中医药防治阿尔茨海默病的思路与方法

Thoughts and methods of traditional Chinese medicine in preventing and treating Alzheimer disease

目的:以中西医理论与临床实践分析相结合的方法,探讨中医药防治阿尔茨海默病的思路与方法。方法:神机失灵是阿尔茨海默病发病的基本病理,治疗当以开窍醒神、强记益智为施治总则。①从心论治:治疗以益心养心、开通神窍法使血脉和利,心神明畅,处方可选用孔圣枕中丹合四君子汤加减。②从肾论治:临床广泛应用六味地黄汤加味、左归丸、地黄饮子、补肾益智方、补肾方等以补肾填精,益髓养神法治疗阿尔茨海默病。中晚期阶段使用补肾填精,益髓养神改善二便失禁和生活能力,延缓病情发展。③从痰论治:以二陈汤、涤痰汤、黄连温胆汤、白金丸、猴枣散、苏合香丸、醒脑静均为常用之方。④从瘀论治:水蛭配通天草、菖蒲配蒲黄、黄芪配川芎药对,用于阿尔茨海默病的各个阶段,均收到满意的疗效。结果:神明失用是阿尔茨海默病发病的基本病理,心肾虚衰、痰瘀阻滞是导致神明失用的内在机制。结论:防治阿尔茨海默病以开窍醒神、强记益智为总则;从心、肾、痰、瘀施治,殊途同归益神明;谨守病机缓图治,防治结合效果明显。

AIM： To investigate the thoughts and methods of traditional Chinese medicine in the prevention and treatment of Alzheimer disease by means of combining the theory of Chinese and western medicine with the analysis of clinical practice. METHODS： Mental abnormality was the basic pathology of the onset of Alzheimer disease, and the treatment should follow the general principles of inducing resuscitation and supplementing mind, reinforcing memory and benefiting intelligence. ①Treatment considering from heart： The treatment could regulate blood and smooth mind and spirit by means of supplementing heart and inducing resuscitation, and the prescription of Kongsheng Zhenzhong Dan combined with Si Junzi Tang Jiajian decoction could be selected. ②Treatment considering from kidney： Liuwei Dihuang Tang adding extra ingredients, Zangui Wan, Dihuang Yinzi, Bushen Yizhi Fang and Bushen Fang were widely used in clinic to treat Alzheimer disease through the methods of reinforcing the kidney to replenishing easence, and nourishing marrow to refresh mind. At the middle and late periods, the methods of reinforcing the kidney to replenishing essence, and nourishing marrow to refresh mind were used to improve the urine and fecal incontinences and the living ability, so as to postpone the development of the disease. ③Treatment considering from sputum： The common used prescriptions were Ercheu Tang, Ditan Tang, Huanglian Wendan Tang, Baijin Wan, Houzao San, Suhexiang Wan and Xingnao Jing. ④Treatment considering from stasis： The prescriptions of leech plus green bristlegrass, sweet flag plus cat-tail pollen, astragalus root plus Chuanxiong were used at different periods of Alzheimer disease, all had satisfactory effects. RESULTS： Mental abnormality was the basic pathology of the onset of Alzheimer disease. The deficiencies of heart and kidney, stagnations of phlegm and stasis were the internal mechanism of mental abnormality. CONCLUSION： The general principles of the prevention and treatment of Alzheimer disease are inducing resuscitation and supplementing mind, reinforcing memory and benefiting intelligence. The treatment should be considered from heart, kidney, phlegm and stasis, which are all for the supplement of mind. The disease should be treated slowly close to its mechanism, the effect is more obvious if prevention combines with treatment.