【作者】 宋旭霞；

【导师】 曹晓岚；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2002， 硕士

【摘要】 本研究作为“九五”国家重点攻关课题(96-906-09-03)的一部分，旨在通过科学严谨的临床研究，结合导师临证心得体会，对血管性痴呆的中医病机及聪圣胶囊的临床疗效及作用机理进行较深入的探讨。临床研究部分，中医病名诊断标准参照1995年国家卫生部颁布的《中药新药治疗痴呆的临床研究指导原则》中的病名诊断标准，西医诊断标准参照世界卫生组织(WHO)正式公布的美国精神神经疾病分类学中VaD诊断的DSM-Ⅲ和DSM-Ⅳ标准，痴呆分度参照DSM-Ⅲ中痴呆严重程度标准，疗效判定以MMSE得分为主要参考指标，采用尼莫地平法计算公式。共纳入病例55例，其中聪圣胶囊治疗组30例，喜得镇对照组25例。临床研究结果显示治疗组总有效率达80.00％，而对照组总有效率为48.00％；中医证候疗效，治疗组总有效率为90.00％，对照组为68.00％，经比较有非常显著性差异；治疗组对MMSE、Blessed评分、MMSE亚项、痴呆主要症状、痴呆兼有症状及全血高切粘度、红细胞压积、红细胞变形指数情况均有改善作用，并明显优于对照组，提示聪圣胶囊可显著改善痴呆患者智能低下、日常生活能力下降情况、痴呆主要症状及兼有症状。根据本课题组其他单位相关实验研究资料分析，聪圣胶囊对血管性痴呆的作用机理有以下几个方面：抗血栓作用；降低脑缺血再灌后的脑损伤程度，减轻脑水肿；改善缺血再灌注引起的能量耗竭；对抗EAAs的兴奋毒性作用；激活皮质、海马等处神经元BDNF mRNA、trkB mRNA的表达，促进BDNF、trkB的合成及分泌，对胆碱能神经元起到营养保护作用。本研究揭示肾虚浊毒是血管性痴呆的主要病机，具有益肾化浊、解毒通络功效之聪圣胶囊治疗血管性痴呆具有十分确切的临床疗效及明确的作用机理。更多还原

【Abstract】 This research is the part of the "95" national emphased tackle key problem task(96-906-09-03). To study the effects and mechanism of Congsheng Capsule on Vascular Dementia(VaD),55 patients with VaD were randomly divided into two groups : Congsheng Capsule treating group (SOcases) and control group ( 25cases ) .All the 55 cases observed were diagnosed according to the Diagnostic Standard of VaD of DSM-III and DSM-IV,the curative effects were determined with the MMSE scores according to nimodipin method.The result showed that the total effective rate was 80.00% in treating group and 48.00% in control group, the TCM syndrome effective rate was 90.00% in treating group and 68.00% in control group,there was evident difference between tow groups.At the same time,Congsheng Capsule has evident effects in curing the patients’ clinical symptoms , improving the scores of MMSE and reducing the scors of Blessed .The conclusion of the research showed that insufficience of kedney and the turbid toxin is the main mechanism of VaD; Supplementing the Kedney-essence , subducing turbid, detoxifing and regulating the meridians is the main therapeutic method of VaD; Congsheng Capsule has evident effects in curing VaD.更多还原