自拟痴呆汤治疗轻中度血管性痴呆

目的探讨自拟痴呆汤治疗血管性痴呆(vasculardementia,VD)的疗效和脑CT的变化情况。方法将符合美国精神病学会DSM-IV诊断标准的血管性痴呆患者68例,按入院顺序分为观察组(38例)和对照组(30例),分别采用以自拟痴呆汤为主和吡硫醇(Pyritinol)(脑复新)治疗,疗程6个月。采用简明精神状态量表(MMSE)和日常生活活动(ADL)积分变化进行评估疗效,检测患者治疗前后血清雌二醇(E2)和睾酮(T)的水平变化,观察脑萎缩分度变化情况。结果观察组经治疗后血清E2和T水平均提高犤从治疗前的(100±30)pmol/L,(7±5)mmol/L升至治疗后的(160±30)pmol/L,(15±4)mmol/L,E2/T比值降低(由治疗前的20±17降至治疗后的13±4)(t=8.7128,7.701,2.470,P<0.01)。观察组MMSE和ADL治疗前后差值为4.7±2.5,5.2±2.5;对照组为2.3±2.5,2.7±2.9;观察组优于对照组(t=3.7485,3.8974,P<0.01);观察组治疗后脑萎缩恢复情况比对照组好,(t=20.10,3.2314,2.4936,2.0046,P<0.01)。结论中西医结合治疗血管性痴呆,能提高血清E2和T水平,降低E2/T比值,调节神经内分泌,使脑萎缩在形态学上有恢复正常的趋势。

Self-made Chidai Tang on mild and moderate vascular dementia

AIM:To explore the therapeutic effect of self made Chidai Tang on vascular dementia(VD) and changes of brain CT. METHODS:68 VD patients in accordance with American psychiatric association DSM IV diagnosis standard were divided by admitting order into observation group receiving self made Chidai Tang treatment(n=38) and control group receiving pyritinol(Naofuxin) treatment(n=30).The therapeutic courses were 6 months.Mini mental state examination(MMSE) and activity of daily life(ADL) were used to evaluate therapeutic effects.Changes of serum estradiol(E2) and testosteone(T) levels were detected and degrees of brain atrophy were observed. RESULTS:In observation group,levels of E2 and T were increased[from ( 100± 30) pmol/L,( 7± 5) mmol/L before treatment to ( 160± 30) pmol/L,( 15± 4) mmol/L after treatment].The ratio of E2/T decreased(from 20± 17 before treatment to 13± 4 after treatment,t=8.712 8,7.701,2.470,P< 0.01).The differences of MMSE and ADL were 4.7± 2.5,5.2± 2.5 in observation group and 2.3± 2.5,2.7± 2.9 in control group( t=3.748 5,3.897 4,P< 0.01) ;The improvement of brain atrophy in observation group was superior to control group( t=20.10,3.231 4,2.493 6,2.004 6,P< 0.01) . CONCLUSION:Combination of TCM and western medicine on vascular dementia can increase serum levels of E2 and T,decrease ratio of E2/T,regulate neuroendocrine and improve brain atrophy in morphology.