银杏叶提取物对阿尔茨海默病患者认知功能的效果及其对相关因子的影响

Effect of Ginkgo biloba extract on Cognitive Function of Senile Dementia Patients and Its Effect on Related Factors

目的:观察银杏叶提取物对阿尔茨海默病患者认知功能的改善效果以及探讨其部分作用机制。方法:将本院2013年1月至2014年1月收治的80例阿尔茨海默病患者随机分为对照组和观察组各40例。2组患者均口服盐酸多奈哌齐,1次/d,10 mg/次。在此基础上观察组患者加用银杏叶提取物注射液,2组均连续治疗3个月,分别比较2组患者治疗前、治疗1个月及治疗3个月后简易精神状态量表(MMSE)、画钟试验积分(CDT)、日常生活能力积分(ADL)的变化,以及检测2组患者治疗前后外周血清c AMP-PKA-CREB信号通路上标志性蛋白c AMP、PKA及CREB浓度的变化。结果:1)2组患者治疗前MMSE、CDT及ADL的积分差异无统计学意义(P>0.05),治疗1个月后2组患者MMSE、CDT及ADL积分较治疗前有所提升(P<0.05),组间差异无统计学意义(P>0.05);治疗3个月后2组患者MMSE、CDT及ADL积分进一步改善,其中观察组改善的幅度明显高于对照组,差异有统计学意义(P<0.05)。2)使用Elisa法检测c AMP、PKA浓度,用Western blotting检测CREB浓度,治疗前2组患者c AMP、PKA、CREB蛋白水平差异无统计学意义(P>0.05),治疗3个月后观察组患者外周血清c AMP、PKA、CREB蛋白浓度均明显高于对照组(P<0.05)。结论:银杏叶提取物可改善阿尔茨海默病患者认知能力,其作用机制可能通过介导c AMP-PKA-CREB信号通路有关。

Objective：To observe the improvement effect of the ginkgo biloba extract on the cognitive function in the patients with senile dementia,and discuse its mechanism.Methods：A total of 80 senile dementia patients in our hospital during in January 2013-January 2014 were randomly divided into control group and observation group,40 cases in each group.Both of the two groups orally took Donepezil HCL,once a day,10 mg/time.The observation group additionally had ginkgo biloba extract injection on these basis,both two group had continuous treatment for 3 months and then compare the two groups＇mini-mental state examination （MMSE）,clock drawing task （CDT）,activity of daily living （ADL）before treatment,and 1 month and 3 months after treatment,as well as detect two groups＇concentration changes of iconic proteins cAMP,PKA and CREB in patients with peripheral serum cAMP-PKA-CREB signaling pathways before and after treatment.Results：1）Integral differences of MMSE,CDT and ADL were showed no statistical significance in the two groups after the treatment （P 〉0.05）,the MMSE,CDT and ADL integral rose after 1 month＇s treatment in the two groups （P 〈0.05）,but there was no statistically significant differences between the two groups （P 〉0.05）;and 3 months after treatment,MMSE,CDT,ADL integral of the two groups further improved,which the improvement extent of observation group was significantly higher than the control group,the differences were statistically significant （P 〈0.05 ）.2）The cAMP,PKA concentration detected by Elisa method,and CREB concentration by Western blotting test showed no statistically significant differences between the two groups （P 〉0.05）,but 3 months after treatment,cAMP,PKA,and CREB protein concentrations in peripheral blood in the treatment group were significantly higher than that of control group （P 〈0.05）.Conclusion：Ginkgo biloba extract can improve the cognitive ability in patients with senile dementia,the mechanism may be related to cAMP-PKA-CREB signaling pathways.