九雀方联合盐酸多奈哌齐片对血瘀证阿尔茨海默病病人舌下络脉及血清PAF、VEGF水平的影响

Effects of Jiuque Prescription Combined with Donepezil Hydrochloride Tablets on Sublingual Venae and Levels of Serum PAF and VEGF in Alzheimer′s Disease Patients with Blood Stasis Syndrome

目的:探讨九雀方联合盐酸多奈哌齐片对血瘀证阿尔茨海默病(AD)病人舌下络脉及其血清血小板活化因子(PAF)、血管内皮生长因子(VEGF)水平的影响。方法:选取2019年5月—2021年5月于上海市第六人民医院就诊的AD血瘀证病人120例,按照随机数字表法分为对照组和干预组,每组60例。两组均给予基础治疗,同时对照组给予盐酸多奈哌齐片治疗,干预组给予九雀方联合盐酸多奈哌齐片治疗。两组疗程均为3个月。观察比较治疗前后两组病人疾病认知、舌下络脉变化及其血清PAF、VEGF的表达水平。结果:与治疗前比较,治疗后两组阿尔茨海默病评定量表认知部分(ADAS-cog)评分、日常生活功能量表(ADL)评分、神经精神科问卷(NPI)评分及舌下络脉积分均下降,蒙特利尔认知评估量表(MoCA)评分和简易智能量表(MMSE)评分、血清PAF及VEGF水平均升高,差异均有统计学意义(P<0.05或P<0.01)。治疗后,与对照组比较,干预组ADAS-cog评分、ADL评分、NPI评分及舌下络脉积分下降更明显,MoCA评分和MMSE评分、血清PAF及VEGF水平升高更明显,差异均有统计学意义(P<0.05)。对照组不良反应发生率为3.45%,干预组不良反应发生率为5.08%,两组比较差异无统计学意义(P>0.05)。结论:九雀方联合盐酸多奈哌齐片可以改善血瘀证AD病人的认知功能,其可能通过降低AD病人舌下络脉积分、提高血清PAF及VEGF水平从而发挥治疗血瘀证AD的作用。

Objective:To investigate the effects of Jiuque Prescription combined with donepezil hydrochloride tablets on the sublingual venae,serum platelet activating factor(PAF)and vascular endothelial growth factor(VEGF)in Alzheimer′s disease(AD)patients with blood stasis syndrome.Methods:A total of 120 AD patients with blood stasis syndrome were selected and divided into control group and intervention group according to random number table method,with 60 cases in each group.Both groups were given basic treatment,while the control group was treated with Donepezil hydrochloride tablets,and the intervention group was treated with Jiuque Prescription combined with Donepezil hydrochloride tablets.The treatment course of both groups was 3 months.The sublingual venae and the expression levels of serum PAF and VEGF were observed and compared between two groups before and after treatment.Results:Compared with data before treatment,after treatment,Alzheimer′s Disease Assessment Scale-Cognitive section(ADAS-cog)score,Activities of Daily Living(ADL)score,Neuropsychiatric Symptom Inventory(NPI)score,and sublingual venae score were all decreased,while Montreal Cognitive Assessment(MoCA)score,Mini Mental State Examination(MMSE)score,serum PAF and VEGF levels were all increased,with statistical significance(P<0.05 or P<0.01).After treatment,compared with the control group,the ADAS-cog score,ADL score,NPI score,and sublingual venae score were decreased more significantly in the intervention group,while the MoCA and MMSE scores,serum PAF and VEGF levels were increased more significantly,with statistical significance(P<0.05).The adverse reaction rate was 3.45%in the control group and 5.08%in the intervention group,and there was no statistical significance between two groups(P>0.05).Conclusion:Jiuque Prescription combined with Donepezil hydrochloride tablets can improve the cognitive function of AD patients with blood stasis syndrome,which may be related by reducing the sublingual venae score and increasing the levels of serum PAF and VEGF.