中医药防治老年性痴呆研究中几个关键问题的思考

Several Key Points for the Prevention and Treatment of Alzheimer's Disease in Traditional Chinese Medicine

老年性痴呆 (阿尔茨海默病 ,Alzheimer’sdisease ,AD)是一种原因未明、以认知功能减退为主要临床表现的神经系统退行性疾病 ,已成为世界范围内危害人类健康最严重的疾病之一。中医药防治AD的研究是近年的研究热点。为深入开展AD防治的研究 ,寻找有效的防治方法 ,改善和提高患者的生存质量 ,结合AD现代医学研究进展 ,就中医药防治AD研究中的几个重要问题进行了较为系统的阐述。强调在中医药防治AD的研究中应注重科学地选择和应用权威的AD临床诊断标准 ;选择多因素复合动物模型 ;注意AD的肾虚本质特征和病因病机特点 ;注意观察指标特异性、敏感性和稳定性的综合考虑 ,强调功能整合水平观察指标的评价 ;充分认识中药复方的多途径、多靶点作用优势 。

Alzheimer's disease(AD) is a neuronal degenerative disease manifested by progressive reduced cognitive function. It is one of the most serious diseases that affects the health of the aged population and the traditional Chinese medicine (TCM) for its prevention and treatment is a recent studying focus. In this article, several main points regarded to the prevention and treatment for AD was systemically discussed. For the animal model of AD, a multiple-factor-combined model was suggested; for clinical diagnosis of AD, an authorized diagnosis standard should be intellectually choosen and applied;for the etiology and mechanisms, especially kidney deficiency should be taken into account; for the appraisal and evaluation of TCM treatment in AD, the specificity, sensitivity and stability of observation index should all be taken under consideration, and the integrated functional level is specially recommended; the advantage of multi-way and multi-target of Chinese herbal compound should be fully recognized; and the randomized, double-blind,placebo-controlled clinical trials should be strictly conducted.