阿尔茨海默病不同治疗方式研究新进展

doi:10.3969/j.issn.1000-8535.2024.03.004

摘要/Abstract

摘要： 阿尔茨海默病（Alzheimer's disease,AD）是一种复杂的、起病隐秘的、病因不明的、缺乏特异性诊断方式的神经退行性病变。面对与日俱增的患病率,却缺乏有效的治疗方式。中医药治疗方式具有多层次、多靶点、多通路的独特优势,中西医结合方式的互补,非药物疗法的辅助,干细胞疗法、新的分子药物、抗体及蛋白疫苗、γ感官刺激等新颖的实验阶段新疗法等方式治疗AD。本文综述近年来的不同治疗方式治疗AD研究新进展,旨在为临床上治疗AD提供新思路、新方法及参考价值。

关键词: 阿尔茨海默病, 治疗方式, 中西医疗法, 干细胞疗法, 新疗法

Abstract: Alzheimer's disease is a complex,secrectly onset neurodegenerative disease with unknown etiology,and lacking of specific diagnosis．In the face of the increasing prevalence,there is a lack of effective treatment ways．The treatment of traditional Chinese medicine has the unique advantages of multi-level,multi-target,and multi-channel．With the combination of traditional Chinese and Western medicine and supplement to non-drug therapy,stem cell therapy,new molecular drugs,antibodies and protein vaccines,γ sensory stimulation,and other novel experimental stage new therapies are uesd in the treatment of AD．The article focuses on the new progress of different treatment methods in the treatment of AD in recent years,aiming to provide new ideas,new methods,and reference value for the clinical treatment of Alzheimer's disease．

Key words: Alzheimer's disease, treatment methods, the combination of traditional Chinese and Western medicine, stem cell therapy, new therapy

袁行勇, 姚春, 陈炜, 王晋平, 黄钰铧, 曲一荻, 曾汉林, 崔恩山, 廖雨芯. 阿尔茨海默病不同治疗方式研究新进展[J]. 广州医药, 2024, 55(3): 236-244.

YUAN Xingyong, YAO Chun, CHEN Wei, WANG Jinping, HUANG Yuhua, QU Yidi, ZENG Hanlin, CUI Enshan, LIAO Yuxing. Recent advance in different therapies for Alzheimer's disease[J]. Guangzhou Medical Journal, 2024, 55(3): 236-244.

