阿尔茨海默病治未病之从肾论治

Preventive treatment of Alzheimer’s disease:Treatment from kidney

阿尔茨海默病(AD)是一种以认知损害为主要临床特征的神经退行性疾病。其病程是从无症状的临床前AD、轻度认知损害到痴呆的连续谱,病理生理学改变可早于临床症状数十年。由于现有常规治疗适应证需满足痴呆诊断,且只有短期认知获益,不能延缓疾病进展,2022年世界阿尔茨海默病日提出AD诊治的未来方向在于“早防早智”;但现有临床诊疗框架在AD早期诊断及早期干预手段有限。本团队前期研究发现AD始于肾虚,早期治当补肾,是以本研究在中医治未病理念指导下,提出“从肾论治”的中医AD治未病防治策略三部曲,为达成AD“早防早智”的临床目标提供了新思路。

Alzheimer’s disease(AD)is a neurodegenerative disease featuring in cognitive impairment.The course of AD is a continuum that ranges from asymptomatic preclinical AD,mild cognitive impairment(MCI),to dementia,during which pathophysiological changes can precede clinical symptoms by decades.The conventional treatment has several limitations.Firstly,it can only be applied to those who meet the diagnostic criteria of dementia,but not preclinical AD and MCI;secondly,it can only provide cognitive benefits in a short term but cannot delay or put a stop in the progression of disease.Given that,there has been a consensus that the best chance to intervene is at the early stage of the AD continuum.However,the current clinical framework is having difficulty with early diagnosis and intervention.Previous studies of our research group found that AD starts from kidney deficiency;reinforcing kidney in the early stage of AD was proposed and verified.By combining previous findings and the theory of preventive treatment of disease,in this study we developed a three-step AD prevention and treatment strategy of‘treating from the kidney’,providing an alternative approach to AD clinical early prevention and intervention.