以針刺及補腎益氣活血中藥PSUNHT1對中臺灣阿茲海默氏症病人療效評估之研究

An Evaluation of Effects of Combination Treatment of Acupuncture and TCM PSUNHT1 to Alzheimer's Disease in Central Taiwan Hospitals

林慶鐘(Chin-Chung Lin) ； 洪良一(Liang-Yi Hung) ； 陸建民(Chien-Ming Chen)

《台灣中醫臨床醫學雜誌》 17卷2期 (2011/06) Pp. 101-115

https://doi.org/10.6968/TJCCM.201106.0101

摘要

「失智症」包括「阿茲海默氏病」(Alzheimer's Disease; AD)和「血管性癡呆」。下一個世紀「失智症」發病率將僅次於癌症之重大疾病。估計目前台灣痴呆人口約有十五萬人。阿茲海默氏症給家人帶來沈重的精神和經濟負擔，已成爲一個社會健康的問題。本研究以中台灣地區醫院，經診斷爲輕、中度阿茲海默氏症患者，符合DSM IV阿茲海默失智診斷且MMSE10~24分。將病人依其意願取實驗組（針刺加中藥及西藥Aricept）與對照組（只用西藥Aricept）之男性或女性病人共90名，女性病人需排除懷孕及預備懷孕之可能性，年齡至少50歲，排除嚴重或其他可能影響研究身體疾病。研究期間施治前後並採用簡易智能量表MMSE、知能篩檢測驗CASI C-20阿茲海默氏症評估量表ADAS、阿茲海默氏症非認知部分評估量表ADAS-NON等方法來評估病情改善程度。評估時間分別爲治療12週後及治療26週後，探討以針刺及自擬補腎益氣活血中藥PSUNHT1（六味地黃丸10g；補陽還五湯6g；合方）對阿茲海默氏症之療效。結果以二項式檢定驗證，實驗組在經過中醫治療後，CASI及ADASN的評估分數有進步，支持以針刺及補腎益氣活血中藥PSUNHT1的中醫藥治療後，會改善阿茲海默氏症症狀。另外統計結果發現，實驗組的ADAS平均分數，治療前爲25.42分，治療12週後進步到22.9分，治療26週後更進步到15分；相較於對照組，其治療前ADAS平均分數爲27.11分，治療後僅進步至26.03分。而在ADASN中的平均分數，也是由治療前的5.46分進步爲治療後的3.00分，進步幅度勝於對照組。本研究透過統計方法分析後顯示，阿茲海默氏症患者經過針刺及中藥治療後，其評估分數進步幅度是優於對照組的平均分數。因此中醫藥方法對阿茲海默氏症疾病病情的改善具有著預防及治療上的貢獻。

關鍵字

阿茲海默氏症Alzheimer's Disease ； 針刺Acupuncture ； 補腎益氣活血中藥PSUNHT1 ； 簡易智能評量表MMSE ； 知能篩檢測驗CASI C-20 ； 阿茲海默氏症認知功能量表ADAS

並列摘要

Alzheimer's Disease mainly cause the cerebrum nerve cell incessancy to degenerate,. it is estimated that approximately 3~5% of the 65 year-old above population, or 15,0,000 senior citizens around Taiwan suffer from this sickness. It has become a public health problem for the society.This research is conducted in Fong Yuan hospital located in central Taiwan. The patients with slight to moderate level of Alzheimer's Disease were diagnosed by neuron doctors and were given the experiment by us. All of these patients were conformed to the dementia diagnosis (DSM IV MMSE 10~24). In accordance with the acceptance, patients had been divided into the experimental group (acupuncture adds traditional Chinese medicine and western medicine Aricept), and the control group (only uses Aricept). There were 90 patients with three groups and the each of the patients is at least 50 years old.The three groups were examined with MMSE, CASI C-20, ADAS to evaluate the effectiveness of Acupuncture and TCM for Alzheimer's patients. The above methods and ADAS-NON evaluate the degree of improvement of the patient's condition. The first treatment and the second treatment course were evaluated after 12 weeks, and 26 weeks. The main research mainly focuses on effectiveness of Acupuncture and TCM PSUNHT1 for Alzheimer's patients.The above research employed the binomial examination. After the process of Chinese medicine treatment, the experimental group of Alzheimer patient CASI and the ADASN were evaluated and given score regarding the progress. The result could support our research goal: the combination treatment of acupuncture and TCM PSUNHT1 can improve Alzheimer illness. Moreover, the statistical results indicated that the average score the experimental groups receive progressiveness after treatment in ADAS1 and the ADAS2 were from 25.42 scores to 22.9 scores. On the other hand, by receiving the average score of 15, the group of DAS3 treatment sees progressiveness after the treatment. Comparing to in the control groups in ADAS1 and the ADAS2 with average score of 27.11, experimental groups' progressive scope surpasses the control groups with score of 26.03. Also, among the experimental groups, ADASN received an average score of 5.46 before treatment, and saw progresses to 3.00 scores after the treatment. The progressive scope indicates that the experimental groups surpass the control groups.Conducted by using statistical method and analysis, the result of the research indicates that a combination treatment of acupuncture and TCM PSUNHT1 can significantly improve the Alzheimer's illness. We expect that the acupuncture and TCM PSUNHT1 will become useful methods to improve blood circulation and heal functional brain. In conclusion, we prove that the combination of traditional Chinese medicine PSUNHT1 and acupuncture can be very helpful and effective in treating the Alzheimer's illness.

並列關鍵字

Alzheimer's Disease ； vascular dementia ； PSUNHT1 ； Acupuncture ； MMSE ； ADAS ； CASI C-20 ； CDR