补肾健脾法治疗老年性痴呆（脾肾两虚型）的临床观察

发布时间：2018-08-25 09:06

【摘要】：目的:本课题拟通过用补肾健脾法联合安理申与单用安理申治疗后患者MMSE、ADL量表积分及中医证候积分的前后对比,来判断补肾健脾法治疗脾肾两虚型老年性痴呆的临床疗效。方法:按照本课题诊断标准,选取脾肾两虚型老年性痴呆患者48例,采用随机数字表法分为治疗组:补肾健脾法方药:党参20g、黄芪30g、白术20g、淫羊藿15g、熟地黄20g、肉苁蓉30g、茯苓20g、陈皮12g、甘草6g,由河南中医学院一附院制剂室煎药机统一煎煮,每日2次,每次一袋200ml,口服;盐酸多奈哌齐片(安理申),5mg/d,晚上睡前口服;对照组:盐酸多奈哌齐片(安理申),5mg/d,晚上睡前口服。两组各24例,连续服药8周。观察两组患者治疗前后MMSE、ADL量表积分及中医证候积分的变化情况,并进行统计学分析。结果:两组共收集完整病例48例,无脱落及剔除病例。1.治疗后两组MMSE积分较前均显著提高(P0.01),组间对比存在显著差别(P0.05)。认知功能改善疗效总有效率治疗组83.3%,对照组66.7%,组间对比分析存在显著差别(P0.05)2.治疗后两组ADL积分较前均显著降低(P0.01),组间对比存在显著差别(P0.05)。行为能力改善疗效治疗组总有效率87.5%,对照组75%,组间对比分析存在显著差别(P0.05)3.治疗后两组中医证候积分均显著降低(P0.01),组间对比存在显著差别(P0.05)。中医证候疗效改善治疗组总有效率87.5%,对照组70.8%,组间对比分析存在显著差别(P0.05)4.不良反应及毒副作用:治疗后两组患者的血、尿、粪常规及心、肝、肾功能较治疗前均未出现异常改变,且临床观察期间治疗组与对照组患者均未发生明显不良反应。结论:本次临床观察表明,运用补肾健脾法联合盐酸多奈哌齐治疗的老年性痴呆(脾肾两虚型)患者,其临床症状(认知功能、行为功能)改善和中医证候改善均明显优于单用盐酸多奈哌齐的患者,且在临床观察期间未发生明显不良反应。结果反应补肾健脾法能明显改善脾肾两虚型老年性痴呆(AD)患者的临床症状,提高认知功能,改善患者的生活质量。
[Abstract]:Objective: to evaluate the clinical effect of tonifying kidney and invigorating spleen on senile dementia of deficiency of spleen and kidney by comparing the scores of MMSE,ADL scale and syndromes of traditional Chinese medicine (TCM) after treatment with Anlisen alone and the method of tonifying kidney and invigorating spleen. Methods: according to the diagnostic criteria, 48 cases of senile dementia with deficiency of spleen and kidney were selected. The treatment group was randomly divided into three groups: Codonopsis 20g, Astragalus 30g, Atractylodes macrocephala 20g, Herba Epimedii 15g, Radix Rehmanniae 20g, Cistanche Cistanche 30g, Poria cocos 20g, Chenpi 12g, Glycyrrhiza 6g. Two times a day, a bag of 200 ml was taken orally; Donepezil hydrochloride was given 5 mg / d at night before bedtime; in control group, Donepezil hydrochloride was given 5 mg / d before bedtime. 24 cases in each group were treated continuously for 8 weeks. The changes of MMSE,ADL scale and TCM syndrome integral before and after treatment were observed and statistically analyzed. Results: a total of 48 complete cases were collected in both groups. After treatment, the MMSE scores in the two groups were significantly higher than before (P0. 01), and there was significant difference between the two groups (P0.05). The total effective rate of cognitive function improvement was 83.3% in the treatment group and 66.7% in the control group. There was significant difference between the two groups (P0.05). After treatment, the ADL scores of the two groups were significantly lower than before (P0. 01), and there was significant difference between the two groups (P0.05). The total effective rate of the treatment group was 87.5%, while that of the control group was 75%. There was significant difference between the two groups (P0.05). After treatment, the scores of TCM syndromes in the two groups were significantly decreased (P0.01), and there was significant difference between the two groups (P0.05). The total effective rate of the treatment group was 87.5%, while that of the control group was 70.8%. There was significant difference between the two groups (P0.05). Adverse reactions and side effects: there were no abnormal changes in blood, urine, fecal routine, heart, liver and kidney function in the two groups after treatment, and there were no obvious adverse reactions in the treatment group and the control group during the period of clinical observation. Conclusion: the clinical observation shows that the clinical symptoms (cognitive function) of senile dementia treated with tonifying kidney and strengthening spleen combined with Donepezil Hydrochloride are related to the deficiency of spleen and kidney. The improvement of behavioral function and the improvement of TCM syndromes were significantly better than those of the patients with Donepezil hydrochloride alone, and no significant adverse reactions occurred during the clinical observation. Results the method of reaction tonifying the kidney and strengthening the spleen could obviously improve the clinical symptoms, cognitive function and quality of life of the patients with senile dementia with deficiency of spleen and kidney.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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