益智醒脑方联合西医治疗对阿尔茨海默病患者脑脊液炎性因子及神经递质的影响
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摘要
目的:探讨益智醒脑方联合西医治疗对阿尔茨海默病患者脑脊液炎性因子及神经递质的影响。方法:选择2014年10月~2016年10月收治的阿尔茨海默病患者124例为研究对象,采用随机数字表法分为观察组和对照组各62例。对照组给予多奈派齐片等西医常规治疗,观察组给予益智醒脑方联合西医治疗。治疗12周后,比较两组脑脊液炎性因子、神经递质、临床疗效等指标。结果:观察组有效率80.65%明显高于对照组64.52%(χ~2=4.052 9,P<0.05);脑脊液TNF-α、IL-6明显低于对照组,IL-4、IL-10含量明显高于对照组(t=10.911、8.739、5.000、4.046,P<0.05、P<0.01);多巴胺(DA)、5-羟色胺(5-HT)、去甲肾上腺素(NE)含量明显高于对照组(t=9.435、7.916、5.985,P<0.05、P<0.01)。结论:益智醒脑方联合西医治疗有助于缓解阿尔茨海默病临床症状,提高治疗效果,可能与抑制患者炎症症状、调节神经递质表达水平有关。
Objective: To study the effect of inflammatory factor and neurotransmitter of Yizhi Xingnao Fang combined with western medicine for patients with alzheimer' s disease. Methods: 124 cases alzheimer' s patients from October 2014 to October 2016 were divided into observation group and control group,the control group given donepezil etc conventional western medicine therapy,observation group given Yizhi Xingnao Fang combinde with western medicine therapy. 12 weeks after treatment,cerebrospinal fluid inflammatory factors,neurotransmitter and clinical efficacy were compared between two groups. Results: Observation group effective rate80. 65% was significantly higher than control group 64. 52%( χ~2= 4. 052 9,P < 0. 05); cerebrospinal fluid TNF-α,IL-6 were significantly lower than control group,IL-4,IL-10 were significantly higher than control group( t = 10. 911,8. 739,5. 000,4. 046,P<0. 05,P<0. 01); DA,5-HT,NE were significantly higher than control group( t = 9. 435,7. 916,5. 985,P < 0. 05,P < 0. 01). Conclusion: Yizhi Xingnao Fang combined with western medicine therapy help to improve the clinical symptoms and therapeutic effect,which may be related to the suppression of inflammatory symptoms,regulation of neurotransmitter expression level.
Objective: To study the effect of inflammatory factor and neurotransmitter of Yizhi Xingnao Fang combined with western medicine for patients with alzheimer' s disease. Methods: 124 cases alzheimer' s patients from October 2014 to October 2016 were divided into observation group and control group,the control group given donepezil etc conventional western medicine therapy,observation group given Yizhi Xingnao Fang combinde with western medicine therapy. 12 weeks after treatment,cerebrospinal fluid inflammatory factors,neurotransmitter and clinical efficacy were compared between two groups. Results: Observation group effective rate80. 65% was significantly higher than control group 64. 52%( χ~2= 4. 052 9,P < 0. 05); cerebrospinal fluid TNF-α,IL-6 were significantly lower than control group,IL-4,IL-10 were significantly higher than control group( t = 10. 911,8. 739,5. 000,4. 046,P<0. 05,P<0. 01); DA,5-HT,NE were significantly higher than control group( t = 9. 435,7. 916,5. 985,P < 0. 05,P < 0. 01). Conclusion: Yizhi Xingnao Fang combined with western medicine therapy help to improve the clinical symptoms and therapeutic effect,which may be related to the suppression of inflammatory symptoms,regulation of neurotransmitter expression level.
引文
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[15]罗晓平,于之伦,邓超,等.黄芩素对2,4,6-三硝基苯磺酸诱导的小鼠实验性肠炎的作用和机制[J].中国药理学与毒理学杂志,2017,31(6):541-546.Lou XP,Yu ZL,Deng C,et al.Effect and mechanism of baicalein on 2,4,6-trinitrobenzene sulfonic acid-induced experimental colitis of mice[J].Chin J Pharmacol Toxicol,2017,31(6):541-546.
