【作者】 乔昕；

【导师】 朱振铎；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2003， 硕士

【摘要】 为了探讨老年性痴呆的有效治疗方法和药物，本研究基于导师长期的临床实践，结合现代治疗研究进展，提出心肾亏虚，髓海不足，心肾不交是老年性痴呆的主要病机，进而制定了滋肾养心，健脑益智，交通心肾的基本治法，以此为据拟定益智合剂方，进行了临床观察和急、慢性毒性实验。临床观察老年性痴呆患者54例，随机分为治疗组(28例)和对照组(26例)，分别给予益智合剂和脑复康治疗3个疗程。治疗组的总有效率为85.71％，优于对照组的53.85％，在治疗前后主要临床症状、神经心理学检查HDS、MMSE、ADL、FAQ积分的改善方面，治疗组均优于对照组。由此证明本研究对老年性痴呆病因病机的认识是符合临床实际情况的，益智合剂能有效改善患者的智能障碍，提高社会活动功能和日常生活能力，缓解临床症状。急性毒性实验以相当于临床成人用药量360倍的剂量连续灌胃小白鼠7天，在此期间小白鼠无不良反应及死亡，随后处死解剖检查，各主要脏器均无中毒性病理改变。慢性毒性实验以相当于临床成人用药量12、40和80倍的剂量连续灌胃大鼠3个月，在此期间各剂量组与对照组大鼠的一般状况、体重增长、外周血象、肝肾功能及脏器系数均未见异常反应，随后处死解剖检查，各主要脏器均无中毒性病理改变，同时发现各剂量组大鼠血清性激素含量与对照组比较明显升高(P＜0.01)。因此，临床长期应用益智合剂是安全的，其提高性激素水平的作用机理有待进一步研究。更多还原

【Abstract】 Based on my tutor’s clinical practice and modern research on AD, the theory that the pathologic mechanism of AD is deficiency of heart and kidney was put forward and intended to help find the effective therapeutic method and drug of AD. So we established the therapeutic method as nourishing kidney and heart and made Yi Zhi Mixture (YZM) to treat AD. In the clinical observation, 54 cases of AD were divided randomly into an experimental group and a control group who were treated with YZM and Piracetam respectively. The total effective rate of the experimental group was 85.71%, better than that of the control group which was 53.85%.The scores of HDS, MMSE, ADL, FAQ tests and clinical symptoms of the experimental group were greatly improved compared with that of the control group. This showed YZM is an effective drug in treating AD. In the acute toxic experimented rats were given YZM, the dose of which was 360 times greater than the normal dose. The rats had no adverse reaction and their dissected organs had no signs of poisoning. In the chronic toxic experiment, three groups of Wistar rats were given YZM, the doses of which were 12, 40, 80 times greater than the normal dose respectively. The rats had no adverse reaction and their dissected organs had no signs of poisoning. Meanwhile the content of sex incretion of the three groups was improved greatly compared with the control group. The toxic experiments showed the application of YZM in clinical therapy is safe and the mechanism of YZM’s improving the content of sex incretion should be further explored.更多还原