中医综合疗法治疗血管性痴呆的疗效及对患者脑神经递质的影响

Impact of Comprehensive Therapy of TCM on Clinical Effect and Brain Neurotransmitter in Patients with Vascular Dementia

目的:观察中医综合治疗方案治疗血管性痴呆的临床疗效,并探讨其作用机制。方法:采用多中心、随机对照试验的设计方法,将203例本病患者分为治疗组(103例)和对照组(100例),两组均予内科基础治疗。治疗组予中医综合治疗,对照组予盐酸多奈哌齐片、康复训练。观察治疗前后两组认知功能疗效、行为能力疗效、脑电地形图改变和脑神经递质水平的变化。结果:两组均可以提高认知功能和行为能力临床疗效,且治疗组的作用明显优于对照组(P<0.05);治疗组治疗后脑电地形图疗效的改善较对照组明显(P<0.05);治疗组治疗后患者全脑Ach、NE、DA和5-HT均明显改善(P<0.05或P<0.01),且治疗组改善作用明显优于对照组(P<0.05)。结论:中医综合治疗方案能有效地改善VD患者的认知和行为能力及脑电地形图,其机制可能与改善患者脑内神经递质水平有关。

Objective： To observe the clinical therapeutic effect of Comprehensive Therapy of TCM on vascular dementia（VD） and its function mechanism. Methods： A multi-center, randomized, parallel-controlled trial was conducted. The 203 VD patients were randomly divided to treatment group of Chinese Medicine（103 cases） and control group of western medicine（100cases）. All patients＇ cognitive function and behavior ability were assessed by MMSE and Blessed Behavior Scale（BBS） to evaluate the therapeutic effect after treatment. Brain wave topgraphic map and changes of neurotransmitter of two groups before and after treatment were observed to evaluate the therapeutic effect. Results： Both treatment group and control group remarkably improved the clinical curative effect of cognition and activity, while treatment group has a better curative effect than control group（P〈0.05）. Compared with control group, brain wave topgraphic map of treatment group was better in curative effect（P〈0.05）.Treatment group could significantly improve acetylcholine（Ach）, dopamine（DA）, 5-hydroxytryptamine（5-HT） and noradrenaline（NE） of whole brain（P0.05 or P0.01）, and the treatment group was superior to the control group in the improvement（P0.05）.Conclusion： The comprehensive therapy of TCM is effective on cognition and activity of VD and its mechanism is possibly related with the improvement of brain neurotransmitter.