中西医结合疗法对阿尔茨海默病认知功能和精神行为的影响

Effects of integrated Traditional Chinese and Western medicine on cognitive function and mental behavior in Alzheimer's disease

目的:观察中西医结合疗法对阿尔茨海默病认知功能、精神行为的影响。方法:200例阿尔茨海默病患者根据治疗方法分为对照组和观察组,每组各100例。对照组口服多奈哌齐片,观察组患者在对照组基础上加用复方苁蓉益智胶囊并联合针刺。对比两组治疗的临床效果、简易智能状态量表(MMSE)、日常生活能力(ADL)量表、阿尔茨海默病行为病理学量表(BEHAVE-AD)评分、尿阿尔茨海默病相关神经丝蛋白(AD7c-NTP)含量、单胺类递质水平及不良反应发生情况。结果:观察组有效率高于对照组(P<0.05)。治疗后,观察组的认知能力MMSE、日常生活能力ADL评分高于对照组(P<0.05);情感障碍、焦虑与恐惧、幻觉、日夜节律紊乱低于对照组(P<0.05),但偏执和妄想观念、行为紊乱评分比较,差异无统计学意义(P>0.05)。治疗后3、6个月,观察组患者的尿AD7c-NTP含量均低于对照组(t=7.697、24.130,P<0.05);治疗后,与对照组比较,观察组患者的血清中神经递质5-HT、GAB均升高(t=-8.831、-8.105,P<0.05)。对照组不良反应发生率高于观察组(P=0.030)。结论:中西医结合疗法更利于改善阿尔茨海默病患者的认知功能、日常生活能力、精神行为,可能与降低尿AD7c-NTP含量、增加体内神经递质分泌有关。

Objective:To observe the effects of integrated Traditional Chinese and Western medicine on cognitive function and mental behavio in Alzheimer's disease.Methods:A total of 200 patients with Alzheimer's disease were divided into control group and observation group according to the random number table method,100 cases in each group.In the control group,donepezil tablets were taken orally.Patients in the observation group were added with compound Cistanche Yizhi capsule and combined with acupuncture on the basis of the control group.The clinical effect,MMSE,ADL,BEHAVING-AD,urinary Alzheimer's disease related neurofilament protein(AD7C-NTP),monoamine transmitter levels and adverse reactions of the two groups were compared.Results:The effective rate in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the MMSE and ADL scores of cognitive ability and daily life ability of the observation group were significantly higher than those of the control group(P<0.05),affective disorder,anxiety and fear,hallucination and disturbance of circadian rhythm were significantly lower than those of the control group(P<0.05),but there were no statistically significant differences in the scores of paranoid and delusional concepts and behavioral disorders(P>0.05).3 months and 6 months after treatment,urine AD7C-NTP content in the observation group was significantly lower than that in the control group(t=7.697,24.130,P<0.05).After treatment,the levels of 5-HT and GAB in the serum of the patients in the observation group were significantly higher than those in the control group(t=-8.831,-8.105,P<0.05).The incidence of adverse reactions in the control group was significantly higher than that in the observation group(χ^(2)=4.735,P=0.030).Conclusion:The combination of Traditional Chinese and western medicine is more beneficial to the improvement of the cognitive function,daily life ability and mental behavior of Alzheimer's disease patients.It is speculated that the reason may be related to the decrease of urinary AD7C-NTP content and the increase of neurotransmitter secretion in the body.