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针药结合治疗血管性痴呆作用机制研究进展
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Abstract:
血管性痴呆作为一种由血管因素引起的严重认知障碍综合征，随着患病人群逐年增加，逐渐成为国内外第2大痴呆类型。认知功能减退加重了患者与家属的生活负担，因此，血管性痴呆的预防及治疗逐渐成为现代医学研究的热点之一。中医疗法治疗血管性痴呆发挥了独特优势，本文旨在从针药结合方面探讨防治血管性痴呆的新途径，以期为血管性痴呆的早期干预策略、预后提供科学、系统的指导，同时为今后中医药治疗血管性痴呆的临床研究和实验进展机制研究提供思路借鉴。
Vascular dementia, as a syndrome of severe cognitive impairment caused by vascular factors, is currently the second largest type of dementia at home and abroad, and the number of patients is increasing year by year, which increases the burden on the lives of patients and their families. The prevention and treatment of vascular dementia has gradually become one of the hot spots in modern medicine. Traditional Chinese medicine therapy has played a unique advantage in the treatment of vascular dementia. This paper aims to explore a new way to prevent and cure vascular dementia from the aspect of acupuncture and medicine combination, in order to provide scientific and systematic guidance for the early intervention strategy and prognosis of vascular dementia, and provide ideas for future clinical research and experimental progress of traditional Chinese medicine in the treatment of vascular dementia.
| [1] | 《中成药治疗血管性痴呆临床应用指南》标准化项目组. 中成药治疗血管性痴呆临床应用指南(2020年) [J]. 中国中西医结合杂志, 2021, 41(3): 273-279. |
| [2] | Smith, E.E. (2017) Clinical Presentations and Epidemiology of Vascular Dementia. Clinical Science, 131, 1059-1068. https://doi.org/10.1042/cs20160607 |
| [3] | Jia, L., Du, Y., Chu, L., Zhang, Z., Li, F., Lyu, D., et al. (2020) Prevalence, Risk Factors, and Management of Dementia and Mild Cognitive Impairment in Adults Aged 60 Years or Older in China: A Cross-Sectional Study. The Lancet Public Health, 5, e661-e671. https://doi.org/10.1016/s2468-2667(20)30185-7 |
| [4] | Kuring, J.K., Mathias, J.L. and Ward, L. (2018) Prevalence of Depression, Anxiety and PTSD in People with Dementia: A Systematic Review and Meta-analysis. Neuropsychology Review, 28, 393-416. https://doi.org/10.1007/s11065-018-9396-2 |
| [5] | Grande, G., Qiu, C. and Fratiglioni, L. (2020) Prevention of Dementia in an Ageing World: Evidence and Biological Rationale. Ageing Research Reviews, 64, Article ID: 101045. https://doi.org/10.1016/j.arr.2020.101045 |
| [6] | Sun, M. (2018) Potential Therapeutics for Vascular Cognitive Impairment and Dementia. Current Neuropharmacology, 16, 1036-1044. https://doi.org/10.2174/1570159x15666171016164734 |
| [7] | 张雯雯, 王丽, 郭雅雯, 等. 针药结合治疗血管性痴呆疗效的Meta分析[J]. 循证护理, 2023, 9(18): 3245-3250. |
| [8] | 倪伟, 钟润琪, 陈海交, 等. 基于肠道菌群探析针刺通调阳明治疗血管性痴呆的机制[J]. 湖南中医药大学学报, 2024, 44(7): 1292-1297. |
| [9] | 卢美住, 杨茜, 周哲屹, 等. 血管性痴呆与肠道菌群的相关研究进展[J]. 医学综述, 2022, 28(1): 7-11. |
| [10] | 周雨慧, 芦锰, 苗明三. 基于肠道菌群的血管性痴呆的中医药防治[J]. 中药药理与临床, 2019, 35(5): 172-175. |
| [11] | 段拖弟, 李梦, 李佩芳, 等. 通督调神法针刺联合石冰醒脑颗粒对血管性痴呆大鼠肠道菌群微生物的影响[J]. 安徽中医药大学学报, 2024, 43(4): 53-59. |
| [12] | 杨元庆, 李思, 吉学群, 等. 调神益智针法结合定志益聪方对血管性痴呆患者认知功能及肠道微生态的影响[J]. 北京中医药大学学报, 2021, 44(6): 562-568. |
| [13] | Wang, Z., Zhang, Z., Liu, J., Guo, M. and Li, H. (2023) Panax Ginseng in the Treatment of Alzheimer’s Disease and Vascular Dementia. Journal of Ginseng Research, 47, 506-514. https://doi.org/10.1016/j.jgr.2023.03.001 |
