【作者】 刘燕池； 张沁园； 蒋云娜；

【Author】 Liu Yan Chi, Zhang Qin Yuan, Jiang Yun Na

【机构】 北京中医药大学；

【摘要】 目的 本课题对古代文献中有关脑理论及脑与脾肾的关系进行了深入的整理和探讨,使之更趋完善.进行了30例AD患者服用益智防呆冲剂的临床疗效观察.并进行深层的益智防呆汤防治小鼠铝中毒所致痴呆的实验研究,本文分三部分:第一部分 理论探讨:从脑理论溯源,脑与脾肾的生理联系和病机关系等方面展开论述.首先回顾了先秦、两汉、唐宋明清时代中国的文化背景与此时期的脑理论发展.脑主神明与心主神明之争.脑的生理功能——脑主无神、司五感、主运动、司记忆、统意志而御五脏.脑的五项生理特点和脑的病理表现,最后重点讨论脑与脾肾相关,脑与脾肾在生理上息息相关,在病机上相互影响.第二部分 临床研究:采用补脾益肾,化痰逐瘀的益智防呆冲剂治疗30例AD患者,并选用西药脑复康作对照组15例.经过1个疗程（90天）的治疗后,MMSE、BBS和临床记忆量表的积分有所改善,患者的智力、生活自理能力,记忆力都有不同程度的改善,且后二项中药治疗组优于西药对照组.第三部分 实验研究:用Alcl₃所致痴呆的小鼠模型对益智防呆汤的疗效进行了探讨.实验中检测了鼠脑组织中DA,5-HT,NE,SOD,ChAT等含量及活性,观测了脑组织中铁与铁蛋白免疫组化染色和海马CAl区神经元的超微结构.实验结果表明,中药组的大部分指标优于西药脑复康组,分析益智防呆汤防治小鼠痴呆的机理可能是:单胺类神经递质代谢系统得到了调节,这是学习记忆功能得以提高改善的神经生化学上的物质基础.海马神经元树突的修复和延长使海马区功能得到了一定程度的改善.而海马与记忆的联系是相当密切的,这同时也为方药临床治疗提供了实验依据.更多还原

【Abstract】 The article provides a further inqury into brain theory and the brain’s relationship with the spleen and kidney, based on ancient works of TCM, The aim is to make it perfect. The clinical study is carried out in 45 patients suffering from AD, at the same time, the experimental reseach is implemented to discuss the mechanisms of the prescription Yi Zhi Fang Dai Tang in prerenting and curing the dementia of mice caused by Alcl; based on modern research methods. So the article discuss the following three aspects .The first part, theoritical search;This section deals with the origin of TCM brain theory, the brain’s pathogenic relationship with the spleen and kidney. Brains function and brains pathological relationship with the spleen and kidney, firstly, we reviews the development of the theory during chun qiu, Qin, Han, Tang, Song, Ming and Qin Dynasties. The article also involves the controversy about brain goving kidney or heart goving it. The function of brain is to govern kidney Specificly, brain is responsible for senses, movement, memory, mental. At the end, the relationship between brain and kidney - spleen is discussed, physiologically, brain promote kidney and spleen, pathologically, brain can implicate kidney and spleen.The second part clinical study:we observed 30 patients suffered from AD by orally using herb capsule, and also observed 15 patients by using west medicine. The Chinese herb capsule possesses the efficiency of invigorating the spleen, benefiting the kidney, eliminating phlegm and blood. ALL the patients were treated one courses (90 days). After treatment, the efficacy of the drug was monitored by neuropsy-chological tests- MMSE, BBS and clinical memory test, statistical analysis evidenced significant improre-ments in the Herb capsule treatment group in respect to the control group in telligence, living ability and memory.The third part: experimental study in the experiment oral application of Alcl3 mice was used to imitate the modle of senile dementia. By the model, we have studied the therapeutic machanism of Yi zhi Fang Tan Tang. We examined Da, 5 - HT, NE, SOD, CAT in the brain of mice, We observed Fe, Ferritin by histochemical methods and neuronal ultrastructure in CA1 of hippocampus. Our observations suggested that the chinese medicine drug played an important role in improving injury of AD’s brain. The effect is superior than the control group. Maybe, The therapeutic machanism of herb is that regulating the metabolism of neuro - transmitter in CNS, promoting dentrite in hippocampus, resisting the neuroexcito-toxicity, In human beings, Senile dementia fully displays the characteristics of encephalopathy, Memory is related to hippocampus. The above results supported the conclusion in the clinical study.更多还原