡。Objective:To explore the curative efficacy and related mechanism of Huangjing Yizhi Formula(黄精益智方)in the treatment of senile vascular cognitive impairment based on cytochrome C(Cyt-C)/Caspase signaling pathway.Methods:A total of 97 senile patients with vascular cognitive impairment were divided into conventional treatment group(48 cases)and traditional Chinese medicine(TCM)treatment group(49 cases)according to the random number table method.Patients in both the two groups received basic symptomatic treatment and orally taken donepezil hydrochloride tablets.The TCM treatment group was additionally given Huangjing Yizhi Formula.With 1 month as a course of treatment,both the two groups were treated for 3 consecutive courses.After treatment,the curative efficacy of the two groups was evaluated,and the TCM symptom scores,MoCA score,plasma homocysteine(Hcy)content,serum Caspase-3 content,Caspase-9 content,and Cyt-C content of the patients in the two groups were compared.Results:After treatment,the curative efficacy classification of the TCM treatment group was significantly better than that of the conventional treatment group(P<0.05).The score of each TCM symptom and total score of all TCM symptoms of the two groups were lower than those before treatment(P<0.05),and the TCM symptom scores of the TCM treatment group were lower than those of the conventional treatment group(P<0.05).The MoCA scores of the two groups were higher than those before treatment,and the MoCA score of the TCM treatment group was higher than that of the conventional treatment group(P<0.05).The contents of plasma Hcy and serum Caspase-3,Caspase-9 and Cyt-C of the two groups were lower than those before treatment(P<0.05),and those of the TCM treatment group were significantly lower than those of the conventional treatment group(P<0.05).Conclusions:Huangjing Yizhi Formula has a good curative efficacy on senile vascular cognitive impairment.It can significantly improve the clinical symptoms and cognitive function of the patients.The mechanis

关 键 词：血管性认知障碍 黄精益智方 Cyt-C/Caspase信号通路 中医症状积分 MoCA得分 同型半胱氨酸 

分 类 号：R277.7[医药卫生—中医学]