| Objective:The treatment of dementia has always been a hot and difficult research topic at home and abroad.This study intends to start with the ancient and modern medical cases of dementia recorded in TCM medical books and domestic authoritative academic databases,combing the ancient and modern medical cases of dementia treated by traditional Chinese medicine,showing the evolution and development of doctors' clinical diagnosis and treatment of dementia under the grand view of history,digging and sorting out the ancient and modern doctors' understanding of the etiology and pathogenesis of dementia and the ancient and modern doctors' diagnosis and treatment rules and experience of dementia,providing reference and expanding ideas for the clinical treatment and scientific research of dementia in traditional Chinese medicine.At the same time,combined with the review of ancient literature on dementia and the overview of related studies of traditional Chinese medicine,the treatment of dementia with traditional Chinese medicine was discussed in general.Method:1.Based on the Classics of Traditional Chinese Medicine,the ancient literature of dementia was collected and sorted out,and the theoretical induction and analysis method was applied to analyze the origin of disease name,etiology and pathogenesis,and treatment evolution.2.The ancient and modern medical records of dementia were collected and sorted out based on the traditional Chinese medicine classics in the library of Heilongjiang University of Traditional Chinese Medicine and electronic databases such as CNKI,Wanfang database,VIP Chinese periodical service platform and Chinese biomedical literature service system.The methods of mathematical statistics,data mining and network pharmacology were used to analyze the age distribution of medical records,the gender and age of patients,the etiology,the location of disease,symptoms and drug application.3.Based on CNKI,Wanfang database,VIP Chinese periodical service platform,Chinese biomedical literature service system and other electronic databases,the research on traditional Chinese medicine of dementia(Alzheimer's disease)in the past 10 years was collected and sorted out.The bibliometric method was used to analyze the published years,regions,units,types,contents,project support,core journals and core authors.Result:1.Dementia was first seen in “The secret biography of Hua Tuo” in the Tang Dynasty,also known as “dullness”,“stupidity”,“sluggish consciousness”,“dementia syndrome” and so on.Before the Ming Dynasty,it was often used as a symptom of other diseases.It can be induced by drug pathogenic factor,innate factors,trauma,excessive emotions and secondary disease.The pathogenesis is based on deficiency of qi and blood in viscera,and phlegm,blood stasis and fire heat are pathologic outcomes.The location of the disease was mainly the heart and brain,with liver,spleen and kidney.Acupuncture and traditional Chinese medicine are used in the treatment.Acupuncture points are mostly on the heart and kidney meridians.Traditional Chinese medicine therapy includes Veratrum,Semen Pharbtidis,Acorus tatarinowii,Polygala tenuifolia and other expectorant drugs,as well as the application of several expectorant and tonifying deficiency prescriptions.2.A total of 376 medical records were recorded,which were divided into a small number of ancient medical records and early modern medical records,and a large number of modern medical records.Male patients aged 60–79 were the majority.The common etiologies were secondary disease,emotional factors,toxic factors,innate factors and trauma.The common natures of disease are phlegm,blood stasis,deficiency of essence,qi deficiency,heat,qi stagnation,yin deficiency,etc.The common locations were kidney,mind(brain),spleen,heart,liver,lung,stomach and gallbladder.The common symptoms are forgetfulness,indifference,slow response,reduced intelligence,emotional change,etc.Common prescriptions are tonifying prescription,resolving phlegm prescription,promoting blood circulation prescription,resolving dampness prescription,promoting qi prescription,clearing heat prescription,etc.Common drugs are tonifying deficiency drugs,clearing heat drugs,expectorant,antitussiveand and antiasthmatic drugs,promoting blood circulation and removing blood stasis drugs,qi regulating drugs,relieving exterior drugs,etc.The most frequently used prescriptions were Dihuang Yinzi,Buyang Huanwu Decoction,Changpu Yujin Decoction,Liuwei Dihuang