|
|
|
| The clinical efficacy of invigorating the kidney, strengthening spleen and eliminating phlegm in the treatment of amnestic mild cognitive impairment |
| WU Dongyue1 WEI Mingqing2 TIAN Jinzhou2 SHI Jing2 |
1.Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
2.Ward 3, Department of Neurology, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 100700, China |
|
|
|
Abstract objective To evaluate the efficacy of invigorating the kidney, strengthening spleen and eliminating phlegm in the treatment of amnestic mild cognitive impairment(aMCI). Methods Using a prospective, open and blank-controlled clinical research method, patients admitted to Ward 3, the Department of Neurology of Dongzhimen Hospital of Beijing University of Chinese Medicine and surrounding communities with a cognitive decline function from January 2014 to January 2017 were screened. A total of 122 patients with aMCI were selected according to the diagnosis and inclusion criteria of this study. The subjects were divided into two groups by number table method: the experimental group (105 cases) received the drugs of invigorating the kidney, strengthening spleen and eliminating phlegm, while the control group (17 cases) was not used any medication or therapy to improves cognitive levels. The observation period was 12 weeks, while the mini mental state examination (MMSE) scores and the pattern element scale for dementia (PES-D/11) scores were recorded before and after treatment. Results In terms of overall cognitive assessment, the MMSE score after 12 weeks of treatment in the experimental group was higher than before treatment, and the difference was statistically significant (P ＜ 0.05). The MMSE score in the experimental group was higher than that in the control group, and the difference was statistically significant (P ＜ 0.05). In terms of Chinese medicine syndromes, the score of kidney deficiency, spleen deficiency and phlegm turbid syndrome in experimental group after 12 weeks of treatment were lower than before treatment, and the differences were statistically significant (P ＜ 0.05). The score of kidney deficiency, spleen deficiency and phlegm turbid syndromes in the experimental group were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). There were 5 cases (6.4%) of adverse reactions in experimental group, and the patients were relieved spontaneously for 1 week without serious adverse events. Conclusion The curative effect and safety of invigorating the kidney, strengthening spleen and eliminating phlegm for the treatment of aMCI for 12 weeks is good. The long-term curative effect can be verified by large-sample and long-course clinical trials.
|
|
|
|
|
|
[1] Alzheimer′s Disease International. World Alzheimer Report 2018 [EB/OL]. https：//www.alz.co.uk/research/world-report-2018.
[2] Petersen RC，Morris JC. Mild cognitive impairment as a clinical entity and treatment Target. [J]. Arch Neurol，2005， 62（7）：1160-1163.
[3] Kelley BJ. Treatment of mild cognitive impairment [J]. Curr Treat Options Neurol，2015，17（9）：372.
[4] Miao YC，Tian JZ，Shi J，et al. Correlation between cognitive functions and syndromes of traditional Chinese medicine in amnestic mild cognitive impairment [J]. Chin Inter Med，2009，7（3）：205-211.
[5] Petersen RC，Doody R. Current concepts in mild cognitive impairment [J]. Aroh Neurol，2001，58（12）：1985-1992.
[6] 倪敬年，时晶，魏明清，等.中药临床试验中的痴呆分期及辨证标准[J].中华中医药杂志，2017，32（2）：452-454.
[7] Trivedi D. Cochrane review summary：Mini-Mental State Examination（MMSE）for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations [J]. Prim Health Care Res 2017，18（6）：527-528.
[8] Sun XY，Li YX，Yu CQ，et al. Reliability and validity of depression scales of Chinese version：a systematic review [J]. Chin J Epidem，2017，38（1）：110-116.
[9] Hachinski V，Oveisgharan S，Romney AK，et al. Optimizing the Hachinski Ischemic Scale [J]. Arch Neurol，2012， 69（2）：169-175.
[10] Bleijenberg N，Zuithoff NPA，Smith AK，et al. Disability in the individual ADL，IADL，and mobility among older adults：a prospective cohort study [J]. Nutrition and Healthy Aging，2017，21（8）：897-903.
[11] Yee A，Tsui NB，Chang YN，et al. Alzheimer′s disease：insights for risk evaluation and prevention in the Chinese population and the need for a comprehensive programme in Hong Kong/China [J]. Hong Kong Med，2018，24（5）：492-500.
[12] Langbaum JB，Fleisher AS，Chen K，et al. Ushering in the study and treatment of preclinical Alzheimer disease [J]. Nat Rev Neurol，2013，32（9）：371-381.
[13] Moyer VA. Screening for cognitive impairment in older adults：U.S. preventive services task force recommendation statement [J]. Ann Intern Med，2014，160（11）：791-797.
[14] Galvin JE，Roe CM，Powlishta KK，et al. The AD8：a brief informant interview to detect dementia [J]. Neurology，2005，65（4）：559-564.
[15] Amanzio M，Benedetti F，Vase L. A systematic review of adverse events in the placebo arm of donepezil trials：the role of cognitive impairment [J]. Int Psychogeriatr，2012， 24（5）：698-707.
[16] 杜磊，韩为，孙健健，等.轻度认知功能障碍的治疗进展[J].中医研究，2015，32（5）：73-76.
[17] 苗迎春，田金洲，时晶，等.遗忘型轻度认知损害的中医证候特征[J].中医杂志，2009，50（3）：244-247.
[18] 龙子弋.基于证候要素的痴呆证候分型量表研究[D].北京：北京中医药大学，2012.
[19] Campbell NL，Unverzagt F，LaMantia MA，et al. Risk factors for the progression of mild cognitive impairment to dementia [J]. Clin Geriatr Med，2013，29（4）：873-893.
[20] Hickman RA，Faustin A，Wisniewski T，et al. Alzheimer disease and Its growing epidemic：risk factors，biomarkers，and the urgent need for therapeutics [J]. Neurol Clin，2016，34（4）：941-953.
[21] Kim J，Na HK，Byun J，et al. Tracking cognitive decline in amnestic mild cognitive impairment and early-stage Alzheimer dementia：Mini-Mental State Examination versus neuropsychological battery [J]. Dement Geriatr Cogn Disord，2017，44（2）：105-117. |
|
|
|
