中医药干预不同类型认知障碍的研究进展  

Research Progress on Traditional Chinese Medicine Intervention for Different Types of Cognitive Disorders

作　　者：范欣[1] 罗乐 刘莹 吴晓翠 冯丽莎[1] 栗锦迁 FAN Xin;LUO Le;LIU Ying;WU Xiaocui;FENG Lisha;LI Jinqian(Affiliated Hospital of Tianjin Academy of traditional Chinese Medicine,Tianjin 300120,China)

机构地区：[1]天津市中医药研究院附属医院,天津300120

出　　处：《现代中医药》2025年第2期54-60,共7页Modern Chinese Medicine

基　　金：天津市科技计划项目(18ZXDBSY00080);天津市中医药研究院附属医院科研课题项目(2020015)。

摘　　要：阿尔兹海默病和血管性痴呆是最常见的两种认知障碍类型。中医治疗认知障碍经验丰富,五脏藏神,尤以心、脾、肾三脏为主,髓海空虚、痰瘀蔽窍是其主要的病机。通过数据挖掘技术和现代药理学研究进一步证实,中药改善认知障碍疗效显著。古代医家治疗痴呆方剂的高频药物主要为人参、远志、茯苓等,归经主要为心、脾、肾经;现代各医家治疗阿尔兹海默病常用方剂的高频药物主要为石菖蒲、熟地黄、黄芪等,主要归为心、肝、肾经;现代各医家治疗血管性痴呆常用方剂的高频药物主要为石菖蒲、丹参、川芎等,归经主要为心、肝、脾、肾经。现代药理学研究证实,中药成分可能通过增强中枢胆碱系统活性,抑制海马神经元凋亡,促进突触结构重塑,增加血管生成等改善认知功能。通过总结改善不同类型认知障碍中药的特点,为临床应用提供指导依据。Alzheimer's disease and vascular dementia were the two most common types of cognitive impairment.Traditional Chinese Medicine has rich experience in treating cognitive impairment.The five Zang viscera contained spirits,especially the heart,spleen and kidney.The main pathogenesis was the insufficiency of the sea of medulla and the blinded brain of phlegm and blood stasis.Based on data mining methods and modern pharmacological research,Chinese herbal medicine had significant therapeutic effects on improving cognitive impairment.We found that the high-frequency drugs of ancient medical records in the treatment of dementia were mainly Renshen(Ginseng),Yuanzhi(Polygalae),Fuling(Poria),and the main meridians were the heart,spleen and kidney meridians.The high-frequency drugs commonly used in the treatment of Alzheimer's disease in modern traditional Chinese medicine were mainly Shichangpu(Acorus tatarinowii),Dihuang(Rehmanniae Radix),Huangqi(Astragalus membranaceus),and the main meridians were the heart,liver and kidney meridians.The high-frequency drugs commonly used in the treatment of vascular dementia in modern traditional Chinese medicine were mainly Shichangpu(Acorus tatarinowii),Danshen(Salvia miltiorrhiza),Chuanxiong(Ligusticum chuanxiong),and the main meridians were the heart,liver,spleen and kidney meridians.The modern pharmacological research confirmed that Chinese herbal medicinal ingredient could improve cognitive function by enhancing the activity of central cholinergic system,inhibiting hippocampal neuron apoptosis,promoting synaptic structure remodeling,increasing angiogenesis and so on.This article summarized the characteristics of traditional Chinese medicine for improving different types of cognitive impairment,and provided guidance for clinical application.

关 键 词：痴呆 阿尔兹海默病 血管性痴呆 数据挖掘 认知障碍 

分 类 号：R256.23[医药卫生—中医内科学]