Pill,Tongqiao Huoxue Decoction,Wendan Decoction,etc.The most frequently used drugs were Acorus tatarinowii,Polygala tenuifolia,Chuanxiong,Poria,Salvia miltiorrhiza,licorice,etc.Commonly used drugs can be classified as tonifying deficiency,activating blood and resolving phlegm.By association rule analysis,combined with clinical application and curative effect evaluation,the common couplet medicines and core medicines are Acorus tatarinowii-Polygala,Prepared radix rehmanniae-Cornus officinalis,Peach kernel-Safflower-Chuanxiong,Curcuma-Tangerine peel-Pinellia-Poria-Acorus tatarinowii.The network pharmacology analysis of Acorus tatarinowii and Polygala tenuifolia with the highest percentage of support was conducted to obtain 9 active components,73 potential targets,fluid shear stress and atherosclerosis,c AMP signaling pathway,protein deubiquitination,thyroid hormone signaling pathway,reactive oxygen species metabolic process,rhythmic process and other multiple biological processes and pathways.3.A total of 1558 TCM research literatures on dementia(Alzheimer's disease)in the past decade were included.Annual number of publications is increasing with fluctuation.The main publishing areas are Beijing,Hubei province,Guangdong province,Heilongjiang province,Shandong province and so on.The main publishing units are Hubei University of Chinese Medicine,Beijing University of Chinese Medicine,Heilongjiang University of Chinese Medicine,Guangzhou University of Chinese Medicine,Nanjing University of Chinese Medicine,etc.The main type of literature is journal articles.The research contents include clinical observation,experimental research,theoretical analysis,early protection and post-disease care such as preventive treatment,nursing and rehabilitation.The treatment methods included traditional Chinese medicine,acupuncture,acupoint sticking,massage,flint acupuncture and guidance.The research has been funded and supported by the National Natural Science Foundation of China,the National Major New Drug Development and so on.18 journals with the largest number of articles,such as Chinese Archives of traditional Chinese medicine,Chinese Journal of Gerontology,China Journal of traditional Chinese medicine and pharmacy,and Liaoning Journal of traditional Chinese medicine,are “core area” journals,and have not yet formed “core authors”.Conclusion:1.The understanding of dementia by physicians in past dynasties has evolved from deficiency and phlegm as the main pathogenesis to deficiency and deficiency with phlegm and blood stasis,with fire and heat,qi stagnation,dampness resistance,cold coagulation,water retention and so on.The treatment has also developed from tonifying deficiency and resolving phlegm to tonifying deficiency,resolving phlegm,activating blood,resolving depression,clearing heat,drying dampness,dispelling cold,and inducing diuresis.2.The etiologies of dementia include secondary disease,emotional factors,trauma,toxic factors and innate factors.The nature of the disease is mainly phlegm,blood stasis,and deficiency of essence.The location of the disease is mainly kidney,brain,spleen,heart,and liver.The symptoms are amnesia,indifference,slow response,and low intelligence.The syndromes are mainly deficiency of healthy qi and deficiency with phlegm and blood stasis.In the treatment,the drugs of tonifying deficiency,resolving phlegm,activating blood and clearing heat should be used to treat the syndrome differentiation according to the specific syndrome types.3.The commonly used prescriptions are Dihuang Yinzi,Buyang Huanwu Decoction,Changpu Yujin Decoction,Tongqiao Huoxue Decoction,Wendan Decoction,etc.The commonly used traditional Chinese medicines are Acorus tatarinowii,Polygala tenuifolia,Chuanxiong,Poria,Salvia miltiorrhiza,licorice,Astragalus,Pinellia,Curcuma,Angelica,etc.Common couplet medicines and core medicines are Acorus tatarinowii-Polygala,Prepared radix rehmanniae-Cornus officinalis,Peach kernel-Safflower-Chuanxiong,Curcuma-Tangerine peel-Pinellia-Poria-Acorus tatarinowii.4.The study of dementia in traditional Chinese medicine is in a steady development stage.The treatment mode of combination of internal and external treatment such as traditional Chinese medicine,acupuncture,acupoint sticking,massage,flint acupuncture and guidance,and multi-target targeted therapy is becoming more and more perfect.The research trend is early intervention and post-disease care of dementia. |
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