Discussion on Connotation of "Essence Generating Marrow " Based on Intervention of Guilu Erxian Gum in Perivascular Space of Alzheimer's Disease Patients / 中国实验方剂学杂志

ABSTRACT

Objective:To study the effect mechanism of Guilu Erxian gum on Alzheimer's disease （AD） from the perspective of regulating perivascular space （PVS），and to explore the scientific connotation of "essence generating marrow". Method:The 80 patients with AD diagnosed by western medicine and kidney deficiency and marrow empty syndrome diagnosed by traditional Chinese medicine were randomly divided into two groups，with 40 cases in each group. Both groups of patients were orally administered with cholinesterase inhibitor Alison，one tablet （5 mg） each time before sleep at night. On this basis，the control group additionally received placebo，while the treatment group was additionally treated with Guilu Erxian gum for 60 days. The Mini-Mental State Examination scale （MMSE）， Wechsler Memory Scale and Activity of Daily Living Scale （ADL） were used before treatment （0 d），as well as 31 d and 61 d after treatment. The number and diameter of PVS in midbrain，basal ganglia，deep insular white matter and semiovale center were counted and their diameters were measured with use of nuclear magnetic resonance imaging （MRI） for head. In addition，the curative effect was evaluated according to MMSE scores on 61 d. Result:There was no significant difference between the two groups 31 d. On 61 d，MMSE and WMS scores increased，while ADL scores decreased as compared with the conditions on 0 d（<italic>P</italic><0.01），and there were significant differences in the three indexes and clinical effective rate between two groups （<italic>P</italic><0.05，<italic>P</italic><0.01） . In addition，there was no significant difference in the number of PVS as compared with the number before treatment and in the comparison between the two groups after treatment，but there was a significant difference in the diameter of PVS（<italic>P</italic><0.01）. Conclusion:Guilu Erxian gum is effective in the treatment of AD，and it can improve the PVS diameter in patients，which may be related to the mechanism of "essence generating marrow ".