血管性痴呆患者应用参龙汤改善神经功能缺损的临床研究  

Clinical study on shenlong tang for improving neurological impairment in patients with vascular dementia

作　　者：王发渭[1] 姜楠[2] 仝战旗[1] 王治宽[1] 田嘉禾[3] 刘毅[1] 尹大一[3] 

机构地区：[1]解放军总医院中医科,北京市100853 [2]北京协和医院中医科,北京市100730 [3]解放军总医院PET中心,北京市100853

出　　处：《中国临床康复》2004年第4期679-681,共3页Chinese Journal of Clinical Rehabilitation

基　　金：国家中医药管理局中医药科技研究基金课题资助(2000-01LP07)~~

摘　　要：目的:观察参龙汤改善血管性痴呆(vasculardementia,VD)患者神经功能缺损的临床疗效。方法:参照WHO公布的美国精神病学会VD诊断标准(DSM-IV),入选18例(36例次)VD患者,随机、安慰剂对照,双盲给药,自身前后交叉试验为研究方法,选择简易智能量表(MMSE)、Blessed行为量表(BBS)于疗程前后统计分值变化进行疗效评估。结果:参龙汤治疗VD患者18例,显效3例,有效9例,无效6例,临床总体有效率为67%,对VD患者的认知障碍和行为均有明显改善作用,其效应明显优于安慰剂(P<0.05)。该药有提高VD患者的智力量表成绩,改善其日常生活自理能力、临床症状和神经功能缺损的作用;对VD患者血脂、血液黏度及脑葡萄糖代谢亦有一定改善作用。结论:肾虚精亏,气虚血瘀是VD的主要病机,补肾填精,益气活血法治疗本病的重要方法,参龙汤对VD确有一定疗效,安全可靠。AIM:To observe the clinical effect of shenlong tang in improving neurological im pairment in patients with vascular dementia(VD). METHODS:Eighteen patients with VD were selected according to the diagnostic c riteria of the Diagnostic and Statistical Manual of Mental Disorder-Fourth Edi tion(DSM-IV) published ty the American Psychiatric Association.It was a random ized,placebo-controlled,double-blind and auto-crossed study.The curatice e ffect was evaluated based on the statistics with mini mental state examination(M MSE)and Blessed behavior schedule(BBS)before and after treatment. RESULTS:Among the 18 patients in the shenlong tang group,notable effect was a chieved in 3 cases,fair in 9 cases and unchanged in 6 cases.The total effective rate of shenlong tang group was 67% ,significantly higher than that of the plac ebo group (P< 0.05).The results of MMSE and BBS showed that shenlong tang played a curative role not only in improving patients'disturbance of intelligence and behavior, but also in improving daily self-care abitlity,clinical symptoms an d neurological impairment.It also played a certain role in improving lipoprotein ,blood viscosity and cerebral glucose metabolism. CONCLUSION:The main pathogenic mechanism of VD is the deficiency of the kidne y essence,deficiecy of qi and blood stasis.So the principal treatment of VD is t o reinforce the didey,supplement qi and activate blood circulation.Shenling tang has a certain safe and reliable role in treatment of VD.

关 键 词：血管性痴呆 VD 参龙汤 神经功能缺损 老年痴呆 脑血管病 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R969.4[医药卫生—临床医学]