基于“肾生髓”理论应用fMRI技术探讨补肾法治疗Alzheimer病的机理

项目名称： 基于“肾生髓”理论应用fMRI技术探讨补肾法治疗Alzheimer病的机理

项目编号： No.81202795

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 医学八处

项目作者： 陈薇

作者单位： 天津中医药大学

项目金额： 23万元

中文摘要： 中医"肾生髓"理论认为肾藏精, 精生髓，脑为髓之海。Alzheimer病(AD)的基本病性为本虚标实，"肾精亏虚、髓海渐空"是AD的基本病机，因此从肾论治是中医药治疗AD的根本。补肾中药"左归丸"、"右归丸"能够显著改善AD患者的临床症状，延缓病程进展。本研究在"肾生髓"理论指导下，以肾虚髓减型AD偏肾阴虚患者和偏肾阳虚患者为研究对象，以正常老年人为对照，采用无创的MR脑功能成像技术（弥散张量成像、动脉自旋标记灌注及血氧水平依赖对比成像），分别在左归丸或右归丸治疗前、后检测两组证型AD患者的海马体积、全脑皮层厚度、脑白质完整性、脑血流灌注状态及认知任务刺激下的脑功能活动，揭示中医证型与脑组织结构和功能的关系，并以MMSE和中医证候评分为标准，分别在脑形态和功能两方面评价补肾中药对AD的疗效，进而从影像学角度探讨"肾生髓"理论指导下补肾法治疗AD的作用机理。

中文关键词： 肾生髓；脑功能成像；阿尔滋海默病；MR波谱成像；动脉自旋标记

英文摘要： The traditional Chinese theory of "Kidney Generating Marrow" considers that kidney is the foundation of life, behavior and brain activity. The basic pathogenesis of Alzheimer's disease (AD) is brain disfunction induced by "the insufficiency of kidney essence and decreasing of kidney function". Based on this theory, kidney is the target of treating AD patients in traditional Chinese medicine. It has been reported that Bushen medicine (e.g."Zuogui pills" and "Yougui pills") could improve AD petients' symptoms and delay AD progress in clinical practice. This study is guided by the theory of "Kidney Generating Marrow". The subjects with AD of renal deficiency type will be recruited and divided into two groups, which are the deficiency of kidney-YIN group and the deficiency of kidney-YANG group, respectively. Non-invasive brain functional MR imaging techniques will be used to measure the volume of the hippocampus, thickness of gray matter, integrity of white matter, brain perfusion and cognitive task-induced activity in AD before and after using "Zuogui pill" or "Yougui pill". The purpose of this study is: (1) to observe the relationship between brain structure, function and the patterns of syndrome with fMRI, compared with the normal aged people as the control group; (2) to evaluate the clinical effects of Bushen

英文关键词： Kidney Generating Marrow；functional MRI；Alzheimer's disease；MRS；ASL