地黄饮子联合茴拉西坦治疗中风后痴呆(肾虚痰瘀)随机平行对照研究
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摘要
[目的]观察地黄饮子联合茴拉西坦治疗中风后痴呆(肾虚痰瘀)疗效。[方法]使用随机平行对照方法,将116例住院及门诊患者按就诊顺序号随机分两组;调节血压、血脂、血糖水平。对照组58例茴拉西坦,0.2g/次,3次/d。治疗组58例地黄饮子(地黄~熟25g,菖蒲、肉苁蓉各20g,石斛15g,山茱萸、山药~炒、远志、巴戟天、麦冬各12g,五味子、茯苓、附子~(制,先煎)、肉桂~(后下)各10g;肢体酸软加黄芪、党参各20g;头晕加菊花、枸杞各20g;夜不能寐加枣仁~炒30g,郁金12g;舌紫暗加桃仁、红花各12g)1剂/d,水煎400mL,早晚口服;茴拉西坦治疗同对照组。连续治疗30d为1疗程。观测临床症状、改良长谷川痴呆量表(HDS-R)、简易智力状态检查量表(MMSE)、AD评定量表(ADAS)、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效39例,有效16例,无效3例,总有效率94.83%;对照组显效28例,有效16例,无效14例,总有效率75.86%;治疗组疗效优于对照组(P<0.05)。HDS-R、MMSE、ADAS两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。不良反应发生率治疗组低于对照组(P<0.05)。[结论]地黄饮子联合茴拉西坦治疗中风后痴呆(肾虚痰瘀),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the effect of dihuang yinzi combined with anil racetan on post-stroke dementia(kidney deficiency,phlegm and stasis).[Methods] 116 patients in hospital and outpatient department were randomly divided into two groups according to the sequence number of visits by randomized parallel control.Regulate blood pressure,blood lipid and blood glucose levels.The control group included 58 cases of anisocyanine,0.2 g/time and 3 times/d.Treatment group of 58 cases of Dihuang YinZi(rehmannia glutinosa 25 g,calamus,desertliving cistanche,20 g,caulis dendrobii 15 g,dogwood,yam fry,polygala,medicinal indianmulberry root,dwarf lilyturf,12 g,schisandra,poria cocos,lateral root system,after the first decoct,cinnamon under every 10 g; add radix astragali and radix codonopsis radix 20 g each; dizziness,chrysanthemum and wolfberry 20 g each; keep awake at night add jujube kernel stir-fry 30 g,yu jin 12 g; 1 dose/d,400 mL water decoction,oral administration in the morning and evening; The treatment of anisocyanine was the same as the control group.Continuous treatment for 30 days is 1 course of treatment.Observation of clinical symptoms,improved changgu dementia scale(HDS-R),simple intelligence state examination scale(MMSE),AD evaluation scale(ADAS),adverse reactions.Treatment course 1,judge curative effect.[Results]There were 39 cases in the treatment group,16 cases were effective,3 cases were ineffective,and the total effective rate was 94.83%.The control group had 28 cases of obvious effect,16 cases of effective effect,14 cases of ineffective effect,and the total effective rate was 75.86%.The therapeutic effect of the treatment group was better than that of the control group(P<0.05).The HDS-R,MMSE and ADAS groups improved(P<0.01),and the treatment group improved better than the control group(P<0.01).The incidence of adversereactions was lower in the treatment group than in the control group(P<0.05).[Conclusion] Dihuang YinZi combined with anil racetan in the treatment of post-stroke dementia(kidney deficiency,phlegm and blood stasis) has satisfactory efficacy and no serious adverse reactions,which is worthy of promotion.