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[19]李帅坪,黄鑫,张勇,等.红参皂苷组分对大鼠血浆中神经化学物质的影响[J].中草药,2017,48(14):2819-2924.Li SP,Huang X,Zhang Y,et al.Effects of red ginseng saponin components on neurochemicals in rat plasma[J].Chin Traditional Herbal Drugs,2017,48(14):2819-2924.
[20]邓敏贞,朱彩霞,王南卜,等.石菖蒲挥发油联合人参总皂苷对APP/PS1双转基因小鼠海马中单胺类神经递质的影响[J].中药材,2017,40(4):941-944.Deng MZ,Zhu CX,Wang NB,et al.The impact of hippocampal monoamine neurotransmitters of calamus volatile oil combined with ginsenoside in APP/PS1 double transgenic mice[J].Chin Traditional Patent Med,2017,40(4):941-944.
[2]Dias KS,de Paula CT,Dos Santos T,et al.Design,synthesis and evaluation of novel feruloyl-donepezil hybrids as potential multitarget drugs for the treatment of Alzheimer's disease[J].Eur J Med Chem,2017,130:440-457.
[3]齐越,姜鸿,李纪彤,等.益智聪明汤对Aβ25-35致阿尔茨海默病小鼠tau蛋白磷酸化的影响[J].中成药,2017,39(10):1999-2003.Qi Y,Jiang H,Li JT,et al.Yizhi Congming Decoction attenuates learning and memory deficits through reducing tau hyperphosphorylation in Aβ-induced AD mice[J].Chin Traditional Patent Med,2017,39(1):1999-2003.
[4]Jack CR,Albert MS,Knopman DS,et al.Introduction to the recommendations from the National Institute on Aging-Alzheimer's Association work groups on diagnostic guidelines for Alzheimer's disease[J].Alzheimers Dement,2011,7(3):257-262.
[5]田金洲.中国痴呆诊疗指南[M].北京:人民卫生出版社,2012:17-21.Tian JZ.Guidelines for diagnosis and treatment of dementia in China[M].Beijing:People's Medical Publishing House,2012:17-21.
[6]陈以丽.痴呆与轻度认知障碍的流行病学、发病机制和诊治分析[J].临床合理用药杂志,2017,10(1):172-173.Chen YL.Analysis of epidemiology,pathogenesis,diagnosis and treatment in dementia and mild cognitive impairment[J].Chin JClin Rational Drug Use,2017,10(1):172-173.
[7]吴小凡,马斌,侯训尧,等.柿叶提取物对HEK293-APPswe转基因细胞模型的抗氧化作用及对Nrf2/HO-1途径的影响[J].中国免疫学杂志,2017,33(6):854-858.Wu XF,Ma B,Hou XY,et al.Antioxidant effect of persimmon leaf extract to HEK293-APPswe transgenic cells and effect to Nrf2/HO-1 pathway[J].Chin J Immunol,2017,33(6):854-868.
[8]Wu MK,Lu YT,Huang CW,et al.Clinical significance of cerebrovascular biomarkers and white matter tract integrity in alzheimer disease:clinical correlations With neurobehavioral data in crosssectional and after 18 months follow-ups[J].Medicine(Baltimore),2015,194(28):e1192.
[9]邹靖锋,郭培燕,谢珂.针刺联用中药治疗阿尔蒋海默病疗效Meta分析[J].中医学报,2016,31(1):138-143.Zou JF,Gou PY,Xie K,et al.Meta-analysis of the effectiveness of acupuncture treatment combined with traditional chinese medicine treatment of alzheimer disease[J].China J Chin Med,2016,31(1):138-143.
