健脾益肾化浊方治疗轻、中度血管性痴呆脾肾亏虚、痰瘀互阻证的临床研究  

Clinical study of Jianpi Yishen Huazhuo formula in the treatment of mild and moderate vascular dementia with syndrome of spleen and kidney deficiency and mutual obstruction of phlegm and blood stasis

作　　者：王莹[1] 刘金民 黎明全 李涛[4] 李施新 鲁喜悦 秦璎琳 陈宝鑫 周晶 朱晓晨 曹芯华 程苗苗 张允岭 金香兰 WANG Ying;LIU Jinmin;LI Mingquan;LI Tao;LI Shixin;LU Xiyue;QIN Yinglin;CHEN Baoxin;ZHOU Jing;ZHU Xiaochen;CAO Xinhua;CHENG Miaomiao;ZHANG Yunling;JIN Xianglan(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;The Affiliated Hospital to Changchun University of Chinese Medicine,Changchun 130021,China;Shanxi Traditional Chinese Medical Hospital,Taiyuan 030012,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院 [3]长春中医药大学附属医院 [4]山西省中医院 [5]中国中医科学院西苑医院

出　　处：《北京中医药大学学报》2022年第7期670-676,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-C-202007);全国中医临床特色技术传承骨干人才培训项目(No.国中医药人教函[2019]36号);北京中医药大学2020年度基本科研业务费重点攻关项目(No.2020-JYB-ZDGG-124)。

摘　　要：目的 观察健脾益肾化浊方对轻、中度血管性痴呆(VaD)脾肾亏虚、痰瘀互阻证患者的临床疗效及安全性。方法 选取2017年12月—2021年2月就诊于北京中医药大学东方医院、山西省中医院、长春中医药大学附属医院的轻、中度VaD脾肾亏虚、痰瘀互阻证患者,共90例,随机分为对照组(n=45)、试验组(n=45)。对照组给予常规基础治疗,试验组在对照组基础上给予健脾益肾化浊方,共治疗180 d。比较2组患者治疗前后阿尔茨海默病评定量表-认知部分(ADAS-cog)评分及中医证候积分的变化情况。结果 研究过程中试验组脱落4例、对照组脱落5例,最终试验组41例、对照组40例完成本研究。与治疗前比较,治疗后试验组患者ADAS-cog评分降低(P<0.01)。与对照组比较,试验组患者治疗前后ADAS-cog评分差值及治疗前后记忆力、语言能力亚项评分差值均增大(P<0.01)。与治疗前比较,治疗后试验组出现精神抑郁、言善误、言辞贫乏的人数减少(P<0.05,P<0.01);与对照组比较,治疗后试验组出现言辞贫乏的人数减少(P<0.05)。与治疗前比较,治疗后试验组患者头痛、头晕、神疲、心悸、腰膝酸软、肢倦身重、畏寒肢冷、夜尿频多、尿后余沥9个周边症状评分下降(P<0.05,P<0.01);与对照组比较,治疗后试验组患者面色萎黄、善太息、畏寒肢冷、夜尿频多4个周边症状评分下降(P<0.05)。与治疗前比较,治疗后试验组患者周边症状总积分降低(P<0.01);与对照组比较,治疗后试验组患者周边症状总积分降低(P<0.05)。结论 健脾益肾化浊方可改善轻、中度VaD脾肾亏虚、痰瘀互阻证患者的认知功能及相关临床症状,且安全性较好,较常规基础治疗有一定的优势。Objective We aimed to evaluate the clinical efficacy and safety of Jianpi Yishen Huazhuo formula in patients with mild and moderate vascular dementia(VaD) with syndrome of spleen and kidney deficiency and mutual obstruction of phlegm and blood stasis.Methods A total of 90 patients with mild and moderate VaD with syndrome of spleen and kidney deficiency and mutual obstruction of phlegm and blood stasis treated at Dongfang Hospital of Beijing University of Chinese Medicine, Shanxi Traditional Chinese Medical Hospital, and The Affiliated Hospital to Changchun University of Chinese Medicine between December 2017 and February 2021 were enrolled.The patients were randomly divided into the control group(n=45) and the experimental group(n=45).Patients in the control group were given conventional basic treatment, and patients in the experimental group were additionally given Jianpi Yishen Huazhuo formula.Patients in both groups were treated for 180 days. The changes of Alzheimer’s Disease Assessment Scale-Cognitive section(ADAS-cog) scores and traditional Chinese medicine symptoms were compared between the two groups before and after treatment.Results During the treatment, four cases fell off in the experimental group and five cases in the control group. Finally, 41 cases in the experimental group and 40 cases in the control group completed this study. The ADAS-cog scores of the experimental group were decreased after treatment compared with those before treatment(P<0.01).The difference in ADAS-cog scores between before and after treatment and the difference in memory and language scores between before and after treatment were larger in the experimental group compared with the control group(P<0.01).The number of patients with depression, misspeaking, and poor speech was lower in the experimental group after treatment compared with that before treatment(P<0.05, P<0.01).The number of patients with poor speech was lower in the experimental group after treatment compared with the control group(P<0.05).The scores of nine per

关 键 词：健脾益肾化浊方 血管性痴呆 认知功能 疗效评价 阿尔茨海默病评定量表-认知部分 

分 类 号：R285.6[医药卫生—中药学]