Discussion about the Treatment of Alzheimer's Disease with Yisui Fuyong Decoction Based on Synaptic Plasticity

For Alzheimer's disease(AD),the earliest symptom is memory loss,which runs throughout the disease.The mutual growth and decline of long-term potentiation(LTP)and long-term depression(LTD)in synaptic plasticity is the basic condition of learning and memory.In the early stage of AD,there is no significant change in synaptic plasticity,so the treatment should mainly focus on warming yang and replenishing qi.In the middle stage of AD,LTP is continuously damaged and reduced,and synaptic plasticity is destroyed,such as weakness of the spleen and stomach,causing stagnation of endogenous retention of phlegm in the brain,so the treatment should focus on enriching yin and tonifying yang,resolving phlegm to remove stagnation.In the late stage of AD,due to excessive deposition of amyloid and other metabolites,neurotoxins are produced and brain atrophy is aggravated,such as depression leading to stasis,phlegm and stasis binding together,long term of stasis turning to heat toxin,which invades the brain,excessive heat damages yin,then both yin and yang are damaged,finally,the brain collateral loses nutrition,so the treatment should focus on replenishing essence and reinforcing marrow,detoxifying and resolving stasis.Yisui Fuyong Decoction can replenish essence and reinforce marrow to nourish yin,warm yang and tonify qi to strengthen yang,combine phlegm resolving,stasis elimination and collateral vessels dredging,realizing the treatment effects in all three stages of synaptic plasticity.

体阴用阳治脑病

脑白质病变的核心病机是髓海不足,痰瘀阻络,神机受损,其根本在于阳化气、阴成形失司。脑为体阴用阳之腑,"阳化气,阴成形",应益精填髓补其形之阴、温阳益气复其阳之用,兼顾化痰祛瘀通络。地黄饮子具有补肾益精,化痰开窍之功,常用于治疗中风失语,两足痿弱之症。临证在地黄饮子基础上,自拟益髓复用汤治疗脑白质病变,取得佳效。

“体阴用阳治脑病”理论下益髓复用汤治疗痴呆的效果

目的探讨“体阴用阳治脑病”理论下益髓复用汤治疗痴呆的效果。方法选取2020年7月至2022年7月收治于成都中医药大学第四临床医学院的老年期痴呆患者78例,根据随机数字表法将其分为治疗组和对照组,每组39例。对照组给予盐酸多奈哌齐片,治疗组在对照组基础上加用益髓复用汤,两组均治疗6个月。比较两组治疗前后简易精神状态检查量表(MMSE)、Barthel指数、血清同型半胱氨酸(Hcy)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、中医症状积分和治疗后临床效果。结果治疗后,两组MMSE、Barthel指数评分均较治疗前升高,且治疗组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组Hcy、TNF-α和IL-6水平较治疗前降低,且治疗组TNF-α和IL-6水平低于对照组,差异有统计学意义(P<0.05);两组Hcy水平比较,差异无统计学意义(P>0.05)。治疗后,两组中医症状积分较治疗前降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组治疗效果优于对照组,差异有统计学意义(P<0.05)。结论“体阴用阳治脑病”理论下益髓复用汤治疗痴呆可提高效果,改善患者临床症状,值得临床推广应用。