老年期痴呆的中西医结合施治及康复研究
发布时间：2018-08-29 15:59
【摘要】：痴呆是由于脑功能障碍而产生的获得性智能损害综合症。随着我国人口的老龄化,老年期痴呆的发病率有升高趋势,已成为一个日益突出的社会及医学问题,为此,寻求痴呆的治疗,对改善老年人的生活质量尤为重要,在治疗方面,由于痴呆是器质性病变,绝大多数是不可逆的,所以目前尚无满意的疗效,针对痴呆本质上的治疗仍在努力的探索之中,有些原因所致的痴呆试验性药物治疗取得了一些可喜的进展,药物治疗有改善部分症状的作用。与此同时,中医药治疗痴呆具有巨大的潜力,总结和发掘中药的有效成分,建立统一的疗效观察指标和定量疗效评定的药理模型,在攻克痴呆中为人类提供新的希望。因此,进行中西医结合治疗痴呆是迫切需要研究的课题,我们探讨了中西医结合治疗老年性痴呆的临床疗效。中医药是我国的瑰宝,在目前老年期痴呆的治疗尚未有特异疗效的情况下,相比之下,中医药在延缓衰老以及衰老相关疾病的防治方面有着丰富的理论和实践经验,具有潜在的优势和广阔的开发前景。研究发现雌激素对女性认知功能有保护作用,设计了雌激素对女性阿尔茨海默病患者的对照观察的研究,提出了雌激素配合胆碱酯酶抑制剂治疗女性阿尔茨海默病患者的可能性,也取得了理想的效果,达到了改善老年期痴呆认知功能的预期目的,为女性阿尔茨海默病患者的治疗带了了福音。本文通过对痴呆的中西医结合治疗与康复观察研究,发现其有较好的疗效。总之寻找确切有效的防治方法,改善和提高患者的生存质量和对社会的适应能力,以最大程度减少痴呆类疾病所带来的不良后果,都有十分重要的意义。本文在认真研究国内外近期对痴呆的发病机制与治疗研究的基础上,以中西医结合施治与康复为主导思想,运用中医的特点,结合西医的作用,配合康复治疗,对痴呆,尤其是阿尔茨海默病和血管性痴呆进行预防、控制与治疗,取得了明显的疗效。 首先提出并开展了中药提纯针剂(络泰)治疗老年期痴呆(本文主要指血管性痴呆和阿尔茨海默病痴呆)的疗效研究。不管血管性痴呆还是老年性痴呆(阿尔茨海默病),脑血流量的减少可能是共同的病理改变,而络泰的有效成分人参皂苷R1,且其是无菌冻干粉剂,有较高的稳定性。本课题的动物实验表明人参总皂甙对大鼠脑缺血再灌注损伤有明显的保护作用,表现在它可扩张血管,增加脑血流量,减轻脑水肿超微结构损伤和降低死亡率。其保护作用与抑制钙积累密切相关。临床应用证明它具有 WP=4 扩张心脑血管,增加心脑血管流量,改善心脑微循环,并对脑缺血后海马CAI区(与学习和记忆有关)的迟发性神经元损伤有明显的保护作用,且又抗炎作用和雌激素样作用, 临床实践证明,人参皂苷具有与雌激素相似的改善记忆和神经保护作用。雌激素参与中枢神经系统功能的调节,内源性雌激素是Alzheimer Disease(AD), 的保护因素,雌激素替代治疗对AD的预防和治疗有益。因此,人参皂苷作为具有雌激素样作用的中药,可以作为雌激素的替代品,对于AD的防治具有重 要意义。在动物衰老过程中,钙代谢平衡失调造成神经元中游离钙超负荷,使神经元可塑性减低,从而发生记忆障碍。李麟仙研究表明,同样人参皂苷的益智作用机制之一即它的有效成分中的Rb1能够降低细胞内钙的浓度及钙蛋白的活性。缩小脑梗死范围,从而有抗AD和Vascular Dementia(VD)作用。 其次,研究了中草药治疗血管性痴呆的效果,方药组成为:黄芪、红花、枸杞子、五味子、赤芍、川芎、红花、当归、地龙。方中黄芪、红花、枸杞子、五味子可益气补肾,填精生髓;赤芍、川芎、红花、当归活血化瘀,地龙疏通经络。现代药理研究证明,黄芪、五味子、枸杞子对神经系统有兴奋作用,能改善人的智能活动;当归、川芎、赤芍、红花、五味子、黄柏均有不同程度的钙通道阻滞作用,可明显增加脑血流量,改善脑循环,清除自由基。地龙,赤芍含有纤维蛋白溶解酶激活物,有溶栓作用,绞股蓝抗衰老。所以以上诸药配伍可以提高患者血中超氧化物歧化酶的活性,降低过氧化脂质,抗自由基损伤,改善脑微循环,促进神经细胞功能恢复,并对脑缺血后海马CAI区(与学习和记忆有关)的迟发性神经元损伤有明显的保护作用,进一步延缓了痴呆的发生,为众多的血管性痴呆患者提供了价廉的治疗渠道。 第三,提出并开展了从中草药千层塔中的提取物—石杉碱甲(胆碱酯酶抑制剂)配合雌激素治疗阿尔茨海默病的可行性,这和美国Research Nurse Coordinator Alzheimer's Disease Research Center(Houston Baylor College of Medicine)目前几个重点研究阿尔茨海默病的研究机构,观察雌激素治疗阿尔茨海默病的研究几乎同步进行。流行病学证明,女性阿尔茨海默病的发病率远远高于男性,其可能的原因之一是因为雌激素水平的下降有关。雌激素对认知等有保护作用已达共识,本课题的研究表明:雌激素配合石杉碱甲治疗阿尔茨海默病对其认知功能等有保护作用,并且可加强石杉碱甲的疗效,为女性阿尔茨海默病的预防及治疗带来了希望。同时还小样本的采用了安理申配合雌激素治疗阿尔茨海默病的试验,取得了和国外同类研究的一致性。 康复研究在老年期痴呆的治疗中起着举足轻重的作用。由于痴呆是一种慢性疾病 WP=5 且社会生活功能缺损日益加重,需要对其进行照料,而我国的国情决定了多数患者是在家庭内被照料,照料负担极
[Abstract]:Dementia is an acquired intelligence impairment syndrome caused by brain dysfunction. With the aging of the population in China, the incidence of senile dementia has an increasing trend, and has become an increasingly prominent social and medical problem. Therefore, seeking treatment for dementia is particularly important to improve the quality of life of the elderly, in the treatment, because of dementia. Dementia is an organic disease, most of which are irreversible, so there is no satisfactory effect at present. Essential treatment for dementia is still under exploration. Experimental drug therapy for dementia caused by some reasons has made some gratifying progress. Drug therapy can improve some symptoms. It has great potential to summarize and explore the effective ingredients of traditional Chinese medicine, establish a unified efficacy observation index and quantitative efficacy evaluation of the pharmacological model, in order to provide new hope for human beings to conquer dementia. Traditional Chinese medicine is a treasure of our country. At present, the treatment of