The Study Of Angelica Decoction Combined With Donepezil In The Clinical Treatment Of Alzheimer’s Disease

Objective Alzheimer’s disease(AD)is a primary degenerative brain degenerative disease with insidious onset.Up to date the cause of AD is not fully understood.Donepezil is widely used in clinical treatment,but the efficacy needs to be improved,and the side effects also need to be further improved.A variety of traditional Chinese medicines have been used in the treatment of AD,among which angelica decoction has good safety effect and can alleviate the patient’s condition to a certain extent.However,the clinical effect and mechanism of the combination of angelica decoction and donepezil are needed for further study.In this study,80 patients with AD were selected as the subjects,and the effects of angelica decoction combined with donepezil group and donepezil alone on cognitive function,intelligence level and life ability of AD patients were analyzed by ADL and MMSE scores.By detecting the side effects of donepezil treatment,i.g.common heart block,dizziness,nausea and others,the differences between angelica decoction combined with donepezil treatment group and single treatment group were analyzed.By measuring the levels of serum homocysteine(HCY),serum brain-derived neurotrophic factor(BDNF)and 12 inflammatory cytokines,the differences between angelica decoction combined with donepezil treatment and donepezil treatment were analyzed.Finally,correlation statistical analysis was conducted between biochemical indexes,cytokine indexes and their correlation with ADL and MMSE scores.This study provides an important theoretical basis for the combination therapy of angelica decoction and donepezil in AD,and has vital significance for clinical treatment.Methods 1.Eighty AD patients admitted from September 2020 to September 2021 in the Department of Geriatrics of Qingdao Mental Health Center were selected as the research objects,and all patients were divided into two groups by means of random number tables,with 40 AD patients in each group.One group was the monotherapy group treated with donepezil.The other group was the combination group treated with both angelica decoction and donepezil.The total treatment period was 12 weeks,and the relevant indicators were detected at the three time points,before treatment,8 weeks after treatment,and 12 weeks after treatment,repectively.The Mini-mental state examination(MMSE)and the Activity of Daily Living(ADL)were used to compare the cognitive function,intelligence levels,and life abilities between the two groups.2.The side effects of donepezil,such as heart block,dizziness,nausea were detected in the monotherapy group and the combination therapy group.3.The homocysteine determination kit(enzyme cycle method)was used to detect the serum HCY level,and the BDNF level was detected by ELISA method in the monotherapy group and the combination therapy group.4.ELISA method was used to detect serum IL-6,TNF-α,IL-2,IL-5,IL-8,IFN-α,IL-1β,IL-10,IFN-γ,IL-4,IL-12 p and IL-17 levels in the monotherapy group and combination therapy group.5.Statistically analysis was studied in the correlation between cytokines and HCY and BDNF,and the correlation between cytokines,HCY,BDNF and ADL and MMSE scores.Results 1.After 12 weeks of treatment,the ADL score of the combination group decreased significantly,and the MMES score increased significantly,and the difference between the two groups was statistically significant(P<0.01).2.Compared with the monotherapy group,the side effects of the combination therapy group were reduced after 12 weeks of treatment.3.Comparing the serum HCY and BDNF concentrations between the two groups,the HCY in the combination therapy group was significantly lower than that in the monotherapy group(P<0.05),and the serum BDNF in the combination therapy group was significantly higher than that in the monotherapy group(P<0.05)after 12 weeks of treatment.4.Comparing the concentrations of 12 kinds of serum inflammatory factors in the combination therapy group and the monotherapy group,the IL-6 and TNF-α of the combination group decreased significantly,and the difference was statistically significant(P<0.01)after 12 weeks of treatment.5.The results of the correlation analysis of TNF-α,IL-6 and BDNF serum concentrations with ADL and MMSE scores showed that TNF-α and IL-6 were significantly positively correlated with ADL scores(P<0.05),TNF-α and IL-6 were significantly and negatively correlated with MMSE scores(P<0.05),BDNF was significantly negatively correlated with ADL scores,and were significantly positively correlated with MMSE scores(P<0.05).Conclusion 1.Angelica decoction combined with donepezil treatment effectively improved the patient’s intelligence level,improved the patient’s cognitive level,intelligence level and living ability,and significantly reduces the side effects of donepezil monotherapy.2.The treatment of angelica decoction combined with donepezil may affect the ADL and MMSE score by modulating the levels of IL-6,TNF-α,HCY and BDNF in AD patients,hencely improve clinical treatment of donepezil monotherapy.