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健脑益智方联合常规西药治疗阿尔茨海默病的临床体会。

Clinical Experience in Treatment of Alzheimer's Disease with Jiannao Yizhi Formula () and Routine Western Medicine.

机构信息

Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.

Department of Geratology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.

出版信息

Chin J Integr Med. 2020 Mar;26(3):212-218. doi: 10.1007/s11655-019-2718-2. Epub 2020 Mar 16.

Abstract

OBJECTIVE

To investigate the long-term therapeutic effects of the Chinese medicine Jiannao Yizhi Formula (, JYF) in the treatment of Alzheimer's disease (AD).

METHODS

Sixty mild-to-moderate AD participants were recruited and randomly allocated to the treatment (30 with JYF) and the control groups (30 with donepezil) for 6 months with the random numbers. The primary outcomes were scores of Alzheimer's Disease Rating Scale-Cognitive (ADAS-Cog) and Chinese Medicine Symptom Scale (CM-SS). The secondary outcomes were scores of Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Activities of Daily Living (ADL). Safety assessments were conducted at baseline and the 6th month of treatment. Serum levels of acetylcholine (Ach), amyloid-β protein 42 (Aβ), and the microtubule-associated protein tau (Tau) were also determined by enzyme-liked immunosorbent assay.

RESULTS

Fifty-one participants were included in the final analyses (JYF n=27; donepezil n=24). Compared with baseline, both JYF and donepezil increased the MoCA and MMSE scores and decreased the ADAS-Cog and CM-SS scores (P<0.05 or P<0.01). Both drugs increased the serum levels of Ach and decreased the serum levels of Aβ and Tau (all P<0.05). There was no significant difference in these variables between the two groups, which showed that JYF was not inferior to donepezil. No obviously significant changes were observed in the ADL. No severe adverse events were observed in both groups.

CONCLUSION

The effect and safety of JYF for the treatment of AD were not inferior to those of donepezil.

摘要

目的

研究中药健脑益智方(JYF)治疗阿尔茨海默病(AD)的长期疗效。

方法

共纳入 60 例轻中度 AD 患者,按随机数字表法分为治疗组(30 例,JYF)和对照组(30 例,多奈哌齐),疗程 6 个月。主要结局指标为阿尔茨海默病评定量表认知部分(ADAS-Cog)和中医证候量表(CM-SS)评分。次要结局指标为简易智能状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)和日常生活能力量表(ADL)评分。治疗前和治疗 6 个月时进行安全性评估。采用酶联免疫吸附法检测血清乙酰胆碱(Ach)、β淀粉样蛋白 42(Aβ)和微管相关蛋白 tau(Tau)水平。

结果

51 例患者完成了最终分析(JYF 组 27 例,多奈哌齐组 24 例)。与基线相比,JYF 和多奈哌齐均能提高 MoCA 和 MMSE 评分,降低 ADAS-Cog 和 CM-SS 评分(P<0.05 或 P<0.01);均能升高血清 Ach 水平,降低 Aβ和 Tau 水平(均 P<0.05)。两组间上述各指标比较差异均无统计学意义,表明 JYF 与多奈哌齐相当。两组 ADL 评分均无明显变化。两组均未发生严重不良事件。

结论

JYF 治疗 AD 的疗效和安全性不劣于多奈哌齐。

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