| [14] | Linh, T.T.D., Hsieh, Y., Huang, L. and Hu, C. (2022) Clinical Trials of New Drugs for Vascular Cognitive Impairment and Vascular Dementia. International Journal of Molecular Sciences, 23, Article ID: 11067. https://doi.org/10.3390/ijms231911067 |
| [15] | 何轶帆, 唐娅妮, 崔艺敏, 等. 针灸防治血管性痴呆研究进展[J]. 辽宁中医药大学学报, 2024, 26(1): 145-149. |
| [16] | 周雨慧, 苗明三, 李晓宁, 等. 地黄饮子加减方对血管性痴呆模型大鼠行为学及神经保护作用的影响[J]. 中药药理与临床, 2020, 36(1): 46-51. |
| [17] | 张相鹏, 武密山, 袁超, 等. 应用耳针联合地黄饮子治疗血管性痴呆的临床观察[J]. 时珍国医国药, 2019, 30(11): 2670-2672. |
| [18] | Zhang, Y., Li, Y., Wang, Y., Wang, G., Mao, L., Zhang, D., et al. (2019) Effects of Resveratrol on Learning and Memory in Rats with Vascular Dementia. Molecular Medicine Reports, 20, 4587-4593. https://doi.org/10.3892/mmr.2019.10723 |
| [19] | Huang, Y., Liao, X., Wang, H., Luo, J., Zhong, S., Zhang, Z., et al. (2021) Effects of Imperatorin on Apoptosis and Synaptic Plasticity in Vascular Dementia Rats. Scientific Reports, 11, Article No. 8590. https://doi.org/10.1038/s41598-021-88206-7 |
| [20] | 徐向青, 曲卓锋, 于永刚, 等. 地参益智汤联合通督醒神针刺对血管性痴呆患者认知功能的改善作用[J]. 环球中医药, 2024, 17(4): 708-711. |
| [21] | 李灵芝, 王维峰, 胡瑞锋, 等. 益智开窍针刺法联合益智汤治疗血管性痴呆的疗效观察[J]. 上海针灸杂志, 2023, 42(12): 1247-1252. |
| [22] | 王洋岗, 周春燕, 任惠明, 等. 电针配合加味补阳还五汤对血管性痴呆患者记忆行为学、血清BDNF、VEGF及神经元凋亡相关分子表达的影响[J]. 中华中医药学刊, 2022, 40(5): 81-84, 268. |
| [23] | Tian, Z., Ji, X. and Liu, J. (2022) Neuroinflammation in Vascular Cognitive Impairment and Dementia: Current Evidence, Advances, and Prospects. International Journal of Molecular Sciences, 23, Article No. 6224. https://doi.org/10.3390/ijms23116224 |
| [24] | 阙彬福, 曾小连, 马观福生, 等. 灯盏生脉胶囊联合针刺对脑梗死后血管性痴呆患者的临床疗效[J]. 中成药, 2024, 46(5): 1529-1532. |
| [25] | 尚官红, 关荣杓, 常丹阳, 等. 豁痰开窍汤联合温针治疗痰浊阻窍型血管性痴呆临床研究[J]. 新中医, 2023, 55(23): 76-80. |
| [26] | 张百明, 安静. 基于解郁调神理论探讨越鞠丸联合针刺治疗轻中度血管性痴呆的疗效及调节机制[J]. 辽宁中医杂志, 2023, 50(10): 202-205. |
| [27] | Kuang, H., Zhou, Z., Zhu, Y., Wan, Z., Yang, M., Hong, F., et al. (2021) Pharmacological Treatment of Vascular Dementia: A Molecular Mechanism Perspective. Aging and Disease, 12, 308-326. https://doi.org/10.14336/ad.2020.0427 |
| [28] | Forman, H.J. and Zhang, H. (2021) Targeting Oxidative Stress in Disease: Promise and Limitations of Antioxidant Therapy. Nature Reviews Drug Discovery, 20, 689-709. https://doi.org/10.1038/s41573-021-00233-1 |
| [29] | 李鹏飞, 张铭. 通督醒神电针法联合复智胶囊治疗血管性痴呆患者的临床观察[J]. 广州中医药大学学报, 2024, 41(5): 1238-1243. |
| [30] | 李洪梅, 王晓琴, 郭洋, 等. 复元胶囊联合醒脑开窍针刺法治疗血管性痴呆研究[J]. 康复学报, 2023, 33(3): 264-270. |
| [31] | 李莉, 王锋. 益肾补脑汤联合五神针治疗血管性痴呆临床观察[J]. 光明中医, 2023, 38(13): 2549-2552. |
| [32] | Chun, L.W., Ramachandran, R.K., Othman, S.F.F., Has, A.T.C., George, A., Mat, N.H., et al. (2023) Persicaria Minor Ameliorates the Cognitive Function of Chronic Cerebral Hypoperfusion Rats: Metabolomic Analysis and Potential Mechanisms. Behavioural Brain Research, 447, Article ID: 114423. https://doi.org/10.1016/j.bbr.2023.114423 |
| [33] | 梁倩莹, 李志明. 通督调神针刺法联合补阳还五汤对血管性痴呆患者血液流变学及认知功能的影响[J]. 江西中医药, 2022, 53(1): 51-53. |
| [34] | 侯可强, 赵晓东, 贺斌, 等. 头穴透刺联合丹红颗粒对轻中度血管性痴呆患者疗效及安全性评价[J]. 中国处方药, 2024, 22(4): 142-145. |
| [35] | 王欢, 吕长虹, 郭晓娜, 等. 针刺联合复方苁蓉益智胶囊治疗痰浊阻窍型血管性痴呆临床观察[J]. 河南中医, 2023, 43(5): 772-776. |
