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[醒脑益智胶囊治疗老年轻度认知功能障碍的随机对照双盲试验]

[A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment].

作者信息

Li Hao, Yao Ming-Jiang, Zhao Wen-Ming, Guan Jie, Cai Lin-Lin, Cui Ling

机构信息

Department of Geriatrics, China Academy of Chinese Medical Sciences, Beijing 100091, China.

出版信息

Zhong Xi Yi Jie He Xue Bao. 2008 Jan;6(1):25-31. doi: 10.3736/jcim20080106.

Abstract

OBJECTIVE

To observe the effect and explore the mechanism of Huannao Yicong capsule in treating senile patients with mild cognitive impairment (MCI).

METHODS

The investigational drugs were packed by blind method. A randomized, double-blind and controlled trial was conducted on ninety senile patients with MCI. Other forty-five senile healthy persons were recruited to the healthy control group. The ninety senile patients were randomly divided into the Huannao Yicong capsule-treated group (45 patients administered with three Huannao Yicong capsules and two aniracetam capsule analogues) and aniracetam-treated group (45 patients treated with two aniracetam capsules and three Huannao Yicong capsule analogues). Patients in the two groups were treated three times daily for 16 weeks. Memory, traditional Chinese medicine syndrome, cerebral blood flow, free radicals and inflammatory mediators, such as superoxide dismutase (SOD), malondialdehyde (MDA), acetylcholinesterase (AchE), interleukin-1alpha (IL-1alpha) and interleukin-6 (IL-6) were determined before and after the treatment. Blood lipids, including triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A-1 (ApoA-1) and apolipoprotein B-100 (ApoB-100), were detected before and after the treatment. The safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and electrocardiogram (ECG) were taken before and after the treatment.

RESULTS

Index score of clinical memory scale in senile healthy people was significantly higher than that in MCI patients before treatment (P<0.01), and the content of AchE, IL-1alpha and IL-6 was obviously lower (P<0.01, P<0.05), the activity of SOD was higher (P<0.05). No significant difference was found in direction memory of clinical memory scale between the two treatment groups. Other index scores of clinical memory scale and traditional Chinese medicine syndrome in patients of Huannao Yicong capsule-treated group were significantly improved as compared with those of the aniracetam-treated group (P<0.05, P<0.01). The blood flow parameters of anterior cerebral artery, posterior cerebral artery and resistant index in patients of Huannao Yicong capsule-treated group were increased significantly (P<0.01, P<0.05). Huannao Yicong capsule could significantly increase the activity of serum SOD and decrease the content of AchE, IL-1alpha and IL-6 (P<0.01, P<0.05), better than aniracetam. Furthermore, Huannao Yicong capsule could significantly improve the blood lipid, such as the level of TG, LDL-C, HDL-C, ApoA-1 and ApoB-100 (P<0.01, P<0.05), and better than aniracetam (P<0.01, P<0.05). No significant changes were found after treatment in safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and ECG.

CONCLUSION

Huannao Yicong capsule has better therapeutic effect than aniracetam capsule in treating senile mild cognitive impairment.

摘要

目的

观察还脑益聪胶囊治疗老年轻度认知功能障碍(MCI)患者的疗效并探讨其作用机制。

方法

采用盲法包装试验药物。对90例老年MCI患者进行随机、双盲、对照试验。另招募45例老年健康者作为健康对照组。将90例老年患者随机分为还脑益聪胶囊治疗组(45例,给予3粒还脑益聪胶囊及2粒茴拉西坦胶囊类似物)和茴拉西坦治疗组(45例,给予2粒茴拉西坦胶囊及3粒还脑益聪胶囊类似物)。两组患者均每日治疗3次,共治疗16周。治疗前后测定记忆、中医证候、脑血流、自由基及炎症介质,如超氧化物歧化酶(SOD)、丙二醛(MDA)、乙酰胆碱酯酶(AchE)、白细胞介素-1α(IL-1α)和白细胞介素-6(IL-6)。检测治疗前后血脂,包括甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A-1(ApoA-1)和载脂蛋白B-100(ApoB-100)。治疗前后检测血常规、尿常规、肝肾功能及心电图等安全性指标。

结果

治疗前,老年健康者临床记忆量表指标评分显著高于MCI患者(P<0.01),AchE、IL-1α和IL-6含量明显低于MCI患者(P<0.01,P<0.05),SOD活性高于MCI患者(P<0.05)。两组治疗组临床记忆量表指向记忆方面差异无统计学意义。还脑益聪胶囊治疗组患者临床记忆量表其他指标评分及中医证候评分与茴拉西坦治疗组相比显著改善(P<0.05,P<0.01)。还脑益聪胶囊治疗组患者大脑前动脉、大脑后动脉血流参数及阻力指数显著升高(P<0.01,P<0.05)。还脑益聪胶囊能显著提高血清SOD活性,降低AchE、IL-1α和IL-6含量(P<0.01,P<0.05),优于茴拉西坦。此外,还脑益聪胶囊能显著改善血脂,如TG、LDL-C、HDL-C、ApoA-1和ApoB-100水平(P<0.01,P<0.05),且优于茴拉西坦(P<0.01,P<0.05)。血常规、尿常规、肝肾功能及心电图等安全性指标治疗后未见明显变化。

结论

还脑益聪胶囊治疗老年轻度认知功能障碍疗效优于茴拉西坦胶囊。

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