基于“脑-肠轴”理论探究温脾开窍通络方治疗老年性痴呆的临床疗效及与肠道菌群的相关性

Exploring Clinical Efficacy of Wenpi Kaigiao Tongluo Prescription(温脾开窍通络方)in Treatment of Senile Dementia and lts Correlation with intestinal Flora Based on Theory of“Brain-Gut Axis”

目的基于“脑-肠轴”理论探究温脾开窍通络方治疗老年性痴呆的临床疗效及与肠道菌群的相关性。方法选择2020年5月—2022年7月门诊治疗收集的40例老年性痴呆患者,以随机数字表法分为治疗组(20例)与对照组(20例)。对照组接受常规西医治疗,治疗组在对照组基础上接受温脾通络开窍方治疗。两组均治疗8周,对比两组中医证候评分、认知功能、肠道菌群相关指标、炎症反应、不良反应及临床疗效。结果治疗后,两组主症、次症及总评分均降低(P<0.05),且治疗组更低(P<0.05)。治疗后,两组简易智能精神状态检查量表(Mini-mentalstateexamination,MMSE)评分均升高(P<0.05),但两组MMSE评分比较差异无统计学意义(P>0.05);治疗后,两组血浆5-羟色胺水平均升高(P<0.05),但两组治疗后血浆5-羟色胺水平比较差异无统计学意义(P>0.05)。治疗后,两组血清白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子α(tumornecrosisfactorα,TNF-α)水平均降低(P<0.05),且治疗组更低(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。两组总有效率比较差异无统计学意义(P>0.05)。结论基于“脑-肠轴”理论探究温脾开窍通络方可改善老年性痴呆患者的认知功能,疗效显著,减轻炎症反应,调节肠道菌群,且安全性良好。

0bjectiwe To explore the clinical elficacy of Wenpi Kaiqiao Tongluo Preseription(温牌开窍通络方)in the treat ment of senile dementia and its comelation with intestinal flora based on the theory of“bmain-gut axis”.Methods Forty Alzhei mer's disease patients in the outpatient treatment from May 2020 to July 2022 were selected and divided into treatment group(20 cases)and control group(20 cases)by random number table method.The contrl grup received conventional Westem medicine treatment,and the treatment group received Wenpi Kaiqiao Tongluo Prescripion on the basis of the control group.The two groups were treated for 8 weeks,and the TCM syndme scores,cognitive function,intestinal flora related indexes,infammatory response adverse reactions and clinical eflicacy were compared between the two groups.Results After treatment,the scores of main symp toms and secondary symptoms and total scores of two grup$were decreased(P<0.05),and the scores of the treatment group was lower(P<0.05).After treatment,the mini-mental state examination(MMSE)scores of both groups were inereased(P<0.05),but there was no significant difference in MMSE scores between the two groups(P>0.05).After treatment,the plasma levels of serotonin were inereased in both groups(P<0.05),but there was no staistical significance in the plasma levels of sero tonin between the two groups(P>0.05).After treatment,the serum levels of interleukin-1β(1L-1β).inteneukin-6(1L-6) and tumor necrosis factorα(TNF-α)were deereased in both groups(P<0.05),and those were lower in the treatment groug(P<0.05).There was no sigmificant difference in the total ineidence of adverse reactions between the two groups(P>0.05).There was no significant diference in total elfective rte between the two groups(P>0.05).Conchsion Based on the theory of“brain-gut axis”,the study explored that Wenpi Kaiqiao Tongluo Preseription could improve the cognitive function of patients with senile dementia,reduce inflammation and regulate intestinal flora with remarkable efficacy and good safety.