阿尔茨海默病患者治疗各时点中医证型研究

Study on Chinese Medicine Syndrome Types in Different Phases of Alzheimer’s Disease

目的:研究阿尔茨海默病(Alzheimer’s disease,AD)患者在治疗不同时点中医证型的分布特点及与量表相关的证型人数比例。方法:对入组的66例轻中度和25例重度AD患者,通过每月1次的中医辨证,心气虚证用调心方,肾精虚证用补肾方进行治疗,2次/d,疗程48周。研究AD患者中医证型分布特点,并结合简易智能状态检查量表(MMSE)和日常生活能力量表(ADL)的检测,观察患者中医证型的人数比例。结果:轻中度患者心气虚人数比例高于重度患者,重度患者中肾精虚人数比例高于轻中度患者,结合神经心理学量表,心气虚证有效人数比例高于肾精虚证,恶化人数比例低于肾精虚证。结论:轻中度AD患者以心气虚证为主,重度患者以肾精虚证为主;心气虚证易治,肾精虚证则难治。

Objective ：To explore the distribution pattern and occurrence proportion of various types of Chinese medicine syndrome in different phase of Alzheimer ＇ s disease （AD）. Methods：Sixty-six mild to moderate AD patients and 25 severe AD patients were includ- ed to receive monthly treatment of TCM syndrome differentiation. Patients with Heart-qi deficiency were treated by Tiaoxin Formula and patients with Kidney-essence deficiency were treated by Bushen Formula, twice a day for 48 weeks as the therapeutic course. The distri- bution pattern and occurrence proportion of various types of Chinese medicine syndrome were studied using Mini Mental State Examina- tion （MMSE） and Activity of Daily Living Scale （ADL） testing. Results：The proportion of the patients with Heart-qi deficiency was higher among mild to moderate AD patients than that among severe AD patients. The proportion of the patients with Kidney-essence defi- ciency was higher among severe AD patients than that among mild to moderate AD patients. According to neuropsychologieal testing, the response rate of treatment in patients with Heart-qi deficiency was higher than that in patients with Kidney-essence deficiency; the dis- ease deterioration rate in patients with Heart-qi deficiency was lower than that in patients with Kidney-essence deficiency. Conclusion： AD patients with mild to moderate disease usually suffer Heart-qi deficiency, while patients with severe disease mainly suffer Kidney-essence deficiency. Chinese medicine syndrome type of Heart-qi deficiency is easier to be treated compared to the type of Kidney-essence deficiency.