养生益智汤治疗血管性痴呆临床观察
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摘要
目的:探讨养生益智汤治疗血管性痴呆的临床疗效。方法:将112例血管性痴呆患者随机分为实验组与对照组各56例。对照组给予盐酸多奈哌齐片治疗,实验组给予养生益智汤治疗。4周为1疗程,2组均治疗3疗程。评价2组临床疗效,比较2组治疗前后日常生活量表(ADL)评分、简易精神状态检查表(MMSE)评分、长谷川痴呆量表修订版(HDS-R)评分、中医证候积分、血清微管相关(Tau)蛋白及半胱氨酸天冬氨酸蛋白水解酶-3(Caspase-3)蛋白表达水平。结果:总有效率实验组为83.93%,对照组为66.07%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组ADL、MMSE、HDS-R评分均较治疗前明显提高(P<0.05),实验组ADL、MMSE、HDS-R评分明显高于对照组(P<0.05);2组中医证候积分均较治疗前有明显降低(P<0.05),实验组中医证候积分明显低于对照组(P<0.05);2组血清Tau蛋白、Caspase-3蛋白表达水平较治疗前均有明显降低(P<0.05),实验组血清Tau蛋白、Caspase-3蛋白明显低于对照组(P<0.05)。结论:养生益智汤治疗血管性痴呆效果显著,能提高患者生活自理能力,明显改善痴呆症状,降低血清Tau蛋白、Caspase-3蛋白表达水平,具有良好的应用价值。
Objective:To discuss the clinical effect of Yangsheng Yizhi tang for vascular dementia.Methods:Divided 112 cases of patients with vascular dementia into the test group and the control group randomly,56 cases in each group.The control group was given donepezil hydrochloride tablets for treatment,while the test group was given Yangsheng Yizhi tang for treatment.The treatment lasted for 3 courses,which covered four weeks in one course.Evaluated the clinical effect in two groups,and compared the activity of daily living scale(ADL),mini-mental state examination(MMSE),hasegawa dementia scale revision(HDS-R),Chinese medicine syndrome scores,and expression levels of microtubule associated(Tau)protein in serum and cysteine aspartate protease-3(Caspase-3)protein in the two groups before and after treatment.Results:The total effective rate was 83.93%in the test group and 66.07%in the control group,difference being significant(P<0.05).After treatment,scores of ADL,MMSE and HDS-R in both groups were evidently increased when compared with those before treatment(P<0.05).Scores of ADL,MMSE and HDS-R in the test group were obviously higher than those in the control group(P<0.05).Chinese medicine syndrome scores in the two groups were clearly decreased when compared with those before treatment(P<0.05).Chinese medicine syndrome scores in the test group were distinctly lower than those in the control group(P<0.05).The expression levels of Tau protein and Caspase-3 protein in serum in two groups were clearly decreased when compared with those before treatment(P<0.05).The expression levels of Tau protein and Caspase-3 protein in serum in the test group were all markedly lower than those in the control group(P<0.05).Conclusion:The therapy of Yangsheng Yizhi tang has an significant effect in treating vascular dementia.It can improve self-care ability of patients,significantly improve the symptoms of dementia,reduce the expression levels of Tau protein and Caspase-3 protein in serum,and has an effective application value.
Objective:To discuss the clinical effect of Yangsheng Yizhi tang for vascular dementia.Methods:Divided 112 cases of patients with vascular dementia into the test group and the control group randomly,56 cases in each group.The control group was given donepezil hydrochloride tablets for treatment,while the test group was given Yangsheng Yizhi tang for treatment.The treatment lasted for 3 courses,which covered four weeks in one course.Evaluated the clinical effect in two groups,and compared the activity of daily living scale(ADL),mini-mental state examination(MMSE),hasegawa dementia scale revision(HDS-R),Chinese medicine syndrome scores,and expression levels of microtubule associated(Tau)protein in serum and cysteine aspartate protease-3(Caspase-3)protein in the two groups before and after treatment.Results:The total effective rate was 83.93%in the test group and 66.07%in the control group,difference being significant(P<0.05).After treatment,scores of ADL,MMSE and HDS-R in both groups were evidently increased when compared with those before treatment(P<0.05).Scores of ADL,MMSE and HDS-R in the test group were obviously higher than those in the control group(P<0.05).Chinese medicine syndrome scores in the two groups were clearly decreased when compared with those before treatment(P<0.05).Chinese medicine syndrome scores in the test group were distinctly lower than those in the control group(P<0.05).The expression levels of Tau protein and Caspase-3 protein in serum in two groups were clearly decreased when compared with those before treatment(P<0.05).The expression levels of Tau protein and Caspase-3 protein in serum in the test group were all markedly lower than those in the control group(P<0.05).Conclusion:The therapy of Yangsheng Yizhi tang has an significant effect in treating vascular dementia.It can improve self-care ability of patients,significantly improve the symptoms of dementia,reduce the expression levels of Tau protein and Caspase-3 protein in serum,and has an effective application value.
