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韩国传统医学治疗轻度认知障碍患者:一项多中心前瞻性观察病例系列研究。

Korean Traditional Medicine in Treating Patients with Mild Cognitive Impairment: A Multicenter Prospective Observational Case Series.

作者信息

Choi Yujin, Kim Young-Eun, Jerng Ui Min, Kim Hwan, Lee Sung Ik, Kim Ga-Na, Cho Seung-Hun, Kang Hyung Won, Jung In Chul, Han Kyungsun, Lee Jun-Hwan

机构信息

Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daro, Yuseong-gu, Daejeon 34054, Republic of Korea.

Future Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daro, Yuseong-gu, Daejeon 34054, Republic of Korea.

出版信息

Evid Based Complement Alternat Med. 2020 Feb 22;2020:4323989. doi: 10.1155/2020/4323989. eCollection 2020.

Abstract

In Korea, patients with mild cognitive impairment can choose to receive treatment of Korean medicine, and Korean medicine hospitals provide specialized medical care for the prevention and management of cognitive disorders. The aim of the study is to explore the role of Korean medicine therapy for patients with mild cognitive impairment in a real clinical setting. Fifteen patients with amnestic mild cognitive impairment were enrolled in this prospective observational study in three Korean medicine hospitals. Korean medicine treatments were delivered by experienced professionals and not restricted to standardized treatment. Outcome measures were prospectively planned to examine the Korean-Montreal Cognitive Assessment (K-MoCA), Korean-Mini Mental State Examination (K-MMSE), and other detailed neuropsychological assessment at the baseline and after 12 and 24 weeks of treatment. Korean medicine treatment for MCI treatment in the real-world clinical setting included herbal medicine and acupuncture. The most frequently used herbs in herbal decoctions were , , and . The herbal medicine formulae used in this study were classified into three categories: tonifying Qi (33.3%), tonifying kidney (46.7%), and calming liver (20%) formulae. In the cognitive ability assessment, the K-MoCA score significantly improved after treatment (mean difference 2.6; 95% CI: 1.3 to 3.9, =0.001). The K-MMSE score slightly increased after treatment; however, the improvement was not statistically significant (mean difference 0.8; 95% CI: -0.5 to 2.0, =0.195). In detailed neuropsychological assessment, the cognitive domains of executive functions and memory after the treatment were distinctively improved. In this prospective observational case series, we could see the real clinical environments of treating patients with mild cognitive impairment in Korean medicine hospitals. Patients treated with Korean medicine showed improved results in the neuropsychological assessment after 12 and 24 weeks.

摘要

在韩国,轻度认知障碍患者可选择接受韩医治疗,韩医医院为认知障碍的预防和管理提供专业医疗服务。本研究的目的是在实际临床环境中探索韩医治疗对轻度认知障碍患者的作用。15例遗忘型轻度认知障碍患者纳入了这三家韩医医院开展的前瞻性观察性研究。韩医治疗由经验丰富的专业人员实施,并不局限于标准化治疗。前瞻性计划采用韩国蒙特利尔认知评估量表(K-MoCA)、韩国简易精神状态检查表(K-MMSE)以及其他详细的神经心理学评估,于基线期、治疗12周和24周后进行测评。现实临床环境中针对轻度认知障碍的韩医治疗包括草药和针灸。草药汤剂中最常用的草药为 、 和 。本研究中使用的草药配方分为三类:补气配方(33.3%)、补肾配方(46.7%)和平肝配方(20%)。在认知能力评估中,治疗后K-MoCA评分显著改善(平均差值2.6;95%置信区间:1.3至3.9,P = 0.001)。治疗后K-MMSE评分略有升高;然而,改善无统计学意义(平均差值0.8;95%置信区间:-0.5至2.0,P = 0.195)。在详细的神经心理学评估中,治疗后执行功能和记忆的认知领域有明显改善。在这个前瞻性观察性病例系列中,我们可以看到韩医医院治疗轻度认知障碍患者的实际临床环境。接受韩医治疗的患者在12周和24周后的神经心理学评估中结果有所改善。

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