健脾益肾化浊方对轻、中度血管性痴呆患者认知功能及精神行为症状的影响  

Effect of Jianpi Yishen Huazhuo Recipe on Cognitive Function and Psychobehavioral Symptoms of Patients with Mild and Moderate Vascular Dementia

作　　者：鲁喜悦 黎明全[2] 李涛[3] 王莹[1] 李施新 秦璎琳 刘雪梅[4] 谢玉晗[4] 申伟 魏竞竞 覃蔚岚[4] 傅晨[4] 陈宝鑫[4] 张允岭 金香兰[4] LU Xiyue;LI Mingquan;LI Tao;WANG Ying;LI Shixin;QIN Yinglin;LIU Xuemei;XIE Yuhan;SHEN Wei;WEI Jingjing;QIN Weilan;FU Chen;CHEN Baoxin;ZHANG Yunling;JIN Xianglan(Beijing University of Chinese Medicine,Beijing China 100029;The Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Changchun Jilin China 130021;Shanxi Provincial Hospital of Traditional Chinese Medicine,Taiyuan Shanxi China 030012;Oriental Hospital of Beijing University of Chinese Medicine,Beijing China 100078;Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing China 100091)

机构地区：[1]北京中医药大学,北京100029 [2]长春中医药大学附属医院,吉林长春130021 [3]山西省中医院,山西太原030012 [4]北京中医药大学东方医院,北京100078 [5]中国中医科学院西苑医院,北京100091

出　　处：《中医学报》2023年第10期2222-2227,共6页Acta Chinese Medicine

基　　金：全国中医临床特色技术传承骨干人才培训项目{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(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(vascular dementia,VaD)患者的认知功能及精神行为症状(behavioral and psychological symptoms,BPSD)的影响。方法:选取2017年12月至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、痰瘀互阻患者,随机分为干预组和对照组。对照组为空白对照,干预组给予健脾益肾化浊方,共治疗180 d。采用简明精神状态量表(mini-mental state examination,MMSE)、神经精神问卷(neuropsychiatric inventory,NPI)对VaD患者认知功能及精神行为症状进行评价。结果:治疗180 d后,干预组患者较治疗前MMSE评分提高(P<0.01),NPI评分降低(P<0.01),对照组患者治疗前后MMSE、NPI评分无显著变化(P>0.05)。与对照组比较,干预组患者MMSE、NPI评分差值及“抑郁/心境恶劣”“焦虑”“情感淡漠”等3项精神行为症状的评分差值显著改善,差异均有统计学意义(P<0.05,P<0.01)。结论:健脾益肾化浊方可以改善轻、中度VaD患者的认知功能,在改善精神行为症状方面亦有疗效,尤其在“抑郁/心境恶劣”“焦虑”“情感淡漠”阴性症状方面较为明显。Objective:To observe the effect of Jianpi Yishen Huazhuo recipe on cognitive function and behavioral symptoms(BPSD)in patients with mild and moderate vasculardementia(VaD).Methods:From December 2017 to February 2021,patients with mild and moderate VaD with deficiency of spleen and kidney and mutual obstruction of phlegm and blood stasis were randomly divided into intervention group and control group.The control group was blank control,and the intervention group was given Jianpi Yishen Huazhuo Recipe for 180 d days.The mini-mental state questionnaire(MMSE)and neuropsychiatricinventory questionnaire(NPI)were used to evaluate the cognitive function and mental behavior symptoms of VaD patients.Results:After 180 days of treatment,the MMSE score in the intervention group was significantly higher than that before treatment(P<0.01),and the NPI score was significantly lower(P<0.01),while the MMSE and NPI scores in the control group had no significant changes before and after treatment(P>0.05).Compared with the control group,the scores of MMSE and NPI and the scores of depression/dysthymia,anxiety and apathy in the intervention group were significantly different(P<0.05,P<0.01).Conclusion:Jianpi Yishen Huazhuo Recipe can improve the cognitive function of patients with mild and moderate VaD,and it is also effective in improving mental and behavioral symptoms,especially in the negative symptoms of"depression/bad mood","anxiety"and"apathy".

关 键 词：血管性痴呆 健脾益肾化浊方 脾肾亏虚证 痰瘀互阻证 认知功能 精神行为症状 

分 类 号：R259.43[医药卫生—中西医结合]