Effect of reinforcing kidney-essence, removing phlegm, and promoting mental therapy on treating Alzheimer's disease

OBJECTIVE: To explore the mechanism of reinforcing kidney-essence, removing phlegm, and promoting mental therapy in treating Alzheimer's disease (AD). METHODS: Sixty patients with AD in Wuhan No.1 Hospital of Traditional Chinese Medicine for Geriatrics from May 2009 to April 2011 were randomly divided into two groups, with 30 in each group. Patients in Bushenhuatanyizhi group (BHY group) took BHY instant granules (6 g, twice per day). Patients in the control group took piracetam (0.8 g, 3 times per day). There were twelve weeks in a course. Changes in the mini-mental state examination (MMSE) score and Activity of Daily Living Scale (ADL) score were analyzed before and after treatment. RESULTS: MMSE scores in the two groups in-creased and ADL scores decreased after treatment, compared with those before treatment (both P< 0.05).The total effective rate was 86.67% in the BHY group (10 very effective, 13 effective, 7 non-responsive). The control group was 57.69% (5 very effective, 16 effective, 9 non-responsive) (P<0.05). Superoxide dismutase levels were increased, lipid peroxide and triglyceride levels decreased after treatment in the BHY group as compared with the control group. CONCLUSION: Reinforcing kidney-essence, removing phlegm, and promoting mental therapy can improve cognitive function and daily life of AD patients. The mechanism of the therapy might be related to improving blood fat, scavenging free radicals, and inhibiting lipid peroxides.

Study of Serum Metabonomics and Formula-Pattern Correspondence in Coronary Heart Disease Patients Diagnosed as Phlegm or Blood Stasis Pattern Based on Ultra Performance Liquid Chromatography Mass Spectrometry

Objectives： To study the characteristics of serum metabonomics in coronary heart disease （CHD） patients diagnosed as phlegm or blood stasis pattern and explore effects of formula-pattern correspondence treatment. Methods： A total of 102 stable CHD patients were enrolled and divided into phlegm group （P group, n=52） and blood stasis group （BS group, n=50） according to pattern identification. Gualou Xiebai Banxia Decoction （瓜萎薤白半夏汤, GXBD） and Xuefu Zhuyu Decoction （血府逐瘀汤, XZD） were used as drug interventions. Relevant indicators of metabonomics were observed by ultra performance liquid chromatography mass spectrometry （UPLC-MS） and pattern recognition. Results： Levels of amino acids and phosphatidylethanolamine （PE） in the CHD group were much higher than those in healthy control group, while the levels of unsaturated fatty acids, sphingosine, Lyso, phosphatidylcholine （PC） were significantly lower （P〈0.01）. Most of the differential metabolites between the CHD and the healthy groups were also common metabolites of phlegm and blood stasis. 7（Z）, 10（Z）- hexadecadienoic acid and DPA were decreased in the P group and increased in the BS group. According to the quantity of retraced metabolites, improvement in metabonomics by formula-pattern correspondence was superior to that without correspondence in the BS group. Based on the varieties of metabolites, GXBD could improve the levels of docosapentaenoic acid （DPA）, sphingomyelin （SM） （d34：1）, and L-Lactic acid and XZD could ameliorate the levels of sphingosine and Vit E in the P group, in the BS group, GXBD could improve vitamin E level and XZD could make improvements in the levels of octadecanoic acid, phosphoglycerol, and SM （d34：1）. Conclusions： Phlegm and blood stasis in CHD patients present specific differential metabolites, and share common metabolites. Remarkable differences have been displayed in pathological properties and severity of phlegm and blood stasis. Patients with phlegm are more likely to have lipid metabolism disorders. However, in patients with blood stasis, problems mainly lie in glucose, protein and fat metabolism and the injury of vascular cell membrane is relatively severe. The metabolic disorder is more complicated in blood stasis pattem than that in phlegm pattem. Compared with non-correspondence, improvement of differential metabolites is more comprehensive and targeted in formulapattern correspondence with a better effect.