senile dementia has no specific effect. In contrast, traditional Chinese medicine has rich theoretical and practical experience in delaying senility and preventing and treating senility-related diseases. It has potential advantages and broad prospects for development. Sexual cognitive function has a protective effect. A comparative study of estrogen on female patients with Alzheimer's disease was designed. The possibility of estrogen combined with cholinesterase inhibitor in the treatment of female patients with Alzheimer's disease was put forward. The ideal effect was achieved. The anticipated purpose of improving cognitive function of senile dementia was achieved. The treatment of patients with Alzheimer's disease has brought the gospel.Through the observation and Study on the treatment and rehabilitation of dementia with the combination of traditional Chinese medicine and Western medicine, we found that it has a better effect.In a word, we should find a precise and effective prevention and treatment method to improve the quality of life and social adaptability of patients, so as to minimize the adverse effects caused by dementia-like diseases. On the basis of studying the pathogenesis and treatment of dementia at home and abroad in recent years, this paper takes the treatment and rehabilitation of integrated traditional Chinese and Western medicine as the leading ideology, applies the characteristics of traditional Chinese medicine, combines the role of Western medicine, and cooperates with rehabilitation therapy to predict dementia, especially Alzheimer's disease and vascular dementia. Prevention, control and treatment have achieved obvious curative effects.
In this paper, we first proposed and carried out a study on the curative effect of Chinese medicine (Luotai) on senile dementia (vascular dementia and Alzheimer's disease). The animal experiment showed that the total saponins of ginseng had obvious protective effect on cerebral ischemia-reperfusion injury in rats. It could dilate blood vessels, increase cerebral blood flow, alleviate ultrastructural damage of cerebral edema and reduce mortality. Its protective effect was closely related to inhibition of calcium accumulation. Clinical application proves that it has
WP=4
Expanding cardio-cerebrovascular, increasing cardio-cerebrovascular flow, improving cardio-cerebral microcirculation, and protecting delayed neuronal damage in hippocampal CAI area (related to learning and memory) after cerebral ischemia, and anti-inflammatory and estrogen-like effects, clinical practice has proved that ginsenoside can improve memory and neuroprotection similar to estrogen. Estrogen participates in the regulation of central nervous system function. Endogenous estrogen is the protective factor of Alzheimer Disease (AD). Estrogen replacement therapy is beneficial to the prevention and treatment of AD. Therefore, ginsenoside, as a traditional Chinese medicine with estrogen-like effect, can be used as an alternative to estrogen and has important significance for the prevention and treatment of AD. Li Linxian has shown that Rb1, an active component of ginsenoside, can reduce the concentration of intracellular calcium and the activity of calcium protein. The range of cerebral infarction has the effect of anti AD and Vascular Dementia (VD).
