The Clinical And Mechanism Researeho On YiZhiNing Decoetion In Treating ADHD

Objective:Retrospective clinical research methods used to observe the Treatment of YiZhiYing decoction obstruct the Long-term efficacy of ADHD, while studies it's impact on the signal trasmission of the neurotransmitter DA of the prefrontal cortex-basal ganglial circuit loop in the center of the ADHD animal model------SHR. The project tries to make clear explore in depth the mechanism of treating ADHD with Chinese medicine.Methods:1. Retrospective clinical research methods used to study Case Information of 41cases which in accordance with Clinical diagnostic criteria and Telephone follow-up the Long-term efficacy2. randomly divide 30 SHR of SPF grade, them into three groups.10 rat each group, use YiZhiNing, methylphenidate hydrochloride and physiological saline to caculate each rat's. after 28days, depart the protein expression of SHR's, detect with immunohistochemistry and in situ hybridization the characteristics of the protein expression of SHR's cortex, lentiform nucleusTH, DAT, DRD1, DRD2 under the effect of YiZhiYing.Results:1. Results of clinical studies:41 Clinical Cases:(1) Sex ratio:36 males and 19 females Male to female ratio is7:1(2) Age of onset:2-5years take up36.6%;6-9years take up 56.1%,10-15years take up; (3) Mean age:6-9years about 61%,10-15years about 39%; (4) ADHD-H take up14.6%, ADHD-I take up39%, ADHD-C take up46.4%;(5)Patterns:Kidney deficient and Liver Yang rising take up 53.6%; Heart and Kidney are deficiency take up 34.2%; Phlegm fire moving internally take up 12.2%(6) Merge tic disorder:17 Clinical Cases Merge tic disorder, take up 42.5%; (7) Onset time:56.1%Cases onset in 4 weeks,39%in 8 weeks and 4.9%more than8weeks;(8) The total effective is 73.2%, Cure rate is 26.8%, Markedly is 24.4%.2. Experimental results:(1). With the use of Immunohistochemistry the expression of TH in the prefrontal cortex and lentiform nucleus of SHR from the YiZhiYing group and the western medicine group, are higher than the control group. The expression of DAT, DRD1, DRD2 from the western medicine group and the Chinese medicine group are lower than that in the control group. (2). The results of in situ hybridization of TH in the prefrontal cortex and lentiform nucleus of SHR from the YiZhiYing group and the western medicine group, are higher than the control group. The expression of DAT, DRD1, DRD2 from the western medicine group and the Chinese medicine group are lower than that in the control group.Conclusion:1. Research found ADHD-C and ADHD-I is majority, ADHD-H's relatively is small; Kidney deficient and Liver Yang rising is mostly of patterns.2.Age and Course of disease are No effect on onset time.3. the Treatment of YiZhiYing of ADHD is Effective, and the Long-term efficacy is Stable.4. Age, Different Subtypes, Course of disease have no effective on Long-term efficacy,and Course of treatment has effective on Long-term efficacy.5. The YiZhiYing improves the main symptoms of ADHD animal model by influencing the signal transmission of the DA nerves in the the prefrontal cortex-basal ganglial circuit loop of the control center.6. The YiZhiYing can promote DA synthesis to improve the core symptoms of an animal model of ADHD is through a multi-target, multi-role approach to achieve: (1) To promote the biosynthesis of DA and peripheral presynaptic release of DA by increasing DA synthesis rate-limiting enzymes THcontent; (2) The impact of dopamine transporter gene expression and protein expression, thereby reducing the re-uptake of DA. (3) The impact of DA receptors (including D1 and D2) of gene expression and protein expression, increase central DA function.