At present, pharmaceutical services for Alzheimer's disease (AD) patients are mostly based on the western medication therapy management (MTM) model, which includes conducting drug treatment evaluations for patients, identifying drug treatment issues, proposing drug treatment recommendations, restructuring drug treatment checklists, follow-up visiting and recording, etc. However, in recent years, more and more domestic clinical practices have proven that individualized treatment with dialectical treatment of traditional Chinese medicine can effectively prevent and delay the occurrence and development of AD, while the MTM pharmaceutical service model has some limitations when facing such AD patients. Therefore, it is necessary to explore a new pharmaceutical service model with Chinese medicine characteristics for AD MTM, so as to provide pharmaceutical services for patients receiving individualized treatment of AD through the combination of traditional Chinese and Western medicine. Combining the traditional Chinese medicine sequential therapy of AD with the MTM concept, MTM was conducted on a typical outpatient AD patient, which effectively solved the medication related problems of the patient and ensured the medication safety and efficacy.
1.Alzheimer's Association. 2023 Alzheimer's disease facts & Figures[J]. Alzheimers Dement, 2023, 19(4): 1598-1695. DOI: 10.1002/alz.13016.
2.登博. 《2019中国阿尔茨海默病患者家庭生存状况调研报告》发布[EB/OL]. (2023-02-16) [2024-07-01]. https://zhuanlan.zhihu.com/p/606759964.
3.Moon JY, Walek S, Walburg K. Meeting the criteria of medication therapy management[J]. JAMA Intern Med, 2018, 178(11):1562-1563. DOI: 10.1001/jamainternmed. 2018.5789.
4.李一平, 谢宁, 王素. 中医辨证论治阿尔茨海默病研究进展[J]. 中医学报, 2020, 35(3): 559-563. [Li YP, Xie N, Wang S. Research progress of the treatment of Alzhemer's disease based on syndrome differentiation of Chinese medicine[J]. Acta Chinese Medicine, 2020, 35(3): 559-563.] DOI: 10.16368/j.issn.1674-8999.2020.03.127.
5.周金平, 郁东海, 王利丽. 轻度认知障碍运用中医预防保健干预后效果评价[J]. 内蒙古中医药, 2014, 33(12): 20-21. [Zhou JP, Yu DH, Wang LL. Evaluation of the effect of traditional Chinese medicine preventive and healthcare intervention on mild cognitive impairment[J]. Inner Mongolia Journal of Traditional Chinese Medicine, 2014, 33(12): 20-21.] DOI: 10.16040/j.cnki.cn15-1101.2014.12.032.
6.陈斌, 孙绪举, 许明望. 阿尔茨海默症治疗药物的研究进展[J]. 中国医院药学杂志, 2003, 23(6): 364-365. [Chen B, Sun XJ, Xu MW. Progress in research on therapeutic drugs for Alzheimer's disease[J]. Chinese Journal of Hospital Pharmacy, 2003, 23(6): 364-365.] DOI: 10.3321/j.issn:1001-5213.2003.06.024.
7.Tian J, Shi J, Ni JN, et al. Sequential therapy based on evolvement of patterns: a new model for treatment of Alzheimer's disease[J]. Chin J Integr Med, 2019, 25(8): 565- 573. DOI: 10.1007/s11655-019-3066-y.
8.郑茂凤, 时晶, 倪敬年, 等. 从“肾藏志”理论探讨阿尔茨海默病的治疗思路[J]. 现代中医临床, 2023, 30(1): 65-68. [Zheng MF, Shi J, Ni JN, et al. Exploring the treatment approach for Alzheimer's disease from the perspective of the theory of "kidney hidden records"[J]. Modern Chinese Clinical Medicine, 2023, 30(1): 65-68.] DOI: 10.3969/j.issn.2095-6606.2023.01.015.
9.李傅尧, 时晶, 田金洲. 论阿尔茨海默病“病证结合”分期辨治[J]. 现代中医临床, 2023, 30(3): 83-87. [Li FY, Shi J, Tian JZ. On the staging and treatment of Alzheimer's disease through the combination of disease and syndrome[J]. Modern Chinese Clinical Medicine, 2023, 30(3): 83-87.] DOI: 10.3969/j.issn.2095-6606.2023.03.016.
10.Shi J, Ni J, Lu T, et al. Adding Chinese herbal medicine to conventional therapy brings cognitive benefits to patients with Alzheimer's disease: a retrospective analysis[J]. BMC Complement Altern Med, 2017, 17(1): 533-535. DOI: 10.1186/s12906-017-2040-5.
