补肾祛痰化瘀健脑法在治疗阿尔茨海默病中作用及对患者智力状态及生活能力的影响OA
Effect of Tonifying Kidney,Expelling Phlegm,Removing Blood Stasis and Strengthening Brain Method in Treatment of Alzheimer's Disease and Its Influence on Mental State and Living Ability of Patients
目的 研究补肾祛痰化瘀健脑法在治疗阿尔茨海默病中作用及对患者智力状态及生活能力的影响.方法 选取2023年4月—2024年1月医院诊治的阿尔茨海默病患者80例,采用单双号法对患者进行分组,分为观察组、对照组,每组40例.对照组采用西药盐酸多奈哌齐治疗,观察组采用补肾祛痰化瘀健脑法联合西药盐酸多奈哌齐治疗,均用药12周,比较两组患者症状(中医证候评分)、智力状态[阿尔茨海默病评定量表认知分表(Alzheimer's Disease Assessment Scale-cognitive subscale,ADAS-Cog)、简易精神状态检查量表(Mini-Mental State Examination,MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)]、生活能力[日常生活能力量表(Activity of Daily Living Scale,ADL)]、血清指标[β-淀粉样蛋白(amyloid β-protein,Aβ)、磷酸化 Tau(phosphorylated Tau protein,p-Tau)蛋白、促肾上腺皮质激素释放因子(corticotropin-releasing factor,CRF)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)和皮质醇(corti-sol,CORT)]及不良反应情况.结果 治疗后,观察组中医证候二便失禁、腰膝酸软、耳鸣耳聋、夜尿频多评分均显著下降(P＜0.05),并且观察组低于对照组(P＜0.05);治疗后,两组ADAS-Cog、MMSE、MoCA评分以及ADL评分均显著改善(P＜0.05),观察组优于对照组(P＜0.05);治疗后,两组血清Aβ、p-Tau蛋白、CRF、ACTH、CORT水平均显著改善(P＜0.05),观察组优于对照组(P＜0.05).两组均无严重不良反应发生.结论 补肾祛痰化瘀健脑法治疗阿尔茨海默病能够显著改善患者症状,提高其智力状态及生活能力,可以作为安全、有效的优选治疗方案.
Objective To study the effect of the tonifying kidney,expelling phlegm,removing blood stasis and strengthening brain method on the mental state and living ability of patients with Alzheimer's disease.Methods Eighty patients with Alzheimer's disease diagnosed and treated in the hospital from April 2023 to January 2024 were selected.The patients were divided into ob-servation group and control group by single and double number method,with 40 cases in each group.The control group was trea-ted with donepezil hydrochloride,while the observation group was treated with the method of tonifying kidney,expelling phlegm,removing blood stasis and strengthening brain combined with donepezil hydrochloride.Both groups were treated for 12 weeks.The symptoms(TCM syndrome scores),mental state[Alzheimer's Disease Assessment Scale-cognitive subscale(ADAS-Cog),Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA)],living ability[Activity of Daily Living Scale(ADL)],serum indicators[amyloid β-protein(Aβ),phosphorylated Tau protein(p-Tau)protein,corticotropin-releasing fac-tor(CRF),adrenocorticotropin-releasing factor(CRF),adrenocorticotropic hormone(ACTH)and cortisol(CORT)]and adverse reactions were compared between the two groups.Results After treatment,the scores of TCM syndromes of incontinence,soreness and weakness of waist and knees,tinnitus and deafness,and frequent nocturia in the observation group were significantly de-creased(P＜0.05),and those indexes in the observation group were lower than those in the control group(P＜0.05).After treatment,the ADAS-Cog,MMSE,MoCA scores and ADL scores of the two groups were significantly improved(P＜0.05),and the results of the observation group were better than those of the control group(P＜0.05).After treatment,the levels of serum Aβ,p-Tau protein,CRF,ACTH and CORT in the two groups were significantly improved(P＜0.05),and those in the observa-tion group were better than those in the control group(P＜0.05).No serious adverse reactions occurred in both groups.Conclu-sion The method of tonifying kidney,expelling phlegm,removing blood stasis and strengthening brain can significantly improve the symptoms,the intellectual status and living ability in the treatment of Alzheimer's disease,and can be used as a safe and effective preferred treatment plan.
刘美真;周蓉靖;陈慧丽;吴王芳;凌军
浙江中医药大学附属宁波市中医院,浙江宁波 315000浙江中医药大学附属宁波市中医院,浙江宁波 315000浙江中医药大学附属宁波市中医院,浙江宁波 315000浙江中医药大学附属宁波市中医院,浙江宁波 315000浙江中医药大学附属宁波市中医院,浙江宁波 315000
医药卫生
阿尔茨海默病补肾祛痰化瘀健脑法盐酸多奈哌齐智力状态生活能力
Alzheimer's diseasemethod of tonifying kidney,expelling phlegm,removing blood stasis and strengthening braindonepezil hydrochloridemental stateliving ability
《中华中医药学刊》 2026 (1)
48-51,4
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)浙江省名老中医专家传承工作室建设计划项目(GZS20120030)浙江省中医药科技计划项目(2023ZF161)宁波市公益性科技计划项目(2023S083)
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