Clinical study of Dihuang-Yinzi Decoction combined with donepezil hydrochloride tablets in the treatment of mild to moderate Alzheimer's disease / 国际中医中药杂志

ABSTRACT

Objective:To evaluate the efficacy of Dihuang-Yinzi Decoction combined with donepezil hydrochloride in the treatment of mild to moderate Alzheimer's disease (AD). Methods:114 patients with mild to moderate AD in the First Hospital of Yulin in Suide District from February 2017 to February 2019 were divided into two groups according to the method of random number table, with 57 cases in each group. The control group took donepezil hydrochloride tablets orally, and the study group took Dihuang-Yinzi Decoction based on the control group. Both groups were treated continuously for 3 months. The activities of daily living scale (ADL), Mini-Mental State Examination (MMSE) and the Alzheimer’s disease assessment scale-cognitive section (ADAS-cog) were used to evaluate the life ability and cognitive function of patients. The concentrations of Notch 1 signaling protein, a disintegrin and metalloproteinase 10 (ADAM10) and β-amyloid precursor protein endonuclease 1 (BACE1) in serum were detected by Western blot. The levels of acrolein were detected by ELISA, the adverse reactions during the treatment were recorded, and the clinical efficacy was evaluated. Results:The total effective rate was 84.2% (48/57) in the study group and 64.9% (37/57) in the control group. The difference between the two groups was statistically significant ( χ2=5.596, P=0.018). After the treatment, the ADL and ADAS-cog scores of the study group were lower than those of the control group ( t values were 5.939, 6.124, respectively, all Ps<0.01), and MMSE scores were higher than that of the control group ( t=6.087, P<0.01). The levels of Notch1 signaling protein (3.43 ± 0.58 vs. 1.31 ± 0.47, t=21.440) and ADAM10 (1.86 ± 0.23 vs. 1.12 ± 0.25, t=16.446) in the study group were higher than those of the control group ( P<0.01), and the levels of BACE1 (0.62 ± 0.15 vs. 0.98 ± 0.17, t=11.988) and acrolein (2.19 ± 0.39 nmol/mg vs. 4.76 ± 0.54 nmol/mg, t=12.354) were lower than those of the control group ( P<0.01). The adverse reaction rate was 14.7% (11/57) in the study group and 14.0% (8/57) in the control group, and there was no significant difference between the two groups ( χ2=0.568, P=0.451). Conclusions:Dihuang-Yinzi Decoction combined with donepezil hydrochloride tablets can effectively improve the cognitive function and life ability of patients with mild to moderate AD, with clinical efficacy.