益智健脑方加减联合西药对早中期老年痴呆患者认知功能及DWI表现的影响

Effect of Yizhi Jiannao Formula Combined with Western Medicine on Cognitive Function and DWI for Patients with Early and Middle Senile Dementia

目的:观察益智健脑方加减治疗对早中期老年痴呆患者认知功能及扩散加权成像(DWI)表现的影响。方法:选取2018年9月至2020年10月我院收治早中期老年痴呆患者80例,按随机数字表法分为对照组及观察组,每组40例。对照组给予盐酸多奈哌齐口服,观察组在对照组基础上加用益智健脑方加减治疗。观察两组患者认知功能、生活能力、中医症状积分及DWI表现。结果:治疗前两组患者蒙特利尔认知评估量表(MoCA)、改良Barthel指数评分比较差异无意义(P>0.05),治疗后两组患者MoCA、Barthel指数评分均有所上升,且观察组高于对照组,比较差异有意义(P<0.05);治疗前两组患者中医症状积分比较差异无意义(P>0.05),治疗后两组患者中医症状积分均有所降低,且观察组低于对照组,比较差异有意义(P<0.05);治疗后观察组额叶、顶叶、颞叶、胼胝体压部表观弥散系数(ADC)值低于对照组,比较差异有意义(P<0.05),两组患者枕叶及胼胝体膝部ADC值比较差异无意义(P>0.05);两组患者不良反应发生率比较无显著差异(χ^(2)=0.949,P=0.330)。结论:益智健脑方加减治疗应用于早中期老年痴呆患者治疗可改善患者认知功能,提高患者生活能力,减轻患者临床症状及DWI表现。

Objective:To observe the effect of Modified Yizhi Jiannao Decoction on cognitive function and diffusion-weighted imaging(DWI)findings for patients with early and mid-stage Alzheimer’s disease.Methods:80 patients with early and mid-stage Alzheimer’s disease in the hospital were selected between September 2018 and October 2020,and they were divided into a controlled group and an observation group according to the random number table method with 40 cases in each group.The controlled group was given oral administration of Donepezil Hydrochloride,and the observation group was additionally given Modified Yizhi Jiannao Decoction on the basis of the controlled group.The cognitive function,living ability,scores of TCM symptoms and DWI findings were observed in the two groups.Results:Before treatment,there were no significant differences in the scores of Montreal Cognitive Assessment Scale(MoCA)and Modified Barthel Index between the two groups(P>0.05).After treatment,the scores of MoCA and Barthel index in the two groups were increased,and the scores in the observation group were higher than those in the controlled group(P<0.05).There were no statistical differences in the scores of TCM symptoms before treatment between the two groups(P>0.05).After treatment,the scores of TCM symptoms were decreased in the two groups,and the scores were lower in the observation group than those in the controlled group(P<0.05).The apparent diffusion coefficient(ADC)values of the frontal lobe,parietal lobe,temporal lobe and splenium of the corpus callosum in the observation group after treatment were lower compared with those in the controlled group(P<0.05),but the differences in the ADC values of the occipital lobe and genu of the corpus callosum were not significant between the two groups(P>0.05).There was no statistical difference in the incidence rate of adverse reactions between the two groups(χ^(2)=0.949,P=0.330).Conclusion:Modified Yizhi Jiannao Decoction can improve the cognitive function,enhance the living ability,and relieve the clinical symptoms and DWI findings in patients with early and mid-stage Alzheimer’s disease.