地黄饮子方结合胞磷胆碱治疗血管性痴呆肾精亏虚兼痰瘀阻络证疗效及对血清β-AP、E_2、Livin水平的影响
|
摘要
目的观察地黄饮子方结合胞磷胆碱治疗血管性痴呆肾精亏虚兼痰瘀阻络证疗效及对血清β淀粉样蛋白(β-AP)、雌二醇(E2)及抗凋亡因子(Livin)水平的影响。方法将96例血管性痴呆肾精亏虚兼痰瘀阻络证患者随机分为观察组和对照组各48例。对照组给予胞磷胆碱钠胶囊口服治疗,观察组给予地黄饮子方结合胞磷胆碱钠胶囊治疗。治疗3个月后,对比2组认知功能(记忆力、定向力、计算力和注意力、语言能力、MMSE总分)、生活自理能力(ADL评分)、精神病理症状(NPI评分)及血清β-AP、E2、Livin水平的改善情况,并评估临床疗效。结果观察组治疗后总有效率明显高于对照组(P <0. 05); 2组MMSE总分,记忆力、定向力、计算力和注意力、语言能力积分,E2水平、Livin水平及ADL评分均显著升高(P均<0. 05),NPI评分和β-AP水平均显著降低(P均<0. 05),且观察组治疗后上述指标改善程度更为明显(P均<0. 05)。结论地黄饮子方结合胞磷胆碱治疗血管性痴呆肾精亏虚兼痰瘀阻络证,能够有效改善患者的认知功能、生活自理能力、精神病理状态以及血清β-AP、E2和Livin表达水平,疗效确切。
Objective It is to observe the therapeutic effect of Dihuangyinzi Decoction combined with citicoline on vascular dementia of syndrome of renal deficiency plus phlegm-stasis obstruction,and its effect on the levels of serum β amyloid protein(β-AP),estradiol(E2) and anti-apoptotic factor(Livin). Methods Ninety-six patients with vascular dementia with kidney essence deficiency and phlegm obstruction syndrome were randomly divided into observation group and control group. The control group was treated with citicoline sodium capsules orally,and the observation group was given Dihuangyinzi Decoction combined with citicoline sodium capsules. After 3 months of treatment,the improvements of cognitive function(memory,orientation,calculation and attention,language ability,MMSE total score),self-care ability(ADL score),psychopathological symptoms(NPI score) and serum β-AP,E2 and Livin levels were compared,and the clinical curative effects were assessed in the two gorups. Results The total effective rate of the observation group was significantly higher than that of the control group(P < 0. 05). The MMSE total scores,the scores of memory,orientation,calculation and attention,language ability,levels of E2 and Livin,and ADL scores were significantly increased(P < 0. 05),while NPI scores and β-AP level were significantly decreased in the two groups(P < 0. 05),and the improvements of the above indicators were more obvious in the observation group(P < 0. 05). Conclusion Dihuangyinzi combined with citicoline can effectively improve the cognitive function,self-care ability,psychopathological state and the levels of serum β-AP,E2 and Livin in the treatment of vascular dementia with renal essence deficiency and phlegm obstruction syndrome,the curative effect is exact.
Objective It is to observe the therapeutic effect of Dihuangyinzi Decoction combined with citicoline on vascular dementia of syndrome of renal deficiency plus phlegm-stasis obstruction,and its effect on the levels of serum β amyloid protein(β-AP),estradiol(E2) and anti-apoptotic factor(Livin). Methods Ninety-six patients with vascular dementia with kidney essence deficiency and phlegm obstruction syndrome were randomly divided into observation group and control group. The control group was treated with citicoline sodium capsules orally,and the observation group was given Dihuangyinzi Decoction combined with citicoline sodium capsules. After 3 months of treatment,the improvements of cognitive function(memory,orientation,calculation and attention,language ability,MMSE total score),self-care ability(ADL score),psychopathological symptoms(NPI score) and serum β-AP,E2 and Livin levels were compared,and the clinical curative effects were assessed in the two gorups. Results The total effective rate of the observation group was significantly higher than that of the control group(P < 0. 05). The MMSE total scores,the scores of memory,orientation,calculation and attention,language ability,levels of E2 and Livin,and ADL scores were significantly increased(P < 0. 05),while NPI scores and β-AP level were significantly decreased in the two groups(P < 0. 05),and the improvements of the above indicators were more obvious in the observation group(P < 0. 05). Conclusion Dihuangyinzi combined with citicoline can effectively improve the cognitive function,self-care ability,psychopathological state and the levels of serum β-AP,E2 and Livin in the treatment of vascular dementia with renal essence deficiency and phlegm obstruction syndrome,the curative effect is exact.
