Clinical Study On The Treatment Of Bugan Yishen Tiansui Decoction For Parkinson's Disease Dementia With Yin Deficiency Of Liver And Kidney

Objective: To study the clinical characteristics of mild to moderate PDD with Yin deficie ncy of liver and kidney;To evaluate the clinical efficacy of Bugan Yishen Tian sui Decoction in the treatment of mild to moderate PDD with Yin deficiency of liver and kidney;To observe the role of oxidative stress in mild to moderate PDD with Yin deficiency of liver and kidney,discuss the change characteristics of related physical and chemical indicators,reveal the mechanism of action of Bugan Yishen Tiansui Decoction,and provide new ideas and methods for the treatment of PDD with TCM.Methods: 1.The cognitive impairment characteristics of 72 patients with mild to moderate PDD with Yin deficiency of liver and kidney meeting the inclusion criteria were revealed by using the cognitive domain assessment tool.2.The above-mentioned 72 cases of mild to moderate PDD with Yin deficiency of liver and kidney were randomly divided into the treatment group and the control group,with 36 cases in each group,and another 30 cases of healthy control group were set.The control group was given huperzine a,and the treatment group was given Bugan Yishen Tiansui Decoction on the basis of the control group,and The treatment cycle was 8 weeks.At the same time,the index of oxidative stress in normal healthy people was measured.3.To evaluate the clinical efficacy of Bugan Yishen Tiansui Decoction,and observe the changes of TCM syndrome score,neurological function rating scale(UPDRS,ADL),neuropsychological scale(MMSE,MoCA,HDS-R),oxidative stress index(SOD,GSH,CAT,MDA)before and after treatment.Results: 1.The proportion of cognitive impairment in 72 patients with mild to moderate PDD with Yin deficiency of liver and kidney was followed by executive ability(90.3%),memory(84.7%),attention(66.7%),visual space(61.1%),and language(48.6%).2.Clinical efficacy:the total effective rate of treating mild to moderate PDD with Yin deficiency of liver and kidney by Bugan Yishen Tiansui Decoction was 91.67%,which was better than the control group.There was a significant difference after statistical treatment(P<0.05),which significantly improved the clinical symptoms and signs of the patients,suggesting that the treatment based on syndrome differentiation plays an important role in the treatment of mild to moderate PDD with Yin deficiency of liver and kidney.TCM syndrome integral,neural function rating scale(UPDRS,ADL)integraland neuropsychological scale(MMSE,Mo CA,HDS-R)integral were better than those before treatment(P<0.01),and better than the control group(P<0.05 or P<0.01),suggesting Bugan Yishen Tiansui Decoction can effectively improve the cognitive dysfunction,social activity ability and quality of life of patients with mild to moderate PDD with Yin deficiency of liver and kidney.3.Physical and chemical indicators:compared with the normal healthy group,serum SOD,GSH and CAT levels decreased and MDA content increased in the two groups before treatment(P<0.01).Compared with the same group before treatment,the serum levels of SOD,GSH and CAT in the two groups after treatment were higher than those before treatment,and the serum MDA level was lower than that before treatment,the difference was statistic ally significant(P<0.01).After 8 weeks of treatment,SOD,GSH,CAT and MDA levels in the two groups were significantly different(P<0.01).4.Safety indicators:after 8 weeks of treatment,there was no statistically significant difference between the two groups in blood routine,liver and kidney function and other safety indicators(P>0.05).Patients in the treatment group had no adverse reactions such as fever,headache,dizziness,nausea,vomiting,diarrhea and rash during the whole treatment process,while 1 patient in the control group had mild dizziness.Conclusion:(1)Patients with mild to moderate PDD with Yin deficiency of liver and kidney are more likely to have cognitive impairment in areas such as executive function and memory.(2)Bugan Yishen Tiansui Decoction has obvious improvement effect on mild to moderate PDD patients with Yin deficiency of liver and kidney.(3)The mechanism of action of Bugan Yishen Tiansui Decoction may be related to the intervention of oxidative stress in mild to moderate PDD patients with Yin deficiency of liver and kidney.(4)The clinical efficacy of Bugan Yishen Tiansui Decoction combined with huperzine a was better than that of huperzine a alone,thus providing a new therapeutic method and drug for the clinical intervention of mild to moderate PDD patients with Yin deficiency of liver and kidney.