天王补心丹对伴睡眠障碍的老年痴呆患者血清IL-6、TNF-α的影响
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摘要
目的评估天王补心丹治疗老年痴呆患者睡眠障碍的效果,探讨白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)在睡眠紊乱、认知减退中的作用。方法 182例患睡眠障碍智能正常的老年患者及伴睡眠障碍的轻中度老年痴呆患者作为研究对象,将87例痴呆患者设为痴呆组,95例智能正常患者设为智能正常组;将痴呆组患者随机分为A组(44例)和B组(43例),智能正常组患者随机分为C组(48例)和D组(47例)。A组给予天王补心丹+痴呆药物治疗,B组给予常规镇静药物、新型抗精神病药物+痴呆药物治疗,C组给予天王补心丹治疗,D组给予常规镇静药物、新型抗精神病药物治疗。比较四组患者治疗前及治疗第12周的匹兹堡睡眠质量指数(PSQI)评分;记录所有患者治疗前及治疗第12周IL-6、TNF-α水平并进行比较;统计A、B组患者治疗前及第12周的简易智力状态检查量表(MMSE)、日常生活活动能力(ADL)评分并比较。观察所有患者不良反应发生情况。结果治疗前、治疗第12周痴呆组IL-6、TNF-α水平均高于智能正常组,差异有统计学意义(P<0.05);第12周A组、C组IL-6、TNF-α水平明显低于治疗前,差异有统计学意义(P<0.05),B组、D组IL-6、TNF-α水平与治疗前比较差异无统计学意义(P>0.05)。治疗前及治疗第12周,A组和B组的MMSE评分比较差异均无统计学意义(P>0.05)。治疗第12周A组ADL评分高于治疗前,B组ADL评分低于治疗前,且A组ADL评分(59.46±16.33)分高于B组的(50.40±14.82)分,差异均有统计学意义(P<0.05)。A、C组不良反应发生率低于B、D组,差异有统计学意义(P<0.05)。治疗第12周A、B、C、D组PSQI评分均低于治疗前,且A组低于B组,C组低于D组,差异均有统计学意义(P<0.05)。结论天王补心丹对老年痴呆患者睡眠障碍症状的治疗安全有效,可使IL-6、TNF-α处于较高水平的伴睡眠障碍的老年痴呆患者在睡眠质量改善的同时,降低其IL-6、TNF-α水平。
Objective To evaluate the effect of Tianwang Buxin Dan in the treatment of elderly dementia patients with sleep disorders and investigate the effect of interleukin(IL)-6 and tumor necrosis factor-α(TNF-α) in sleep disorders and cognitive decline. Methods There were 182 elderly dementia patients withsleep disorders and mild to moderate dementia patients with sleep disorders, 87 dementia patients were regarded as dementia group, and 95 normal intelligent patients were regarded as normal intelligent group. Patients in dementia group were randomly divided into group A(44 cases) and group B(43 cases), and patients in normal intelligence group were randomly divided into group C(48 cases) and group D(47 cases). Group A received Tianwang Buxin Dan + drug therapy for dementia, group B received conventional sedative drugs, new antipsychotic drugs + drug therapy for dementia, Group C received Tianwang Buxin Dan, and group D received conventional sedative drugs and new antipsychotic drugs. The Pittsburgh sleep quality index(PSQI) scores before treatment and after 12 weeks of treatment were compared among the four groups. The levels of IL-6 and TNF-α of all patients before treatment and after 12 weeks of treatment were recorded and compared, and the simple mental state examination(MMSE) scores and activity of daily living(ADL) before treatment and after 12 weeks of treatment were counted in dementia group. The occurrence of adverse reactions in all patients were observed. Results Dementia group had higher IL-6 and TNF-α before treatment and after 12 weeks of treatment than normal intelligence group, and the differences were statistically significant(P<0.05). After 12 weeks of treatment, group A and C had obviously lower IL-6 and TNF-α level than before treatment, and the differences were statistically significant(P<0.05). Group B and D had no statistically significant differences in IL-6 and TNF-α compared with before treatment(P>0.05). Before treatment and after 12 weeks of treatment, group A and B had no statistically significant difference in MMSE score(P>0.05). After 12 weeks of treatment, group A had higher ADL score than before treatment, group B had lower ADL score than before treatment, and group A had higher ADL score as(59.46±16.33) points than(50.40±14.82) points in group B. The differences were statistically significant(P<0.05). Group A and C had lower incidence of adverse reactions than group B and D, and the differences were statistically significant(P<0.05). Conclusion Tianwang Buxin Dan is safe and effective in treating dementia patients with sleep disorders, and it can improve sleep quality of elderly dementia patients with sleep disorders who have high levels of IL-6 and TNF-α, at the same time it can reduce levels of IL-6 and TNF-α.