引文
[1]王太山.通窍活血汤化裁联合奥拉西坦治疗瘀血阻窍证血管性痴呆的临床研究[J].现代中西医结合杂志,2016,25(3):316-317; 342
[2]詹秀玲,范国峰,韩保志,等.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研究[J].现代中西医结合杂志,2016,25(27):3012-3014
[3] Plyn DO. American Phychiatric Association Diagnostic and Statistical Manual of Mental Disorders(DSM-IV)[M]. New York:Springer US,2011:84-85
[4]国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:92
[5] John C,Morris MD. The Clinical Dementia Rating(CDR):Current Version and Scoring Rules[J]. Neurology,1993,43(11):2412
[6]田金洲,韩明向,王永炎,等.血管性痴呆的诊断、辨证及疗效判定标准[J].北京中医药大学学报,2000,23(5):16-24
[7] Bell RD,Winkler EA,Singh I,et al. Apolipoprotein E controls cerebrovascular integrity via cyclophilin A[J].Nature,2013,485(7399):512-516
[8]刘吉昌,陶红星,何剑锋.银杏叶提取物片对轻中度血管性痴呆β-Ap、VEGF的影响[J].中西医结合心脑血管病杂志,2012,10(8):956-958
[9]杨健,蔡志友,晏勇,等.血管性痴呆患者血清Livin、VEGF与MMP-9水平的临床意义[J].重庆医学,2009,38(11):1314-1318
[10]石志华,赵晔.石杉碱甲治疗老年血管性痴呆对患者认知功能及血清E2的影响[J].中国实用神经疾病杂志,2016,19(1):122-123
[11]孙文贤,安红梅.熟地黄及其复方在老年性痴呆治疗中的作用[J].中华中医药学刊,2014,32(4):766-768
[12]杨明明,袁晓旭,赵桂琴,等.山茱萸化学成分和药理作用的研究进展[J].承德医学院学报,2016,33(5):398-400
[13]胡佳琦,冯佳媛.肉苁蓉的化学成分和药理作用[J].中医临床研究,2012,4(15):26-28
[14]赖满香,阮志燕,许意平.补肾中药巴戟天药理作用研究进展[J].亚太传统医药,2017,13(1):63-64
[15]孙森凤,姜雪,张颖颖.附子药理作用研究进展[J].山东化工,2017,46(11):65-67
[16]杨擎,曲晓波,李辉,等.五味子化学成分与药理作用研究进展[J].吉林中医药,2015,35(6):626-628
[17]吴宾,方永奇.石菖蒲益智作用的物质基础及其机理研究[J].中华中医药学刊,2004,22(9):1635-1636
[18]穆俊霞,李新毅.中药远志对阿尔茨海默病大鼠模型学习记忆和胆碱酯酶活性的影响[J].世界中西医结合杂志,2007,2(1):18-20
[2]詹秀玲,范国峰,韩保志,等.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研究[J].现代中西医结合杂志,2016,25(27):3012-3014
[3] Plyn DO. American Phychiatric Association Diagnostic and Statistical Manual of Mental Disorders(DSM-IV)[M]. New York:Springer US,2011:84-85
[4]国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:92
[5] John C,Morris MD. The Clinical Dementia Rating(CDR):Current Version and Scoring Rules[J]. Neurology,1993,43(11):2412
[6]田金洲,韩明向,王永炎,等.血管性痴呆的诊断、辨证及疗效判定标准[J].北京中医药大学学报,2000,23(5):16-24
[7] Bell RD,Winkler EA,Singh I,et al. Apolipoprotein E controls cerebrovascular integrity via cyclophilin A[J].Nature,2013,485(7399):512-516
[8]刘吉昌,陶红星,何剑锋.银杏叶提取物片对轻中度血管性痴呆β-Ap、VEGF的影响[J].中西医结合心脑血管病杂志,2012,10(8):956-958
[9]杨健,蔡志友,晏勇,等.血管性痴呆患者血清Livin、VEGF与MMP-9水平的临床意义[J].重庆医学,2009,38(11):1314-1318
[10]石志华,赵晔.石杉碱甲治疗老年血管性痴呆对患者认知功能及血清E2的影响[J].中国实用神经疾病杂志,2016,19(1):122-123
[11]孙文贤,安红梅.熟地黄及其复方在老年性痴呆治疗中的作用[J].中华中医药学刊,2014,32(4):766-768
[12]杨明明,袁晓旭,赵桂琴,等.山茱萸化学成分和药理作用的研究进展[J].承德医学院学报,2016,33(5):398-400
[13]胡佳琦,冯佳媛.肉苁蓉的化学成分和药理作用[J].中医临床研究,2012,4(15):26-28
[14]赖满香,阮志燕,许意平.补肾中药巴戟天药理作用研究进展[J].亚太传统医药,2017,13(1):63-64
[15]孙森凤,姜雪,张颖颖.附子药理作用研究进展[J].山东化工,2017,46(11):65-67
[16]杨擎,曲晓波,李辉,等.五味子化学成分与药理作用研究进展[J].吉林中医药,2015,35(6):626-628
[17]吴宾,方永奇.石菖蒲益智作用的物质基础及其机理研究[J].中华中医药学刊,2004,22(9):1635-1636
[18]穆俊霞,李新毅.中药远志对阿尔茨海默病大鼠模型学习记忆和胆碱酯酶活性的影响[J].世界中西医结合杂志,2007,2(1):18-20