中西医结合治疗老年性痴呆的临床研究

Clinical study on treatment of dementia by integrative medicine

目的探讨石杉碱甲（哈伯因）加补肾益髓养脑化痰汤剂为主的中西医结合疗法，与单纯西药石杉碱甲及单纯中药补肾益髓养脑化痰汤剂治疗轻、中度老年性痴呆患者的临床效果。方法选择轻、中度老年性痴呆的患者90例，完全随机分为3组：联合用药组30例口服石杉碱甲加补肾益髓养脑化痰汤剂；石杉碱甲组30例单纯应用石杉碱甲0．1mg，2次／d；中药组30例单纯应用补肾益髓养脑化痰汤剂。3组的治疗观察时间3个月。分别于治疗前和治疗后1、2、3个月分别进行认知功能，应用简易智能量表和日常生活活动能力量表进行评估。结果联合用药组在治疗3个月后，认知功能较治疗前有显著改善[（18．5±4．0）比（15．6±3．2），P〈0．05]。生活自理能力2个月后较治疗前有显著提高[（42．2±16．2）比（44．6±15．9）．P〈0．05]，石杉碱甲组3个月后较治疗前有显著提高[（42．9±16．4）比（45．4±16．0），P〈0．05]。中药组无变化。认知功能单纯石杉碱甲和单纯中药治疗组无统计学意义。结论联合用药组3个月评估认知功能的改善、生活自理能力的提高，均优于单纯石杉碱甲和单用中药治疗组。

Objective To contrast the clinical effects of traditional Chinese and western medicine by Huperzine A and BuShenYiSuiYangNaoHuaTanTang on Alzheimer＇s disease. Methods Ninety patients with mild or moderate Alzheimer＇s disease were divided into 3 groups： 30 patients were in combined therapy group; 30 patients were in Huperzine A group and 30 patients were in Chinese medicine group. Cognitive Function and Activities of Daily Living were measured by mini-mental state examination （MMSE） and activities of daily living rating scale （ADL） separately before and l, 2, 3 months after therapy. Results Cognitive Function and activities of daily living were improved in combined therapy group （18.5± 4.0, P 〈 0.05 ） （42.2± 16.2, P 〈 0.05 ）, and no improve- ment was observed in Chinese medicine group. No difference of Cognitive Function was found between Huperzine A group and Chinese medicine group before and after the therapy. Conclusion Combined Huperzine A and Chinese medicine therapy shows better improvement of cognitive function and daily activities than Huperzine A group and Chinese medicine group.