参龙汤治疗血管性痴呆的临床研究

Clinical study on the effect of Shenlong decoction on vascular dementia

目的:观察参龙汤治疗血管性痴呆(VD)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36例(72例次)VD患者,随机双盲给药,安慰剂对照,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36例,显效5例(13. 89% ),有效22例(61. 11% ),无效9例(25% ),总有效率75%。该药可以提高VD患者不同痴呆量表的积分,对VD患者的认知障碍有明显改善作用;还可改善VD患者的临床症状,改善其日常生活自理能力和神经功能缺损程度;对VD患者血脂、血液黏滞度及脑葡萄糖代谢亦有一定改善作用。其效应明显优于安慰剂(P<0. 001)。结论:肾虚精亏,气虚血瘀是VD的主要病机,补肾填精,益气活血法是治疗本病的重要方法,参龙汤对VD确有一定疗效,安全可靠。

Objective:To study the clinical curative effect of Shenlong Decoction in treating Vascular Dementia (VD). Methods:Thirty-six patients (seventy-tow) with VD were chosen according to the diagnostic criteria of the American Society of Psychosis and Neuropathy promulgated by WHO (DSM-IV) and were studied in a crossover fashion. Thirty-two patients in treated group were given Shenlong Decoction by random and double-blind way. The curative effect was evaluated by the statistics bases on the MMSE (Mini Mental State Examination) and BBS (Bless Behaviour Schedule) before and after treatment. Results:In the Shenlong Decoction group,notability was achieved in 5 cases, fair in 22 cases,and unchanged in 9 cases. The total effective rate of Shenlong Decoction was 75%. The results of MMSE and BBS showed that Shenlong Decoction had good curative effect not only on improving patients' results of different dementia scale and disturbance of intelligence, but also improving clinical syndrome, daily self-care ability and reducing the neural functional defect. It also had certain effect on improving lipoprotein, blood viscosity and carbohydrate metabolism of brain. The effects were better than the controlled group(P<0.001). Conclusion:The main pathogenic mechanism of VD is the deficiency of the kidney essence, insufficiency of qi and blood stasis. So the principal treatment of VD is to supply the kidney essence, invigorate qi and promote blood circulation to remove blood stasis. Shenlong Decoction has certain safe and reliable effect on VD.