摘要
目的探究黄芪续命汤对阿尔茨海默病(Alzheimer’s disease,AD)患者认知功能及去甲肾上腺素(noradrenaline,NE)、多巴胺(dopamine,DA)、乙酰胆碱转移酶(acetylcholintransferase,ChAT)表达的影响。方法前瞻性选取2019年1月-2022年12月期间于南阳市第二人民医院接受治疗的110例AD患者,采用随机数字表法将患者分为研究组与对照组,各55例。对照组采用多奈哌齐配合小续命汤治疗,研究组使用多奈哌齐配合黄芪续命汤治疗,2组均连续治疗15 d。比较患者治疗前后蒙特利尔认知评价量表(Mo CA)评分变化、神经精神量表(NPI)、日常生活能力(ADL)、精神状态检查量表(MMSE)、NE、DA、ChAT、血清同型半胱胺酸(Hcy)、血清淀粉蛋白前b位分解酶1(BACE1)与脑源性神经营养因子(BDNF)等指标变化。结果与本组治疗前相比,研究组患者治疗后的Mo CA评分中的回忆力、命名力、抽象、语言、注意力、视空间和执行、定向力评分均有明显升高(均P<0.01),与对照组治疗后的Mo CA评分相比,研究组的回忆力、命名力、抽象、语言、注意力、视空间和执行、定向力评分更高(均P<0.01);与本组治疗前相比,研究组的NPI、ADL评分明显降低而MMSE评分明显提高(均P<0.01),与对照组治疗后相比,研究组的NPI、ADL评分更低而MMSE评分明显更高(均P<0.01);与本组治疗前相比,研究组的NE、DA、ChAT指标水平明显提升(均P<0.01),与对照组治疗后相比,NE、DA、ChAT指标水平均更高(均P<0.01);与本组治疗前相比,研究组的Hcy、BACE1水平降低而BDNF水平提高(均P<0.01),与对照组治疗后相比,研究组的Hcy、BACE1水平明显更低而BDNF水平明显更高(均P<0.01);治疗后将实验组与对照组的总有效率进行对比,实验组总有效率明显更高(P<0.05)。结论黄芪续命汤结合多奈哌齐治疗AD患者具有较为良好的临床疗效,其能进一步改善患者的认知功能、精神状况、智能水平,可提高患者NE、DA、ChAT、BDNF水平,降低患者Hcy、BACE1水平,值得进一步研究。
Objective To explore the effects of Huangqi Xuming decoction on the cognitive function and expressions of norepinephrine(NE),dopamine(DA)and acetylcholintransferase(ChAT)in patients with Alzheimer's disease(AD).Methods A total of 110 AD patients treated in the Second People's Hospital of Nanyang City from January 2019 to December 2022 were prospectively selected and divided into a study group and a control group by the random number table method,with 55 cases in each group.The control group was treated with donepezil combined with Xiao Xuming decoction,while the study group was treated with donepezil combined with Huangqi Xuming decoction.Both groups were treated continuously for 15 days.The changes in scores of the Montreal Cognitive Assessment Scale(MoCA),Neuropsychiatric Inventory(NPI),Activities of Daily Living(ADL),Mental State Examination Scale(MMSE),NE,DA,ChAT,serum homocysteine(Hcy),serum amyloid precursor enzyme 1(BACE1),and brain-derived neurotrophic factor(BDNF)were compared before and after treatment in the two groups.Results Compared with before treatment,the MoCA scores in the study group showed a significant increase in recall,naming,abstraction,language,attention,visual space,execution,and orientation after treatment(all P<0.01).Compared with those in the control group after treatment,the MoCA scores in the study group were much higher in recall,naming,abstraction,language,attention,visual space,execution,and orientation(all P<0.01).Compared with before treatment,the scores of NPI and ADL in the study group were significantly decreased while the scores of MMSE were significantly increased(all P<0.01).Compared with after treatment in the control group,the scores of NPI and ADL in the study group were much lower while the scores of MMSE were much higher(all P<0.01).Compared with before treatment,the levels of NE,DA,and ChAT in the study group were significantly increased(all P<0.01),and the levels of NE,DA and ChAT were much higher than those in the control group after treatment(all P<0.01).Compared with before treatment,the levels of Hcy and BACE1 in the study group were decreased while the level of BDNF was increased(all P<0.01).Compared with after treatment in the control group,the levels of Hcy and BACE1 in the study group were much lower while the level of BDNF was much higher(all P<0.01).After treatment,the total effective rate of the study group was significantly higher than that of the control group(P<0.05).Conclusion Huangqi Xuming decoction combined with donepezil has a relatively good clinical efficacy in the treatment of AD patients,which can further improve their cognitive function,mental status and intelligence level,increase the levels of NE,DA,ChAT and BDNF,and decrease the levels of Hcy and BACE1,which is worthy of further study.
作者
陶录岭
鹿滨麒
袁艳
袁磊
TAO Luling;LU Binqi;YUAN Yan;YUAN Lei(The Second People's Hospital of Nanyang City,Nanyang 473000,China)
出处
《吉林中医药》
2024年第1期62-67,共6页
Jilin Journal of Chinese Medicine
基金
河南省中医药科学研究专项课题(2022ZY1203)。
