【摘要】：目的:本課題擬通過用補腎健脾法聯(lián)合安理申與單用安理申治療后患者MMSE、ADL量表積分及中醫(yī)證候積分的前后對比,來判斷補腎健脾法治療脾腎兩虛型老年性癡呆的臨床療效。方法:按照本課題診斷標(biāo)準(zhǔn),選取脾腎兩虛型老年性癡呆患者48例,采用隨機數(shù)字表法分為治療組:補腎健脾法方藥:黨參20g、黃芪30g、白術(shù)20g、淫羊藿15g、熟地黃20g、肉蓯蓉30g、茯苓20g、陳皮12g、甘草6g,由河南中醫(yī)學(xué)院一附院制劑室煎藥機統(tǒng)一煎煮,每日2次,每次一袋200ml,口服;鹽酸多奈哌齊片(安理申),5mg/d,晚上睡前口服;對照組:鹽酸多奈哌齊片(安理申),5mg/d,晚上睡前口服。兩組各24例,連續(xù)服藥8周。觀察兩組患者治療前后MMSE、ADL量表積分及中醫(yī)證候積分的變化情況,并進行統(tǒng)計學(xué)分析。結(jié)果:兩組共收集完整病例48例,無脫落及剔除病例。1.治療后兩組MMSE積分較前均顯著提高(P0.01),組間對比存在顯著差別(P0.05)。認知功能改善療效總有效率治療組83.3%,對照組66.7%,組間對比分析存在顯著差別(P0.05)2.治療后兩組ADL積分較前均顯著降低(P0.01),組間對比存在顯著差別(P0.05)。行為能力改善療效治療組總有效率87.5%,對照組75%,組間對比分析存在顯著差別(P0.05)3.治療后兩組中醫(yī)證候積分均顯著降低(P0.01),組間對比存在顯著差別(P0.05)。中醫(yī)證候療效改善治療組總有效率87.5%,對照組70.8%,組間對比分析存在顯著差別(P0.05)4.不良反應(yīng)及毒副作用:治療后兩組患者的血、尿、糞常規(guī)及心、肝、腎功能較治療前均未出現(xiàn)異常改變,且臨床觀察期間治療組與對照組患者均未發(fā)生明顯不良反應(yīng)。結(jié)論:本次臨床觀察表明,運用補腎健脾法聯(lián)合鹽酸多奈哌齊治療的老年性癡呆(脾腎兩虛型)患者,其臨床癥狀(認知功能、行為功能)改善和中醫(yī)證候改善均明顯優(yōu)于單用鹽酸多奈哌齊的患者,且在臨床觀察期間未發(fā)生明顯不良反應(yīng)。結(jié)果反應(yīng)補腎健脾法能明顯改善脾腎兩虛型老年性癡呆(AD)患者的臨床癥狀,提高認知功能,改善患者的生活質(zhì)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.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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