参考文献

[1] 刘慧瑛,夏兆云,施扬,等.阿尔茨海默病发病机制概述[J].老年医学与保健,2020,26(6):1098-1100.
[2] 2022 Alzheimer's disease facts and figures[J].Alzheimers Dement,2022,18(4):700-789.
[3] 任汝静,殷鹏,王志会,等.中国阿尔茨海默病报告2021[J].诊断学理论与实践,2021,20(4):317-337.
[4] TAN C C,YU J T,WANG H F,et al.Efficacy and safety of donepezil,galantamine,rivastigmine,and memantine for the treatment of Alzheimer's disease:A systematic review and meta-analysis[J].Alzheimers Dis,2014,41(2):615-631.
[5] ATRI A.The Alzheimer's Disease Clinical Spectrum:Diagnosis and management[J].Med Clin North Am,2019,103(2):263-293.
[6] CUMMINGS J,LEE G,RITTER A,et al.Alzheimer's disease drug development pipeline:2020[J]. Alzheimers Dement,2020,6(1):e12050.
[7] 谭浩,李广诚,董艺.文痴方治疗阿尔茨海默病的疗效及其机制研究[J].湖南师范大学学报(医学版),2019,16(6):19-23.
[8] 张娜,王乐,马涛,等.地黄饮子对轻度阿尔茨海默病患者认知功能的影响[J].中国医药导报,2019,16(35):69-72.
[9] 罗慧,袁梦石.袁梦石以天地转气汤为主治疗中重度阿尔茨海默病经验总结[J].中医药临床杂志,2021,33(9):1684-1687.
[10] 陈丽敏,温若兰,董卫国.“益肾调督”针灸法治疗阿尔茨海默病的探讨[J].福建中医药,2021,52(8):35-37.
[11] 郭永灿,郭秀林.调气益智针法配合董氏奇穴治疗30例阿尔茨海默病的临床观察[J].按摩与康复医学,2021,12(16):1-3.
[12] 詹桂玉. 三焦针法治疗阿尔茨海默病的疗效机制及研究进展[J].现代医学与健康研究电子杂志,2022,6(4):138-141.
[13] 李莲英,李爱民.补元聪脑汤联合针刺治疗老年痴呆(肾虚痰瘀型)临床观察[J].光明中医,2021,36(8):1268-1270.
[14] 李建平,曾宇华,卢巍,等.电针联合复方丹参片治疗老年性痴呆的临床观察[J].中国现代医生,2018,56(23):64-67.
[15] 吕海波,甘收云.头部穴位透刺疗法配合自拟培元开窍汤加减治疗阿尔茨海默病的效果[J].中国当代医药,2017,24(22):135-138,141.
[16] 朱海芳,王春芸,章东元.针刺联合穴位贴敷治疗阿尔茨海默病的临床观察[J].中国中医药现代远程教育,2018,16(13):135-137.
[17] 汪彦博,王超,严辞.利斯的明透皮贴剂联合复方海蛇胶囊辅以电针对阿尔茨海默病患者疗效及依从性的影响[J].中国现代医生,2020,58(33):63-67.
[18] 范思海,苏艳南,马莉.加兰他敏联合盐酸美金刚治疗阿尔茨海默病效果观察[J].中国实用医刊,2019,46(1):105-108.
[19] 王云霞,李旺俊.甘露特钠联合多奈哌齐治疗阿尔茨海默病的临床研究[J].现代药物与临床,2022,37(10):2258-2262.
[20] 郑冬冬,李祎鋆,杨月花,等.补肾健脾方联合西药治疗阿尔茨海默病临床观察[J].山西中医,2020,36(8):27-28.
[21] 杨占团. 益肾活血消痰复方联合美金刚治疗老年性痴呆的疗效研究[J].光明中医,2017,32(19):2850-2852.
[22] 文洁,陈根成.大明汤联合多奈哌齐治疗轻中度老年性痴呆患者的临床疗效[J].世界中医药,2019,14(8):2101-2104.
[23] 许力挺. 针刺配合盐酸多奈哌齐片治疗阿尔茨海默病的疗效及对炎症因子、脑电图的影响[J].中国民间疗法,2021,29(15):67-69.
[24] 周雪,王月花,王艳,等.秦氏“头八针”结合多奈哌齐治疗阿尔茨海默病认知障碍临床观察[J].湖北中医药大学学报,2021,23(6):109-113.
[25] BIANCHI V E,HERRERA P F,LAURA R.Effect of nutrition on neurodegenerative diseases.A systematic review[J].Nutr Neurosci,2021,24(10):810-834.
[26] 余无寒,吕洋.阿尔茨海默病的营养治疗[J].中华老年医学杂志,2021,40(8):1075-1079.
[27] MU L,CAI J,GU B,et al.Treadmill exercise prevents decline in spatial learning and memory in 3×Tg-AD mice through enhancement of structural synaptic plasticity of the hippocampus and prefrontal cortex[J].Cells,2022,11(2):244.
[28] 梁茹冰,林一苹,骆俊宏.跑步机训练对老年阿尔茨海默病患者神经精神症状与生命质量的影响[J].中国实用护理杂志,2019,35(23):1779-1784.
[29] 李彦玲,王修,单淑珍,等.音乐疗法在阿尔茨海默病治疗中的临床应用[J].中国当代医药,2021,28(16):252-254.
[30] 王珊玉,邹顺霞,胡丽莉.探究团体正念认知疗法对化疗期乳腺癌患者的抑郁焦虑情绪及生活质量的影响[J].中国性科学,2019,28(11):143-145.
