补脾益肾汤治疗阿尔茨海默病35例

Effect of Bupi Yishen Decoction in Treating 35 Cases with Alzheimer's Disease

目的:探讨补脾益肾汤治疗阿尔茨海默病(AD)的疗效及对氧化应激的影响。方法:66例AD患者随机按数字表法分为对照组31例和观察组35例。对照组口服盐酸多奈哌齐片,10 mg·d-1;观察组采用补脾益肾汤加减内服,每天1剂。两组疗程均为6个月。进行治疗前后简易精神状态量表(MMSE),AD评定量表的认知次级量表(ADAS-cog),日常生活功能量表(ADL)及中医证候评分;检测治疗前后超氧化物歧化酶(SOD)水平,丙二醛(MDA),总抗氧化能力(T-AOC),人8-异构前列腺素F2α(8-iso-PGF2α)和氧化低密度脂蛋白(ox-LDL)水平。结果:经Ridit分析,观察组MMSE疗效和ADAS-cog疗效均优于对照组(P<0.05);治疗后观察组中医证候评分,ADL,ADAS-cog评分低于对照组(P<0.01),治疗后观察组MMSE评分高于对照组(P<0.01);治疗后观察组血清MDA,8-iso-PGF2α和ox-LDL水平均低于对照组(P<0.01),治疗后观察组SOD和T-AOC水平高于对照组(P<0.01)。结论:补脾益肾汤能提高轻、中度AD患者的认知功能、生活自理能力,临床疗效优于盐酸多奈哌齐片,其作用机制可能与抗氧化及自由基损伤有关。

Objective： To discuss the curative effects of Bupi Yishen decoction in treating Alzheimer＇s disease and to investigate its influence on oxidative stress. Method： Sixty-six patients were randomly divided into the control group （31 cases） and the observation group （35 cases）. Patients in the control group received 10 mg donepezil hydrochloride tablets once daily. Patents in the observation group received 1 does Bupi Yishen decoction, once daily. All patients in two groups received 6 months of treatment. Scores of minimum mental state examination （MMSE）, Alzheimer＇s disease assessment scale-cognitive subscale （ADAS-cog）, activity of daily living scale （ADL） and traditional Chinese medicine syndrome were conducted. Levels of oxide dismutase （SOD）, malondialdehyde （ MDA）, total antioxidant capacity （ T-AOC ）, 8-heterogeneous prostaglandin F2α （ 8-iso- PGF2α） and oxidized low density lipoprotein （ox-LDL） were detected before and after the therapy. Result： The efficacy scores of MMSE and ADAS-cog in the observation group were higher than those in the control group （P 〈0. 05）. Scores of traditional Chinese medicine syndromes, ADL, ADAS-cog in the observation group were lower than those in the control group （P 〈 0.01 ） , while the MMSE score was higher than that in the control group （P 〈 0. 01 ）. After treatment, levels of MDA, 8-iso-PGF2a and ox-LDL were lower, and levels of SOD and T-AOC were higher in the observation group than those in the control group （P 〈 0.01 ）. Conclusion： Bupi Yishen decoction could enhance cognitive function and life self-care ability in patients with mild to moderate AD. Its curative effects are superior to donepezil hydrochloride tablets. Its mechanism may be related to antioxidant and antagonizing free radical damage.