补肾填髓益智方联合常规疗法治疗肝肾亏虚型阿尔茨海默病临床研究

Clinical Study on Bushen Tiansui Yizhi Prescription Combined with Routine Therapy for Alzheimer's Disease of Liver-Kidney Deficiency Type

目的:观察补肾填髓益智方联合常规疗法治疗轻、中度肝肾亏虚型阿尔茨海默病(AD)的效果。方法:选择100例轻、中度肝肾亏虚型AD患者,随机分为联合组和对照组各50例。2组患者均予服用盐酸多奈哌齐片、认知功能训练等常规疗法治疗,联合组加予补肾填髓益智方治疗。2组均治疗8周。治疗前后评定中医证候评分、认知功能[简易精神状态量表(MMSE)评分,AD评定量表(ADAS-Cog)评分]、精神行为症状评分[简易神经精神量表(NPI)评分,AD病理行为评定量表(BEHAVE-AD)评分],检测炎性因子[白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),白细胞介素-1β(IL-1β)]水平。比较2组的临床疗效。结果:治疗8周后,联合组总有效率高于对照组(P<0.05)。联合组中医证候积分较治疗前下降(P<0.05),亦低于对照组(P<0.05)。2组MMSE评分均较治疗前升高(P<0.05),联合组MMSE评分高于对照组(P<0.05)。2组ADAS-Cog评分、NPI评分、BEHAVE-AD评分均较治疗前降低(P<0.05),联合组3项评分均低于对照组(P<0.05)。2组IL-6、TNF-α、IL-1β水平均较治疗前降低(P<0.05),联合组IL-6、TNF-α、IL-1β水平均低于对照组(P<0.05)。结论:应用补肾填髓益智方联合常规疗法治疗轻、中度肝肾亏虚型AD患者疗效显著,可有效减轻炎症反应,改善患者的精神行为症状,提高患者的认知功能。

Objective:To observe the effect of Bushen Tiansui Yizhi Prescription combined with routine therapy for Alzheimer's disease(AD)of liver-kidney deficiency type.Methods:A total of 100 cases of patients with mild to moderate AD of liver-kidney deficiency type were randomly divided into the combination group and the control group,with 50 cases in each group.Both groups were treated with routine therapy like Donepezil Hydrochloride Tablets and cognitive function training,and the combination group was additionally treated with Bushen Tiansui Yizhi Prescription.Both groups were treated for eight weeks.Traditional Chinese medicine(TCM)syndrome scores,cognitive function[Mini-mental State Examination(MMSE)scores,Alzheimer's Disease Assessment Scale-Cognitive Section(ADAS-Cog)scores],and the scores of behavioral and psychological symptoms[Neuropsychiatric Inventory(NPI)scores,rating scale of the behavioral pathology in Alzheimer's disease(BEHAVE-AD)scores]wereevaluated before and after treatment;the levels of inflammatory factors[(interleukin-6(IL-6),tumor necrosis factorα(TNF-α),interleukin-1β(IL-1β)]were detected.The clinical effects in the two groups were compared.Results:After eight weeks of treatment,the total effective rate in the combination group was higher than that in the control group(P<0.05).The TCM syndrome score in the combination group was decreased when compared with that before treatment(P<0.05),and the score was lower than that in the control group after treatment(P<0.05).The MMSE scores in the two groups were increased when compared with those before treatment(P<0.05),and MMSE score in the combination group was higher than that in the control group(P<0.05).The scores of ADAS-Cog,NPI and BEHAVE-AD in the two groups were decreased when compared with those before treatment(P<0.05),and the three scores in the combination group were lower than those in the control group(P<0.05).The levels of IL-6,TNF-αand IL-1βin the two groups were decreased when compared with those before treatment(P<0.05),and the levels of IL-6,TNF-αand IL-1βin the combination group were lower than those in the control group(P<0.05).Conclusion:The application of Bushen Tiansui Yizhi Prescription combined with routine therapy for patients with mild to moderate AD of liver-kidney deficiency has a significant curative effect,which can effectively alleviate inflammatory responses,improve the behavioral and psychological symptoms of patients,and enhance their cognitive function.