从β类淀粉样蛋白等氧化损伤角度探讨健脾填精方对轻度认知障碍的作用机制

Discussion on Mechanism of Jianpi Tianjing Formula for Mild Cognitive Impairment from Amyloidβ-protein Oxidative Injury

目的:通过研究健脾填精方对轻度认知障碍(Mild Cognitive Impairment,MCI)患者血清中β类淀粉样蛋白(Aβ1-42)等氧化产物的影响,探讨本方作用机制;观察健脾填精方治疗MCI的临床疗效及安全性。方法:采用随机双盲方法,将100例MCI病人分成两组,治疗组50例应用"健脾填精方"(由人参、天麻、白术、巴戟天、黄连等组成),对照组50例应用"安慰剂",两组总疗程均为6月,检测两组患者用药前后血清中Aβ1-42、超氧化物歧化酶(SOD)、丙二醛(MDA)、乙酰胆碱酯酶(AchE)的浓度,观察治疗前后简易精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力量表(ADL)及中医症状积分值。结果:用药前后的MMSE、MoCA积分均显著提高,差异均有显著统计学意义(P<0.01);治疗组治疗前后ADL积分显著改善,差异有显著统计学意义(P<0.01);治疗组用药前后主要中医症状明显改善,两者差异有显著统计学意义(P<0.01);用药后治疗组较对照组血清Aβ1-42、MDA、AchE含量明显降低,差异有统计学意义(P<0.05或P<0.01);SOD含量明显升高,差异有统计学意义(P<0.05)。结论:健脾填精颗粒剂可以从改善血清β淀粉样蛋白的代谢功能、提高机体抗氧化损伤能力等角度增强MCI患者的记忆功能,提高生活质量,对延缓MCI的发展具有一定的临床意义。

Objective：Through the research of the influence of Jianpi Tianjing Formula on amyloidβ -protein（ Aβ1 - 42） ,etc. in MCI（ Mild Cognitive Impairment）patients;serum to discuss the function mechanism of Jianpi Tianjing Formula;to observe the clinical effects of Jianpi Tianjing Formula in MCI treatment;to assess the efficacy and the safety of Jianpi Tianjing Formula, so as to provide theoretical basis for putting Jianpi Tianjing Formula into clinical practice in the future. Methods ： 100 MCI patients were chosen in the department of gerontology in Zhejiang Hospital of Traditional Chinese Medicine by double blind and random method, and then they were divided into 2 groups of 50 in each one ： treatment group and control group. Treatment group adopted Jianpi Tianjing Formula （ginseng, gastrodia elata, white atractylodes roots, morinda officinalis, goldthread root, etc）, control group adopted placebo. The treatment lasted 6 months. Before and after treament, the following indexes including SOD, MDA, Ache, MMSE, MoCa, ADL and TCM symptoms integral quantity in the 2 groups patients＇serum were checked. Results：MMSE and MoCA score comparison：in treatment group after using Jianpi Tianjing Formula, MMSE and MoCA increased significantly. Comparing to that before treatment,the difference was statistically significant（P 〈 0.01 ）. ADL score comparison： in treatment group the ADL score after treatment significantly improved,the difference was statistically significant（P 〈 0.01 ）. TCM main syndromes effect comparison： in treatment group the TCM main syndromes improved significantly after treatment. Compared to that before treatment,the difference was statistically significant （P 〈 0. 01 ）. Comparison of the contents of Aβ1 - 42, SOD, MDA and AchE in serum ： compared to the control group, in treatment group they were dropped significantly after treatment, and the difference was statistically significant（ P 〈 0.05 or P 〈 0. 01 ） ; meanwhile SOD content increased significantly, the difference was statistically significant （ P 〈 0. 05 ）. Conclusion ： Jianpi Tianjing Formula can improve the metabolic function of amyloidβ - protein, enhance MCI patients＇memory function by improving the antioxidant injury ability and improve MCI patients＇life quality, and it also has certain clinical significance in the development delay of MCI.