恒清Ⅱ号方联合盐酸多奈哌齐对阿尔茨海默病患者的疗效及其作用机制

Effects of HengqingⅡPrescribtion and Donepezil Hydrochloride on patients with Alzheimer’s disease and its mechanism

目的探讨恒清Ⅱ号方联合盐酸多奈哌齐对阿尔茨海默病(AD)患者的作用及机制。方法将2018年1月—2019年1月在上海交通大学附属第六人民医院就诊的107例AD患者按随机数字表法分为对照组(53例)和治疗组(54例)。两组均给予基础治疗。除基础治疗以外,对照组同时服用盐酸多奈哌齐片治疗,治疗组同时服用恒清Ⅱ号方+盐酸多奈哌齐片治疗。两组疗程均为3个月。两组治疗前后均记录AD评定量表认知部分(ADAS-cog)评分、日常生活功能量表(ADL)评分、蒙特利尔认知评估量表(MoCA)评分、神经精神科问卷(NPI)评分、简易智能量表(MMSE)评分;两组治疗前后均测定血清Aβ前体蛋白(APP)、β淀粉样蛋白1-42(Aβ1-42)、胱抑素C(Cys C)、同型半胱氨酸(Hcy)、白细胞介素1(IL-1)、IL-6和IL-10水平。同时记录两组不良反应发生情况。结果两组治疗后的ADAS-cog、NPI评分均低于治疗前,ADL、MoCA、MMSE评分均高于治疗前,血清APP、Aβ1-42、Cys C、Hcy、IL-1、IL-6及IL-10水平均低于治疗前,差异有统计学意义(P<0.05或P<0.01)。治疗后,治疗组的ADAS-cog、NPI评分均低于对照组,ADL、MoCA、MMSE评分均高于对照组,APP、Aβ1-42、Cys C、Hcy、IL-1、IL-6及IL-10水平均低于对照组,差异均有统计学意义(均P<0.05)。两组总不良反应率比较,差异无统计学意义(P>0.05)。结论恒清Ⅱ号方联合盐酸多奈哌齐可以显著改善AD患者的认知功能,其可能通过降低AD患者血清APP、Aβ1-42、Cys C、Hcy、IL-1、IL-6及IL-10水平从而起到治疗AD的作用。

Objective To explore the effects of HengqingⅡPrescribtion combined with Donepezil Hydrochloride on patients with Alzheimer’s disease(AD)and its mechanism.Methods A total of 107 AD patients admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital from January 2018 to January 2019 were randomly divided into control group(53 cases)and treatment group(54 cases)according to the random number table method.Both groups were given routine therapy.The control group was given Donepezil Hydrochloride Tablets on the basis of conventional treatment,and the treatment group was given HengqingⅡPrescribtion and Donepezil Hydrochloride Tablets on the basis of conventional treatment.The treatment course of both groups was three months.The cognitive scores of AD asesment scale-cognitive section(ADAS-Cog),activities of daily living(ADL),the montreal cognitive assessment scale(MoCA),neuropsychiatric inventory(NPI)and mini-mentalstateexamination(MMSE)were recorded before and after treatment.The levels of serum Aβprecursor protein(APP),Aβ1-42,homocysteine(Hcy),interleukin-1(IL-1),IL-6 and IL-10 were measured.Adverse reactions were recorded.Results The scores of ADAs-cog and NPI of both groups after treatment were lower than before treatment,the scores of ADL,MoCA and MMSE were higher than those before treatment,the levels of serum APP,Aβ1-42,Cys C,Hcy,IL-1,IL-6 and IL-10 were all lower than those before treatment,the differences were statistically significant(P<0.05 or P<0.01).After treatment,the scores of ADAs-cog and NPI of the treatment group were lower than those in the control group,the scores of ADL,MoCA and MMSE were higher than those in the control group,and the levels of APP,Aβ1-42,Cys C,Hcy,IL-1,IL-6 and IL-10 were lower than those in the control group the differences were statistically significant(all P<0.05).There was no significant difference in the total adverse reaction rate between the two groups(P>0.05).Conclusion HengqingⅡPrescribtion combined with Donepezil Hydrochloride can significantly improve cognitive function of AD patients,which was exerted by decreasing the levels of serum APP,Aβ1-42,Cys C,Hcy,IL-1,IL-6 and IL-10 of AD patients.