Secondly, the effects of Chinese herbal medicine on vascular dementia were studied. The prescriptions consisted of Astragalus membranaceus, Safflower, Lycium barbarum, Schisandra chinensis, Radix Paeoniae rubrae, Rhizoma Chuanxiong, Safflower, Angelica sinensis, Dilong. Fructus Schisandrae Chinensis and Fructus Lycium barbarum have exciting effects on nervous system and can improve people's intelligence activities; Angelica sinensis, Ligusticum chuanxiong, Radix Paeoniae rubra, Fructus Schisandrae chinensis, Fructus Phellodendrae chinensis and Fructus Phellodendrae phellodendrae chinensis all have different degrees of calcium channel blockade effect, which can obviously increase cerebral blood flow, improve cerebral circulation and scavenge free radi Blue anti-aging. Therefore, the combination of the above drugs can improve the activity of superoxide dismutase, reduce lipid peroxide, anti-free radical damage, improve cerebral microcirculation, promote the recovery of nerve cell function, and have a significant protective effect on delayed neuronal damage in hippocampal CAI area (related to learning and memory) after cerebral ischemia. The steps slow down the occurrence of dementia and provide a cheap treatment channel for many patients with vascular dementia.
Thirdly, the feasibility of huperzine A (cholinesterase inhibitor) in combination with estrogen in the treatment of Alzheimer's disease, an extract from the Chinese herbal medicinal Millennium tower, has been proposed and developed, which is currently the focus of several studies in the US Research Nurse Coordinator Alzheimer's Disease Research Center (Houston Baylor College of Medicine). Epidemiological studies have shown that the incidence of female Alzheimer's disease is much higher than that of male. One of the possible reasons for this is that estrogen levels have declined. Estrogen has a protective effect on cognition, and so on. It is concluded that estrogen combined with huperzine A has a protective effect on cognitive function of Alzheimer's disease and can enhance the efficacy of huperzine A, which brings hope for the prevention and treatment of female Alzheimer's disease. Consistency of class research.
Rehabilitation research plays an important role in the treatment of senile dementia, which is a chronic disease.
WP=5
And the social life function defect is getting worse and worse, which needs to be cared for. However, the situation of our country determines that most of the patients are cared for in the family, and the burden of care is extremely high.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2004
【分类号】：R749.16
本文编号：2211691
[Abstract]:Dementia is an acquired intelligence impairment syndrome caused by brain dysfunction. With the aging of the population in China, the incidence of senile dementia has an increasing trend, and has become an increasingly prominent social and medical problem. Therefore, seeking treatment for dementia is particularly important to improve the quality of life of the elderly, in the treatment, because of dementia. Dementia is an organic disease, most of which are irreversible, so there is no satisfactory effect at present. Essential treatment for dementia is still under exploration. Experimental drug therapy for dementia caused by some reasons has made some gratifying progress. Drug therapy can improve some symptoms. It has great potential to summarize and explore the effective ingredients of traditional Chinese medicine, establish a unified efficacy observation index and quantitative efficacy evaluation of the pharmacological model, in order to provide new hope for human beings to conquer dementia. Traditional Chinese medicine is a treasure of our country. At present, the treatment of senile dementia has no specific effect. In contrast, traditional Chinese medicine has rich theoretical and practical experience in delaying senility and preventing and treating senility-related diseases. It has potential advantages and broad prospects for development. Sexual cognitive function has a protective effect. A comparative study of estrogen on female patients with Alzheimer's disease was designed. The possibility of estrogen combined with cholinesterase inhibitor in the treatment of female patients with Alzheimer's disease was put forward. The ideal effect was achieved. The anticipated purpose of improving cognitive function of senile dementia was achieved. The treatment of patients with Alzheimer's disease has brought the gospel.Through the observation and Study on the treatment and rehabilitation of dementia with the combination of traditional Chinese medicine and Western medicine, we found that it has a better effect.In a word, we should find a precise and effective prevention and treatment method to improve the quality of life and social adaptability of patients, so as to minimize the adverse effects caused by dementia-like diseases. On the basis of studying the pathogenesis and treatment of dementia at home and abroad in recent years, this paper takes the treatment and rehabilitation of integrated traditional Chinese and Western medicine as the leading ideology, applies the characteristics of traditional Chinese medicine, combines the role of Western medicine, and cooperates with rehabilitation therapy to predict dementia, especially Alzheimer's disease and vascular dementia. Prevention, control and treatment have achieved obvious curative effects.