[31] 徐东升,赵慧玲,马筱慧,等.基于正念认知疗法的心理护理干预对乳腺癌化疗患者焦虑、抑郁及生存质量的影响[J].中国老年学杂志,2019,39(23):5854-5857.
[32] 陈小央,任文,邱艳,等.认知行为疗法的临床应用现状[J].中华全科医学,2022,20(10):1755-1759.
[33] 穆燕. 正念认知疗法干预对抑郁症患者心理状态及自杀意念的影响[J].海军医学杂志,2017,38(6):530-533.
[34] SIMSHÄUSER K,POHL R,BEHRENS P,et al.Mindfulness-based cognitive therapy as migraine intervention:A randomized waitlist controlled trial[J].Int J Behav Med,2022,29(5):597-609.
[35] CHACKO E,LING B,AVNY N,et al.Mindfulness-based cognitive therapy for stress reduction in family carers of people living with dementia:A systematic review[J]. Int J Environ Res Public Health,2022,19(1):614.
[36] 刘莹,郭婧,郝春艳,等.正念认知疗法对阿尔茨海默病患者认知功能和生活质量的影响[J].中华现代护理杂志,2020,26(21):2903-2908.
[37] 宋宛珊,赵冠华,徐伟,等.中药通过激活内源性神经干细胞治疗阿尔茨海默病的研究进展[J].中国老年学杂志,2022,42(17):4344-4349.
[38] 应春苗,麻玉成,樊飞燕,等.中药调控神经干细胞治疗阿尔茨海默病的作用机制[J].中国组织工程研究,2023,27(15):2385-2394.
[39] 张松江,高剑峰,孙宁宁,等.电针对阿尔茨海默病模型幼鼠海马内源性神经干细胞增殖的影响[J].中国针灸,2022,42(2):167-172.
[40] 周舒,陈武龙,徐君铭,等.内源性神经干细胞治疗多发性硬化的研究进展[J].昆明医科大学学报,2020,41(3):1-9.
[41] QIAO J,ZHAO J,CHANG S,et al.MicroRNA-153 improves the neurogenesis of neural stem cells and enhances the cognitive ability of aged mice through the notch signaling pathway[J]. Cell Death Differ,2020,27(2):808-825.
[42] LIAO L Y,LAU B W,SÁNCHEZ-VIDAÑA D I,et al.Exogenous neural stem cell transplantation for cerebral ischemia[J].Neural Regen Res,2019,14(7):1129-1137.
[43] 王金鑫,惠洋,高旭.成体海马神经再生与神经退行性疾病[J].国际遗传学杂志,2018,41(3):207-211.
[44] 庄朋伟,张艳军.中药调控神经干细胞促进中枢神经系统神经再生与修复的研究进展[J].中国医药生物技术,2008(2):134-136.
[45] 侯燕,郭家奎.补肾中药激活内源性神经干细胞与阿尔茨海默病的治疗[J].吉林中医药,2011,31(8):753-754.
[46] WANG J,HU J,CHEN X,et al.Traditional Chinese Medicine Monomers:Novel strategy for endogenous neural stem cells activation after stroke[J].Front Cell Neurosci,2021(15):628115.
[47] MARCATTI M,FRACASSI A,MONTALBANO M,et al.Aβ/tau oligomer interplay at human synapses supports shifting therapeutic targets for Alzheimer's disease[J].Cell Mol Life Sci,2022,79(4):222.
[48] ZHOU CL,ZHAO L,SHI H Y,et al.Combined acupuncture and HuangDiSan treatment affects behavior and synaptophysin levels in the hippocampus of senescence-accelerated mouse prone 8 after neural stem cell transplantation[J].Neural Regen Res,2018,13(3):541-548.
[49] VIVASH L,MALPAS CB,MELETIS C,et al.A phase 1b open-label study of sodium selenate as a disease-modifying treatment for possible behavioral variant frontotemporal dementia[J]. Alzheimers Dement,2022,8(1):e12299.
[50] 金娜. 硒酸钠抑制阿尔茨海默症模型小鼠海马β-淀粉样蛋白产生及嗅球病变的分子机制[D].深圳:深圳大学,2017.
[51] Cimenser A,Hempel E,Travers T,et al.Sensory-evoked 40-Hz gamma oscillation improves sleep and daily living activities in Alzheimer's disease patients[J].Front Syst Neurosci,2021(15):746859.