[Objective] To observe the effect of dihuang yinzi combined with anil racetan on post-stroke dementia(kidney deficiency,phlegm and stasis).[Methods] 116 patients in hospital and outpatient department were randomly divided into two groups according to the sequence number of visits by randomized parallel control.Regulate blood pressure,blood lipid and blood glucose levels.The control group included 58 cases of anisocyanine,0.2 g/time and 3 times/d.Treatment group of 58 cases of Dihuang YinZi(rehmannia glutinosa 25 g,calamus,desertliving cistanche,20 g,caulis dendrobii 15 g,dogwood,yam fry,polygala,medicinal indianmulberry root,dwarf lilyturf,12 g,schisandra,poria cocos,lateral root system,after the first decoct,cinnamon under every 10 g; add radix astragali and radix codonopsis radix 20 g each; dizziness,chrysanthemum and wolfberry 20 g each; keep awake at night add jujube kernel stir-fry 30 g,yu jin 12 g; 1 dose/d,400 mL water decoction,oral administration in the morning and evening; The treatment of anisocyanine was the same as the control group.Continuous treatment for 30 days is 1 course of treatment.Observation of clinical symptoms,improved changgu dementia scale(HDS-R),simple intelligence state examination scale(MMSE),AD evaluation scale(ADAS),adverse reactions.Treatment course 1,judge curative effect.[Results]There were 39 cases in the treatment group,16 cases were effective,3 cases were ineffective,and the total effective rate was 94.83%.The control group had 28 cases of obvious effect,16 cases of effective effect,14 cases of ineffective effect,and the total effective rate was 75.86%.The therapeutic effect of the treatment group was better than that of the control group(P<0.05).The HDS-R,MMSE and ADAS groups improved(P<0.01),and the treatment group improved better than the control group(P<0.01).The incidence of adversereactions was lower in the treatment group than in the control group(P<0.05).[Conclusion] Dihuang YinZi combined with anil racetan in the treatment of post-stroke dementia(kidney deficiency,phlegm and blood stasis) has satisfactory efficacy and no serious adverse reactions,which is worthy of promotion.
引文
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[11]傅琼,储苏平.茴拉西坦治疗老年性痴呆的临床观察[J].老年医学与保健,2010,16(1):48-49.
[12]马玮莉,王亚东.地黄饮子加味治疗老年期痴呆症的理论探讨[J].中医临床研究,2017,9(6):8-10.
[13]国家药典委员会.中国药典2015年版一部[M].北京:中国医药科技出版社,2015.
[14]牛英才,董妙先,兴桂华,等.Apl-40脑内注射对大鼠海马AchE和NOSl表达的影响及加减地黄饮子的干预作用[J].中药药理与临床,2007,23(5):149-153.
[15]季晓东.地黄饮子方治疗血管性痴呆40例临床观察[J].浙江中医杂志,2016,51(3):186.
[2]American Psychiatric Association.Diagnostic and statisticalmanual of mental disorders[M].4th ed.Washington,DC:American Psychiatric Association,1994:143-147.
[3]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2015-04-05]. http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[4]傅仁杰.老年呆病的诊断、辨证分型及疗效评定标准[S].中医杂志,1991(2):56.
[5]王新德.老年人痴呆[M].北京:人民卫生出版社,1990:160-173.
[6]词都.改良长谷川痴呆量表(HDS-R)[EB/OL].[2018-06-01].http://www.dictall.com/indu/308/30771334668.htm.
[7]百度百科.简易智力状态检查量表(MMSE)[EB/OL].[2018-06-01].https://baike.baidu.com/item/MMSE%E9%87%8F%E8%A1%A8/15596034?fr=aladdin.
[8]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.
[9]梅小敏.地黄饮子加减治疗中风后球麻痹的疗效观察[J].临床合理用药杂志,2012,34(12):72.
[10]余环星.地黄饮子加减联合西药治疗2型糖尿病合并脑梗死偏瘫失语疗效观察[J].北方药学,2017,22(2):107-108.
[11]傅琼,储苏平.茴拉西坦治疗老年性痴呆的临床观察[J].老年医学与保健,2010,16(1):48-49.
[12]马玮莉,王亚东.地黄饮子加味治疗老年期痴呆症的理论探讨[J].中医临床研究,2017,9(6):8-10.
[13]国家药典委员会.中国药典2015年版一部[M].北京:中国医药科技出版社,2015.
[14]牛英才,董妙先,兴桂华,等.Apl-40脑内注射对大鼠海马AchE和NOSl表达的影响及加减地黄饮子的干预作用[J].中药药理与临床,2007,23(5):149-153.
[15]季晓东.地黄饮子方治疗血管性痴呆40例临床观察[J].浙江中医杂志,2016,51(3):186.