| Objective:To sort out the characteristics of treating dementia in Traditional Chinese Medicine; To summarize and inherit Professor Tian’s valuable clinical experience of treating dementia in Traditional Chinese Medicine; Through animal experiment To investigate the effect of GEPT extract on expression of APP and Aβ protein in hippocampus of APP/PS1transgenic mice.Method:We retrieved the Randomized Controlled Trial’s (RCTs) reports about treating dementia in TCM from CNKI, VIP, CBM, Wan fang and collected Professor Tian’s clinical prescriptions of treating dementia in TCM. then make a factor analysis and cluster analysis of high frequency medicine.Animal experience research,3-month-old APP/PS1double transgenic mice used as AD model were randomly divided into AD model group, GEPT small-dose group(1.22g/kg·d), GEPT medium-dose group (2.44g/kg-d), GEPT large-dose group(4.88g/kg-d) and donepezil group (0.92mg/kg·d), while3-month-old C57BL normal mice were set as control group. The levels of APP and Aβ protein expression in the hippocampus of nine months old APP/PS1transgenic mice and normal mice (C57BL) were detected respectively via Western Blotting.Result:Aspects of literature research, the frequency analysis results of treatment methods show that, the high-frequency (>16%) treatment methods of the AD group are strengthening the essence, resolving hlegm, invigorating the circulation of blood, tonifying spleen, nifying qi, replenishing vital essence to tonify the kidney, nourishing hepatic yin and enriching the blood; the high-frequency (>16%) treatment methods of the VaD group are invigorating the circulation of blood, resolving hlegm, strengthening the essence, nifying qi, suppressing hyperactive liver and subsiding yang, replenishing vital essence to tonify the kidney, calming the wind, tonifying spleen, tonifying kidney-Qi, enriching the blood and nourishing hepatic yin. The frequency analysis results of medicine show that, the higher-frequency medicine of the AD group and VaD group both play a part in strengthening the essence, invigorating the circulation of blood, resolving hlegm. The amount of AD group is25, accounting for73.52%, and VaD group is31,accounting for70.45%. The factor analysis and cluster analysis results of high-frequency medicine show that, the medication characteristics of AD group are part in strengthening the essence, invigorating the circulation of blood and resolving hlegm However, about VaD group, Except for invigorating the circulation of blood, resolving hlegm and strengthening the essence, benefiting qi for activating blood circulation, calming the liver and suppressing yang and pelling wind and relieving convulsion are very important in the treatment of VaD. A total of347chinese medicine prescription, with MCI (n=74),AD (n=218),VaD (n=55) were included in the clinical research. The frequency analysis of medicines showed that the medicines of three groups all have the following functions: tonifying the spleen and the kidney, invigorating the circulation of blood, resolving hlegm and calming the liver to stop the wind. The amount of MCI group is24, accounting for70.59%, AD group is24, accounting for71.88%and VaD group is28, accounting for77.78%. The result of factor analysis high-frequency medicine show that, the MIC group is primary composed of medicine in calming the liver and suppressing yang, calming the wind and cleaning heat, promoting blood circulation to dispel blood stasis, AD group in resolving hlegm and calming the liver to stop the wind, VaD group in calming the liver and suppressing yang, calming the wind, invi gorati ng the circulation of blood and resolving hlegm. Furthermore, the group of VaD putting much more emphasis on promoting blood circulation and removing blood stasis and expeling wind evil and channel than MIC and AD group. The cluster analysis results of high-frequency traditional Chinese medicine used by Professor Tian. in the treatment of dementia show8common prescription with different effect as following: sedative, loosening bowel to relieve constipation, Phlegm-resolving, tonifying the spleen and kidney, extinguishing liver-wind and suppress yang, supplementing qi and activating blood circulation, promoting blood circulation to remove meridian obstruction and antipyretic method. Aspects of experimental study, After six months of administration of GEPT and donepezil, APP could be detected in the9-mo nth-old mice hippocampus of each group via Western Blotting. It has showed that the level of APP expression in the hippocampus of APP/PS1transgenic mice is significantly higher than normal group, however, the low dose and medium dose of GEPT group (P<0.01), high dose of GEPT group and donepezil group (P>0.05); compared with model group of APP/PS1transgenic mice, the level of APP expression in the hippocampus is lower than each group (P<0.01). Likewise, Ap protein could be detected in the9-month-old mice hippocampus of each group via Western Blotting, It has showed that the level of Aβ protein expression in the hippocampus of APP/PS1transgenic mice is significantly higher than normal group, the medium dose of GEPT group (P<0.05) is with a significant difference, while donepezil, small dose and large dose of GEPT group (P>0.05) is with no significant difference; Compared with model group, the level of Aβ protein expression in the hippocampus of every intervention group are also lower, the small dose and large dose of GEPT group (P<0.05), donepezil group (P<0.01) is with a significantly difference; while the medium dose of GEPT group (P>0.05) is with no significant difference.Conclusion:The principle of nourishing the kidney and strengthening the essence, invigorating the circulation of blood and resolving hlegm are the common therapic methods for AD and VaD, as showed in the part of literature research. The group of AD puts much more stress on nourishing the kidney and strengthening the essence, but the group VaD on invigorate the circulation of blood and resolving hlegm, as while as benefiting qi for activating blood circulation and extinguishing liver-wind is an important method in the treatment of VaD. As for the Treatment of MCI, AD and VaD, Professor Tian often uses traditional Chinese medicine to tonify the spleen and kidney, invigorate the circulation of blood, resolve hlegm and calm the liver to stop the wind. However, AD emphasize the important role of phlegm-resolving and calm the liver to stop the wind, VaD attach importance to calming the liver to stop the wind, invigorating the circulation of blood and phlegm-resolving. The animal experiment shows that GEPT, which plays an dominated part in nourishing kidney, promoting blood circulation and removing blood stasis and reducing phlegm, may inhibit over-expression of APP in hippocampus of APP/PS1transgenic mouse, and reduce the expression levels of Aβ protein in the hippocampus of mouse. |
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