[10]陈炜,蒋凌飞,吴林,等.中西医结合规范化干预治疗阿尔茨海默病的疗效[J].中国老年学杂志,2017,37(6):1486-1488.Chen W,Jiang LF,Wu L,et al.The curative effect of traditional Chinese and western medicine in treatment of alzheimer's diseas[J].Chin J Gerontol,2017,37(6):1486-1488.
[11]Heppner FL,Ransohoff RM,Becher B.Immune attack:the role of inflammation in Alzheimer disease[J].Nat Rev Neurosci,2015,16(6):358-372.
[12]Paouri E,Tzara O,Kartalou GI,et al.Peripheral tumor necrosis factor-alpha(TNF-α)modulates amyloid pathology by regulating blood-derived immune cells and glial response in the brain of AD/TNF transgenic mice[J].J Neurosci,2017,37(20):5155-5171.
[13]吴珍妮,胡满燕,龙子江,等.欣怡胶囊对心肌缺血再灌注损伤大鼠血清炎症因子及心脏组织形态的影响[J].中成药,2015,37(11):2342-2346.Wu ZN,Hu MY,Long ZJ,et al.Infulence of Xinyi Capsules on infammatory and myocardium tissue morphology in rats with myocardial ischemia-reperfusion injury[J].Chin Traditional Patent Med,2015,37(11):2342-2436.
[14]邓敏贞,黄丽平,方永奇.石菖蒲挥发油联合人参总皂苷对D-半乳糖联合扎氯化铝致阿尔茨海默病模型小鼠学习记忆力及脑组织细胞凋亡的影响[J].中药材,2015,38(5):1018-1023.Deng MZ,Huang LP,Fang YQ.Effects of total Ginsenosides and volatile oil of acorus tatarinowii co-administration on ability of learning and memory and apoptosis in alzheimer's disease mice model induced by D-galactose and aluminium chloride[J].JChin Med Materials,2015,38(5):1018-1023.
[15]罗晓平,于之伦,邓超,等.黄芩素对2,4,6-三硝基苯磺酸诱导的小鼠实验性肠炎的作用和机制[J].中国药理学与毒理学杂志,2017,31(6):541-546.Lou XP,Yu ZL,Deng C,et al.Effect and mechanism of baicalein on 2,4,6-trinitrobenzene sulfonic acid-induced experimental colitis of mice[J].Chin J Pharmacol Toxicol,2017,31(6):541-546.
[16]Vermeiren Y,Van Dam D,Aerts T,et al.Monoaminergic neurotransmitter alterations in postmortem brain gegions of depressed and aggressive patients with Alzheimer's disease[J].Neurobiology Aging,2014,35(12):2691-2700.
[17]Mork A,Russell RV,de Jong IE,et al.Effects of the 5-HT6 receptor antagonist idalopirdine on extracellular levels of monoamines,glutamate and acetylcholine in the rat medial prefrontal cortex[J].Eur J Pharmacol,2017,799:1-6.
[18]De Felice FG,Ferreira ST.Inflammation,defective insulin signaling,and mitochondrial dysfunction as common molecular denominators connecting type 2 diabetes to Alzheimer disease[J].Diabetes,2014,63(7):2262-2272.
[19]李帅坪,黄鑫,张勇,等.红参皂苷组分对大鼠血浆中神经化学物质的影响[J].中草药,2017,48(14):2819-2924.Li SP,Huang X,Zhang Y,et al.Effects of red ginseng saponin components on neurochemicals in rat plasma[J].Chin Traditional Herbal Drugs,2017,48(14):2819-2924.
[20]邓敏贞,朱彩霞,王南卜,等.石菖蒲挥发油联合人参总皂苷对APP/PS1双转基因小鼠海马中单胺类神经递质的影响[J].中药材,2017,40(4):941-944.Deng MZ,Zhu CX,Wang NB,et al.The impact of hippocampal monoamine neurotransmitters of calamus volatile oil combined with ginsenoside in APP/PS1 double transgenic mice[J].Chin Traditional Patent Med,2017,40(4):941-944.