Objective To evaluate the effect of Tianwang Buxin Dan in the treatment of elderly dementia patients with sleep disorders and investigate the effect of interleukin(IL)-6 and tumor necrosis factor-α(TNF-α) in sleep disorders and cognitive decline. Methods There were 182 elderly dementia patients withsleep disorders and mild to moderate dementia patients with sleep disorders, 87 dementia patients were regarded as dementia group, and 95 normal intelligent patients were regarded as normal intelligent group. Patients in dementia group were randomly divided into group A(44 cases) and group B(43 cases), and patients in normal intelligence group were randomly divided into group C(48 cases) and group D(47 cases). Group A received Tianwang Buxin Dan + drug therapy for dementia, group B received conventional sedative drugs, new antipsychotic drugs + drug therapy for dementia, Group C received Tianwang Buxin Dan, and group D received conventional sedative drugs and new antipsychotic drugs. The Pittsburgh sleep quality index(PSQI) scores before treatment and after 12 weeks of treatment were compared among the four groups. The levels of IL-6 and TNF-α of all patients before treatment and after 12 weeks of treatment were recorded and compared, and the simple mental state examination(MMSE) scores and activity of daily living(ADL) before treatment and after 12 weeks of treatment were counted in dementia group. The occurrence of adverse reactions in all patients were observed. Results Dementia group had higher IL-6 and TNF-α before treatment and after 12 weeks of treatment than normal intelligence group, and the differences were statistically significant(P<0.05). After 12 weeks of treatment, group A and C had obviously lower IL-6 and TNF-α level than before treatment, and the differences were statistically significant(P<0.05). Group B and D had no statistically significant differences in IL-6 and TNF-α compared with before treatment(P>0.05). Before treatment and after 12 weeks of treatment, group A and B had no statistically significant difference in MMSE score(P>0.05). After 12 weeks of treatment, group A had higher ADL score than before treatment, group B had lower ADL score than before treatment, and group A had higher ADL score as(59.46±16.33) points than(50.40±14.82) points in group B. The differences were statistically significant(P<0.05). Group A and C had lower incidence of adverse reactions than group B and D, and the differences were statistically significant(P<0.05). Conclusion Tianwang Buxin Dan is safe and effective in treating dementia patients with sleep disorders, and it can improve sleep quality of elderly dementia patients with sleep disorders who have high levels of IL-6 and TNF-α, at the same time it can reduce levels of IL-6 and TNF-α.
引文
[1]钟良,刘丽,钟有安,等.老年人失眠症与轻度认知功能障碍的临床研究.中国临床新医学,2016,9(1):20-24.
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[4]张世芳,李爱红,王蕾.安神剂的临床应用研究现状.医学综述,2008,14(17):2689-2691.
[5]李东腾,叶明远,孙晓明.天王补心丹对记忆能力影响的实验研究.中成药,2001,23(4):296-297.
[6]刘丰熙,牛凯,李炜,等.天王补心汤、六味地黄汤治疗血管性痴呆小鼠的疗效对比.中国老年学,2014(17):4891-4894.
[7]施楚明.天王补心丹配合西药舒乐安定治疗阴虚失眠50例的疗效观察.中医临床研究,2015(14):92-93.
[8]刘占兵.天王补心丹加减治疗心肾不交型失眠67例.中国民间疗法,2015(4):32-33.
[9]于学芬.天王补心丹合四物汤加减治疗心脾两虚型失眠60例疗效观察.心理医生月刊,2012(11):206-207.
[10]龚德贵,黄国芳,吴炳煌.天王补心丹结合头部按摩手法治疗阴虚火旺型不寐病疗效观察.福建中医药,2013,44(3):8-9.
[2]王文昭,赵忠新.痴呆相关性睡眠障碍的发生机制和处理.中华神经医学杂志,2004,3(4):310-314.
[3]张小健,刘晶晶,王迎昌,等.脑心同治法对老年卒中后失眠患者总体睡眠状态及失眠药物剂量的影响.世界中医药,2017,12(2):269-271.
[4]张世芳,李爱红,王蕾.安神剂的临床应用研究现状.医学综述,2008,14(17):2689-2691.
[5]李东腾,叶明远,孙晓明.天王补心丹对记忆能力影响的实验研究.中成药,2001,23(4):296-297.
[6]刘丰熙,牛凯,李炜,等.天王补心汤、六味地黄汤治疗血管性痴呆小鼠的疗效对比.中国老年学,2014(17):4891-4894.
[7]施楚明.天王补心丹配合西药舒乐安定治疗阴虚失眠50例的疗效观察.中医临床研究,2015(14):92-93.
[8]刘占兵.天王补心丹加减治疗心肾不交型失眠67例.中国民间疗法,2015(4):32-33.
[9]于学芬.天王补心丹合四物汤加减治疗心脾两虚型失眠60例疗效观察.心理医生月刊,2012(11):206-207.
[10]龚德贵,黄国芳,吴炳煌.天王补心丹结合头部按摩手法治疗阴虚火旺型不寐病疗效观察.福建中医药,2013,44(3):8-9.
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