以肾浊辨识理论认识阿尔茨海默病的诊断与治疗

目的以中医肾浊辨识理论认识阿尔茨海默病的相关特征.方法从病理变化,发病机制,临床表现等几个方面对肾浊与阿尔茨海默病的关系进行分析.结果现代神经病理检查发现阿尔茨海默病患者大脑皮质蒌缩,脑回变平,脑沟增宽,脑室扩大,脑重量减轻,皮质神经细胞有不同程度的减少,这些变化是中医肾精不足的表现.阿尔茨海默病造成神经元丧失的主要机制是氧自由基作用于神经细胞元,引起Ca2+内流增加,中医理论视氧自由基为"肾浊".阿尔茨海默病患者肾精不足,心失所养,加之肾浊上扰,心神失常,投射于脑,影响脑的功能,故产生近记忆障碍常为阿尔茨海默病首发症状.结论对阿尔茨海默病的中医治疗,在注重补肾填精的同时,更要注重泄肾浊,针对肾浊运用祛疾泄浊,除湿化疾之法.

Recognition of differentiation theory of kidney turbidity in the diagnosis and treatment of Alzheimer disease

AIM: The differentiation theory on kidney turbidity is used to recognize the relevant characters of Alzheimer disease. METHODS: The analysis is carried on the interrelationship between kidney turbidity and Alzheimer disease in the aspects of pathology, pathogenesis and clinical manifestations. RESULTS: It was discovered in modern neural pathological examination that in the patients with Alzheimer disease, the cerebral cortex was atrophic, the convolution becomes flat, the cerebral groove was widened, the ventricle was extended, brain weight was declined and cortical nerve cells were de creased in various degrees. All of those changes were the manifestations of kidney essence deficiency in Chinese medicine. The main mechanism on neuron loss caused by Alzheimer disease was that oxygenic free radical works on nerve neurons and induces the increased Ca2+ inner-flow. Con cerning to the theory of Chinese medicine, oxygenic free radical was taken as "kidney turbidity". In the patients with Alzheimer disease, insufficient kid ney essence resulted in malnourishment of heart. In addition, upward dis turbance of kidney turbidity and abnormality of heart mind projected the brain and affected brain function, resulting in recent memory disturbance that was the initial symptom of Alzheimer disease. CONCLUSION: Concerning to the treatment of Alzheimer disease, Chinese medicine emphasizes not only on reinforcing kidney and filling-up essence, but also rather on eliminating kidney turbidity, for which, the method of re solving turbidity and damp is applied specially.