引文
[1]周晓卿.血管性痴呆中医病机理论及证治规律探析[J].中医学报,2012,27(2):181-182.
[2]李思,张智龙,杨元庆,等.调神益智针法联合西药治疗血管性痴呆42例临床观察[J].中医杂志,2014,55(15):1295-1298.
[3]吴俊.尼莫地平联合卡巴拉汀治疗老年血管性痴呆的临床疗效与不良反应[J].中国基层医药,2017,24(8):1257-1261.
[4]贾建平,王荫华,李焰生,等.中国痴呆与认知障碍诊治指南(二):痴呆分型及诊断标准[J].中华医学杂志,2011,91(10):651-655.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:91-98.
[6]翁映虹,黄坚红.阿尔茨海默病评定量表-认知部分中文版与日常生活能力量表评价血管性痴呆的信度与效度[J].中国老年学杂志,2014,34(7):1751-1753.
[7]贾功伟,殷樱,虞乐华,等.蒙特利尔认知评估量表与简易精神状态检查用于评定阿尔茨海默病患者认知功能的比较[J].中国康复医学杂志,2010,25(4):319-321.
[8]曹德鹏,高之旭,方贻儒.改良长谷川痴呆量表在中老年期痴呆筛选中的应用[J].中国心理卫生杂志,1997,10(4):22-24.
[9]隋晓峰,马罕.试析中医固脑益智汤联合多奈哌齐治疗老年肾虚痰浊型血管性痴呆的临床疗效[J].中医临床研究,2017,9(21):17-19.
[10]梁学清,李丹丹,黄忠威.茯苓药理作用研究进展[J].河南科技大学学报:医学版,2012,30(2):154-156.
[11]刘扬,孙中武.血清β-淀粉样蛋白与Tau蛋白在皮质下缺血性血管性痴呆早期诊断的应用价值[J].蚌埠医学院学报,2011,36(3):227-230.
[2]李思,张智龙,杨元庆,等.调神益智针法联合西药治疗血管性痴呆42例临床观察[J].中医杂志,2014,55(15):1295-1298.
[3]吴俊.尼莫地平联合卡巴拉汀治疗老年血管性痴呆的临床疗效与不良反应[J].中国基层医药,2017,24(8):1257-1261.
[4]贾建平,王荫华,李焰生,等.中国痴呆与认知障碍诊治指南(二):痴呆分型及诊断标准[J].中华医学杂志,2011,91(10):651-655.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:91-98.
[6]翁映虹,黄坚红.阿尔茨海默病评定量表-认知部分中文版与日常生活能力量表评价血管性痴呆的信度与效度[J].中国老年学杂志,2014,34(7):1751-1753.
[7]贾功伟,殷樱,虞乐华,等.蒙特利尔认知评估量表与简易精神状态检查用于评定阿尔茨海默病患者认知功能的比较[J].中国康复医学杂志,2010,25(4):319-321.
[8]曹德鹏,高之旭,方贻儒.改良长谷川痴呆量表在中老年期痴呆筛选中的应用[J].中国心理卫生杂志,1997,10(4):22-24.
[9]隋晓峰,马罕.试析中医固脑益智汤联合多奈哌齐治疗老年肾虚痰浊型血管性痴呆的临床疗效[J].中医临床研究,2017,9(21):17-19.
[10]梁学清,李丹丹,黄忠威.茯苓药理作用研究进展[J].河南科技大学学报:医学版,2012,30(2):154-156.
[11]刘扬,孙中武.血清β-淀粉样蛋白与Tau蛋白在皮质下缺血性血管性痴呆早期诊断的应用价值[J].蚌埠医学院学报,2011,36(3):227-230.