In this paper, we first proposed and carried out a study on the curative effect of Chinese medicine (Luotai) on senile dementia (vascular dementia and Alzheimer's disease). The animal experiment showed that the total saponins of ginseng had obvious protective effect on cerebral ischemia-reperfusion injury in rats. It could dilate blood vessels, increase cerebral blood flow, alleviate ultrastructural damage of cerebral edema and reduce mortality. Its protective effect was closely related to inhibition of calcium accumulation. Clinical application proves that it has
WP=4
Expanding cardio-cerebrovascular, increasing cardio-cerebrovascular flow, improving cardio-cerebral microcirculation, and protecting delayed neuronal damage in hippocampal CAI area (related to learning and memory) after cerebral ischemia, and anti-inflammatory and estrogen-like effects, clinical practice has proved that ginsenoside can improve memory and neuroprotection similar to estrogen. Estrogen participates in the regulation of central nervous system function. Endogenous estrogen is the protective factor of Alzheimer Disease (AD). Estrogen replacement therapy is beneficial to the prevention and treatment of AD. Therefore, ginsenoside, as a traditional Chinese medicine with estrogen-like effect, can be used as an alternative to estrogen and has important significance for the prevention and treatment of AD. Li Linxian has shown that Rb1, an active component of ginsenoside, can reduce the concentration of intracellular calcium and the activity of calcium protein. The range of cerebral infarction has the effect of anti AD and Vascular Dementia (VD).
Secondly, the effects of Chinese herbal medicine on vascular dementia were studied. The prescriptions consisted of Astragalus membranaceus, Safflower, Lycium barbarum, Schisandra chinensis, Radix Paeoniae rubrae, Rhizoma Chuanxiong, Safflower, Angelica sinensis, Dilong. Fructus Schisandrae Chinensis and Fructus Lycium barbarum have exciting effects on nervous system and can improve people's intelligence activities; Angelica sinensis, Ligusticum chuanxiong, Radix Paeoniae rubra, Fructus Schisandrae chinensis, Fructus Phellodendrae chinensis and Fructus Phellodendrae phellodendrae chinensis all have different degrees of calcium channel blockade effect, which can obviously increase cerebral blood flow, improve cerebral circulation and scavenge free radi Blue anti-aging. Therefore, the combination of the above drugs can improve the activity of superoxide dismutase, reduce lipid peroxide, anti-free radical damage, improve cerebral microcirculation, promote the recovery of nerve cell function, and have a significant protective effect on delayed neuronal damage in hippocampal CAI area (related to learning and memory) after cerebral ischemia. The steps slow down the occurrence of dementia and provide a cheap treatment channel for many patients with vascular dementia.
Thirdly, the feasibility of huperzine A (cholinesterase inhibitor) in combination with estrogen in the treatment of Alzheimer's disease, an extract from the Chinese herbal medicinal Millennium tower, has been proposed and developed, which is currently the focus of several studies in the US Research Nurse Coordinator Alzheimer's Disease Research Center (Houston Baylor College of Medicine). Epidemiological studies have shown that the incidence of female Alzheimer's disease is much higher than that of male. One of the possible reasons for this is that estrogen levels have declined. Estrogen has a protective effect on cognition, and so on. It is concluded that estrogen combined with huperzine A has a protective effect on cognitive function of Alzheimer's disease and can enhance the efficacy of huperzine A, which brings hope for the prevention and treatment of female Alzheimer's disease. Consistency of class research.
Rehabilitation research plays an important role in the treatment of senile dementia, which is a chronic disease.
WP=5
And the social life function defect is getting worse and worse, which needs to be cared for. However, the situation of our country determines that most of the patients are cared for in the family, and the burden of care is extremely high.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2004
【分类号】：R749.16
【引证文献】
相关硕士学位论文 前1条
1 车鹏;电针与尼莫地平对AD大鼠海马CA_3区α_7烟碱型乙酰胆碱受体的影响[D];宁夏医科大学;2011年
，本文编号：2211691
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