[52] Martorell A J,Paulson A L,Suk H J,et al.Multi-sensory gamma stimulation ameliorates Alzheimer's-associated pathology and improves cognition[J].Cell,2019,177(2):256-271.e22.
[53] LALLI G,SCHOTT J M,HARDY J,et al.Aducanumab:A new phase in therapeutic development for Alzheimer's disease?[J].EMBO Mol Med,2021,13(8):e14781.
[54] BAKRANIA P,HALL G,BOUTER Y,et al.Discovery of a novel pseudo β-hairpin structure of N-truncated amyloid-β for use as a vaccine against Alzheimer's disease[J].Mol Psychiatry,2022,27(2):840-848.
[55] PAULS E,BAYOD S,MATEO L,et al.Identification and drug-induced reversion of molecular signatures of Alzheimer's disease onset and progression in AppNL-G-F,AppNL-F,and 3xTg-AD mouse models[J].Genome Med,2021,13(1):168.
[56] MITRA S,BEHBAHANI H,ERIKSDOTTER M.Innovative therapy for Alzheimer's Disease-With Focus on Biodelivery of NGF[J].Front Neurosci,2019(13):38.
[57] SINGH A K,RAI SN,MAURYA A,et al.Therapeutic potential of phytoconstituents in management of Alzheimer's Disease[J].Evid Based Complement Alternat Med,2021(2021):5578574.
[58] CHAVUSHYAN V,SOGHOMONYAN A,KARAPETYAN G,et al.Disruption of cholinergic circuits as an area for targeted drug treatment of Alzheimer's disease:In vivo assessment of short-term plasticity in rat brain[J]. Pharmaceuticals(Basel),2020,13(10):297.
[59] 廖冬颖,孔凡铭,姚杨,等.基于中医整体观念探析阿尔茨海默病病因病机[J].天津中医药,2022,39(8):1009-1012.
[60] 张静,周亚男,唐于平,等.中西药联合应用治疗阿尔茨海默病的研究进展[J].现代医药卫生,2022,38(2):235-238.
[61] 张敏,薛冰,刘子娇,等.针灸治疗阿尔茨海默症的系统评价再评价[J].世界科学技术-中医药现代化,2022,24(1):113-119.
[62] 陈慧泽,谈世进,孟胜喜.中西医结合防治阿尔茨海默病的研究进展[J].中西医结合心脑血管病杂志,2021,19(12):2025-2029.
[63] 谭展飞,裴卉,刘建勋,等.北京农村地区阿尔茨海默病影响因素及临床特征的横断面研究[J].中西医结合心脑血管病杂志,2022,20(7):1197-1204.
[64] TOSUN D,DEMIR Z,VEITCH D P,et al.Contribution of Alzheimer's biomarkers and risk factors to cognitive impairment and decline across the Alzheimer's disease continuum[J].Alzheimers Dement,2022,18(7):1370-1382.
[65] ZENG K,YU X,MAHAMAN Y A R,et al.Defective mitophagy and the etiopathogenesis of Alzheimer's disease[J].Transl Neurodegener,2022,11(1):32.
[66] 朱丹迪,潘伟刚,刘超猛,等.阿尔茨海默病药物联合治疗研究进展[J].神经疾病与精神卫生,2021,21(12):898-902.
[67] 王月燊,孔立红,余超超,等.阿尔茨海默病非药物疗法研究进展[J].中国老年学杂志,2022,42(4):985-989.
[68] 韩璎,盛灿.非药物干预在阿尔茨海默病临床前期的应用现状与展望[J].中华神经医学杂志,2020(4):325-329.
[69] 陈梅,王立新.中药联合干细胞疗法治疗缺血性脑卒中的研究进展[J].中国实验方剂学杂志,2017,23(19):218-226.
[70] 吴景文,刘中民.应用干细胞治疗阿尔茨海默病的希望与挑战[J].阿尔茨海默病及相关病,2021,4(2):105-109.
[71] 刘宗鑫,王晋平,谢荣鑫,等.中医药治疗阿尔兹海默病的概况及展望[J].海南医学,2022,33(7):926-929.
[72] 孙蓉,宋绍霏,张通.阿尔茨海默病药物治疗的现状及展望[J].中国临床保健杂志,2020,23(2):153-156.
[73] 孙世标,潘小龙,魏智慧,等.补肾抗衰类中药联合干细胞疗法治疗阿尔茨海默病的机制研究进展[J].中国实验方剂学杂志,2023,29(15):199-211.