【目的】探讨黄芪续命汤对阿尔兹海默症 （Alzheimer’ s disease，AD） 脾肾亏虚型患者的治疗效果及其可能的作用机制。 【方法】将134例AD脾肾亏虚型患者随机分为观察组和对照组，每组各67例。对照组给予西医常规治疗，观察组在对照组 的基础上联合黄芪续命汤治疗，疗程为12周。观察2组患者治疗前后中医证候积分、简易精神状态量表 （MMSE） 评分、阿尔 兹海默症评定量表 （ADAS-Cog） 评分及血清5-羟色胺 （5-HT） 、去甲肾上腺素 （NE） 、脑源性神经营养因子 （BDNF） 、超氧化物 歧化酶 （SOD） 、白细胞介素6 （IL-6） 、超敏C反应蛋白 （Hs-CRP） 水平的变化情况，并评价2组患者的临床疗效。 【结果】 （1） 治疗12周后，观察组的总有效率为89.55% （60/67） ，对照组为71.64% （48/67） ，组间比较 （χ2 检验） ，观察组的疗效明显优 于对照组 （P＜0.05） 。 （2） 治疗后，2组患者的MMSE评分均较治疗前升高 （P＜0.05） ，中医证候积分和ADAS-Cog评分均较治 疗前降低 （P＜0.05） ，且观察组对MMSE评分的升高幅度及对中医证候积分和ADAS-Cog评分的降低幅度均明显优于对照组 （P＜0.05） 。 （3） 治疗后，2组患者的血清5-HT、NE、BDNF、SOD水平均较治疗前升高 （P＜0.05） ，血清IL-6、Hs-CRP水平 均较治疗前降低 （P＜0.05） ，且观察组对血清5-HT、NE、BDNF、SOD水平的升高幅度及对血清IL-6、Hs-CRP水平的降低 幅度均明显优于对照组 （P＜0.05） 。 【结论】针对AD脾肾亏虚型患者，在西医常规治疗基础上联合黄芪续命汤治疗，有助于减 轻炎症反应，调节氧化应激失衡，促进患者生活能力改善，提高临床疗效。

Objective To investigate the therapeutic effect of Huangqi Xuming Decoction for Alzheimer’ s disease （AD） patients with spleen and kidney deficiency syndrome and to explore its possible mechanism. Methods A total of 134 patients with AD of spleen and kidney deficiency type were randomly divided into observation group and control group，with 67 cases in each group. The control group was treated with routine western medicine，and the observation group was treated with Huangqi Xuming Decoction on the basis of treatment for the control group. The course of treatment for the two groups covered 12 weeks. The changes of traditional Chinese medicine（TCM） syndrome score， Mini-Mental State Examination（MMSE） score， Alzheimer’s Disease Assessment Scale- Cognitive Subscale（ADAS-Cog） score and serum levels of 5-hydroxytryptamine（5-HT），norepinephrine （NE）， brain-derived neurotrophic factor （BDNF） ，superoxide dismutase （SOD） ，interleukin-6 （IL-6） and hypersensitive C-reactive protein （Hs-CRP） in the two groups before and after treatment were observed. After treatment，the clinical efficacy of the two groups was evaluated. Results （1） After 12 weeks of treatment，the total effective rate of the observation group was 89.55% （60/67） and that of the control group was 71.64% （48/67） ，and the intergroup comparison （tested by chi-square test） showed that the efficacy of the observation group was significantly superior to that of the control group （P＜0.05） . （2） After treatment，the MMSE scores of the patients in the two groups were higher （P＜0.05） and the TCM syndrome scores and ADAS-Cog scores were lower than those before treatment （P＜0.05） . The intergroup comparison showed that the increase of the MMSE scores and the decrease of the TCM syndrome scores and ADAS-Cog scores in the observation group were significantly superior to those in the control group（P＜0.05） . （3）After treatment，the serum 5-HT，NE，BDNF，and SOD levels of the two groups were higher（P＜0.05） and serum IL-6 and Hs-CRP levels were lower than those before treatment （P＜0.05） . The intergroup comparison showed that the increase of serum 5-HT，NE，BDNF，and SOD levels and the decrease of serum IL-6 and Hs-CRP levels in the observation group were significantly superior to those in the control group （P＜0.05） . Conclusion For patients with AD of spleen and kidney deficiency type，the application of Huangqi Xuming Decoction based on the conventional western medicine treatment is helpful to relieving the inflammatory response，regulating the imbalance of oxidative stress，promoting the improvement of the patients’ abilities of daily living，and enhancing the clinical efficacy.

R277.7

河南省中医药科学研究专项课题 （编号：2022ZY1203）