CAJ | 학술논문

目的探讨黄连温胆汤加味治疗老年轻度认知障碍(mild cognitive impairment,MCI)痰浊阻窍证的临床疗效.方法采用区组随机、双盲双模拟、对照的设计原则,将2007年12月-2009年2月入选64例患者随机分为治疗组和对照组,每组32例.同时筛选出老年健康者15名设为健康对照组,治疗组口服黄连温胆汤加味汤剂,每次200 mL,每天2次,同时服用模拟胶囊;对照组给予口服茴拉西坦胶囊,每次0.2 g(70岁以上0.1 g),每天3次,同时服用模拟汤剂.两组均用药3个月.观察患者中医证候、认知能力[简易精神状态检查(MMSE)]、实验指标[乙酰胆碱(Ach)、超氧化物转化酶(SOD)、丙二醛(MDA)]及相关安全性指标.结果两组治疗后MMSE分均提高,治疗组增高幅度大于对照组,差异有统计学意义(P<0.01).对照组治疗后智能减退(健忘)、头沉或头昏不清、肢体困重积分降低,治疗组治疗后除痰多吐涎外,其余各中医症状积分值均降低,且明显低于对照组,差异均有统计学意义(P<0.01,P<0.05).两组治疗后血清Ach、SOD均提高,MDA均降低,治疗组Ach高于对照组,差异有统计学意义(P<0.01).安全检测显示本研究所用方药未见不良反应.结论黄连温胆汤加味在改善老年轻度认知障碍痰浊阻窍证患者的症状、认知能力、提高Ach含量方面疗效优于茴拉西坦胶囊;在提高血清SOD活性、降低MDA含量方面与茴拉西坦胶囊疗效近似.
목적 탐토황련온담탕가미치료노년경도인지장애(mild cognitive impairment,MCI)담탁조규증적림상료효.방법 채용구조수궤、쌍맹쌍모의、대조적설계원칙,장2007년12월-2009년2월입선64례환자수궤분위치료조화대조조,매조32례.동시사선출노년건강자15명설위건강대조조,치료조구복황련온담탕가미탕제,매차200 mL,매천2차,동시복용모의효낭;대조조급여구복회랍서탄효낭,매차0.2 g(70세이상0.1 g),매천3차,동시복용모의탕제.량조균용약3개월.관찰환자중의증후、인지능력[간역정신상태검사(MMSE)]、실험지표[을선담감(Ach)、초양화물전화매(SOD)、병이철(MDA)]급상관안전성지표.결과 량조치료후MMSE분균제고,치료조증고폭도대우대조조,차이유통계학의의(P<0.01).대조조치료후지능감퇴(건망)、두침혹두혼불청、지체곤중적분강저,치료조치료후제담다토연외,기여각중의증상적분치균강저,차명현저우대조조,차이균유통계학의의(P<0.01,P<0.05).량조치료후혈청Ach、SOD균제고,MDA균강저,치료조Ach고우대조조,차이유통계학의의(P<0.01).안전검측현시본연구소용방약미견불량반응.결론 황련온담탕가미재개선노년경도인지장애담탁조규증환자적증상、인지능력、제고Ach함량방면료효우우회랍서탄효낭;재제고혈청SOD활성、강저MDA함량방면여회랍서탄효낭료효근사.
Objective To observe the clinical efficacy of modified Huanglian Wendan Decoction (HWD) in treating senile mild cognitive impairment (MCI) of turbid-phlegm blocking orifice syndrome. Methods With a block randomized, double-blinded and controlled design adopted, the 64 patients of MCI selected from December 2007 to February 2009 were randomly and equally assigned to two groups. The treatment group was treated with HWD in dose of 200 mL, twice a day; the control group was given Aniraectam 0.2 g (for patients over 70 years old, 0.1 g) three times a day. And the illusive medicine in dosage-form of capsule/decoction simulated to that used in the opposite group was applied. The medication and observation lasted for three months. Chinese medicine syndrome, cognition capacity (by MMSE), laboratory indexes [acetylcholine (Ach), superoxide dismutase (SOD), malondialdehyole (MDA)] and safety related indexes in patients were observed. Results After treatment, MMSE score increased in both groups, but the increment in the treatment group was significantly higher than that in the control group (P<0.01); Chinese medine syndrome estimated by scoring showed that after treatment, all scores of syndromes, excepting the expectoration, were improved in the treatment group with the post-treatment scores significantly lower than those in the control group respectively (P<0.05 or P<0.01); while in the control group, lowering of scores only showed in some symptoms such as poor memory, heavy head or dizziness, and heavy sensation in limbs and body. Serum levels of Ach and SOD decreased and MDA increased in both groups after treatment, but the change of Ach was more significant in the treatment group (P<0.01). No obvious adverse reactions were found during the treatment. Conclusion For treatment of MCI, HWD shows effects in improving patients' symptoms, cognition capacity and elevating serum Ach content better than that of Aniraectam; and with effects for raising SOD activity and reducing MDA level similar to those of Aniraectam.