11.陈国华, 单萍, 邱昕. 黄连解毒汤治疗老年性痴呆(心肝火旺型)临床研究[J]. 中国中医急症, 2007, 16(4): 386-387. [Chen GH, Shan P, Qiu X. The clinical study on Huanglianjiedu decoction on for patients with senile dementia, the type of hyperactivity of heart-fire and liver fire in TCM[J]. Journal of Emergency in Traditional Chinese Medicine, 2007, 16(4): 386-387.] DOI: 10.3969/j.issn.1004-745X.2007.04.003.
12.王俊力. 基于“毒损脑络”病机探讨清热解毒法治疗阿尔茨海默病的临床及基础研究[D]. 武汉: 湖北中医药大学, 2022. DOI: 10.27134/d.cnki.ghbzc.2022.000004.
13.黄熏莹, 刘珍珠, 翟双庆, 等. 从《黄帝内经》脾藏意及香入脾理论探讨痴呆的中医治疗[J]. 北京中医药大学学报, 2021, 44(12): 1073-1078. [Huang XY, Liu ZZ, Zhai SQ, et al. Analysis of TCM treatment of dementia with aromatic Chinese herbs based on the theory of "spleen housing ideas" and "aromatics acting on the spleen" in Huangdi Neijing[J]. Journal of Beijing University of Traditional, 2021, 44(12): 1073-1078.] DOI: 10.3969/j.issn. 1006-2157.2021.12.003.
14.中国老年保健协会阿尔茨海默病分会(ADC)指南小组. 中国阿尔茨海默病痴呆诊疗指南(2020年版)[J]. 中华老年医学杂志, 2021, 40(3): 269-283. DOI: 10.3760/cma.j.issn.0254-9026.2021.03.001.
15.李骏峰, 王虹, 邢永红. 3种药物联用方式治疗阿尔茨海默氏症的临床疗效观察[J]. 中国医院药学杂志, 2012, 32(5): 392-393. [Li JF, Wang H, Xing YH. Clinical efficacy observation of three drug combination therapies for Alzheimer's disease[J]. Chinese Journal of Hospital Pharmacy, 2012, 32(5): 392-393.] DOI: 10.13286/j.cnki.chinhosppharmacyj.2012.05.019.
16.刘芳, 翟所迪. 美金刚治疗阿尔茨海默病的临床应用[J]. 中国医院药学杂志, 2008, 28(6): 482-485. [Liu F, Zhai SD. Clinical application of memantine in the treatment of Alzheimer's disease[J]. Chinese Journal of Hospital Pharmacy, 2008, 28(6): 482-485.] DOI: 10.3321/j.issn:1001-5213.2008.06.026.
17.中华医学会骨科学分会关节外科学组. 中国骨关节炎疼痛管理临床实践指南(2020年版)[J]. 中华骨科杂志, 2020, 40(8): 469-470. DOI: 10.3760/cma.j.cn121113-20200403-00215.
18.奥美沙坦酯片(傲坦)药品使用说明书[Z]. 批准文号: 国药准字H20060372, 第一三共制药(上海)有限公司, 2021. https://www.nmpa.gov.cn/datasearch/home-index.html#category=yp.
19.何秉贤. 降压治疗预防阿尔茨海默病[J]. 中华高血压杂志, 2014, 22(3): 201-202. [He BX. Antihypertensive therapy to prevent Alzheimer's disease[J]. Chinese Journal of Hypertension, 2014, 22(3): 201-202.] DOI: 10.16439/j.cnki.1673-7245.2014.03.029.
20.Qiu C, winblad B, Fratidioni L. Low diastolic pressure and risk of dementia in very old people:a longitudinal study[J]. Dement Geriatr Cogn Disord, 2009, 28(3): 213-219. DOI: 10.1159/000236913.
21.Profenno LA, Porsteinsson AP, Famone SV. Meta-analysis of Alzheimer's disease risk with obesity, diabetes, and related disorders[J]. Biol Psychiatry, 2010, 67(6): 505-512. DOI: 10.1016/j.biopsych.2009.02.013.
22.Scarmeas N, Stem Y, Tang Mx, et al. Mediterranean diet and risk for Alzheimer's disease[J]. Ann Neurol, 2006, 59(6): 912-921. DOI: 10.1002/ana.20854.