Overview

As a traditional Chinese medicine compound, Yangxue Qingnao Pills is proven to have beneficial effects on learning and memory ability in animal models of Alzheimer's disease(AD). The purpose of the study is to evaluate the efficacy and safety of Yangxue Qingnao Pills on patients with mild to moderate AD. This phase II randomized, double-blind, parallel controlled trial include a 2 weeks run-in period, and a 48 weeks double-blind treatment period of after randomization. Participants will be randomly allocated to Yangxue Qingnao pills high dose group (7.5 g per time,2 times per day) ; and Yangxue Qingnao pills low dose group (5 g per time,2 times per day), or placebo group. The outcome measures include general cognitive function, ability of daily living, and behavioural and psychological symptoms in AD patients.

Eligibility

Inclusion Criteria:

        Patients, Chinese speaking, in both gender are eligible to be included in the study only if
        they meet all of the following criteria:
          1. Meets NIA/AA core clinical criteria for probable AD;
          2. The body weight is between 45-90kg;
          3. Aged ≥ 65 and ≤ 85 years old;
          4. Mild to moderate stage of AD, defined as( MMSE score of 15 through 26) at baseline;
          5. Has had an MRI scan performed at baseline that has confirmed with a diagnosis of AD,
             Medial temporal atrophy scale (MTA) is used for routine assessment of the medial
             temporal lobe, and the MTA score need ≥1.5 (adjusted by age: 65-74 years ≥ 1.5 points,
             75-84 years old ≥ 2.0 points);
          6. Has a PIB-PET scan or CSF result consistent with the presence of amyloid pathology at
             screening;
          7. And the patients must have adequate vision and hearing to participate in study
             assessments; has normal swallowing function, and can complete the medication;
          8. Have a stable caregiver;
          9. Can read simple articles and write simple sentences;
         10. Informed consent, signed informed consent by legal guardian.
        Exclusion Criteria:
        Patients who confirmed with any of the following excluding criteria conditions were not
        enrolled for the study:
          1. Early-onset Alzheimer disease (oneset at <65 years of age) and moderate to severe AD
             dementia (MMSE 14-0);
          2. Evidence of other reasons caused cognitive impairment, like vascular dementia,
             frontotemporal dementia, Parkinson's disease dementia, Lewy body dementia,
             Huntington's disease, subdural hematoma, communicating hydrocephalus, brain tumor,
             thyroid disease, vitamin deficiency Or other diseases that may cause cognitive
             impairment, or serious brain infections (including neurosyphilis, meningitis or
             encephalitis), etc.;
          3. There are unstable mental disorders, including major depression (HAMD≥17), severe
             anxiety disorder (HAMA≥12 points), bipolar disorder, schizophrenia, etc.;
          4. History of drug or alcohol abuse in the past 5 years;
          5. Other uncontrolled chronic illnesses, such as severe arrhythmia (ventricular rate <60
             beats/min or >100 beats/min, or patients with myocardial infarction within 3 months
             before participating in the trial, or severe heart failure (NY classification III and
             IV), or severe abnormal blood pressure, systolic blood pressure ≤90mmHg or ≥180mmHg;
          6. Severe liver or kidney dysfunction (alanine aminotransferase or aspartate transaminase
             was more than 1.5 times the upper limit of normal, or serum creatinine was more than
             the upper limit of normal);
          7. A history of taking cholinesterase inhibitors, memantine, or proprietary Chinese
             medicines with clear nootropic effects within the past 1 month;
          8. Has received medications that affect the central nervous system (CNS), except
             treatments for AD for less than 4 weeks; that is, doses of chronic medications that
             affect the CNS should be stable for at least 4 weeks;
          9. One of the following manifestations on cranial MRI:> 4 cerebral microhemorrhages,
             evidence of a prior macrohemorrhage, > 3 lacunar infarcts over 10 mm each, any
             cortical infarct over 10 mm, or any other clinically significant finding (e.g., any
             lesion that may account for their cognitive impairment, including but not limited to
             brain tumor, severe white matter disease with a rating of 3 on the Fazekas scale for
             WM lesions ,arteriovenous malformation, cavernous hemangioma, or any infarct in a
             strategic subcortical location);
         10. History of hypersensitivity to the treatment drugs;
         11. Participate in other clinical study within the last 30 days;
         12. Has metal (ferromagnetic) implants, or a cardiac pacemaker and other conditions that
             could not undergo MRI scan;
         13. or other conditions that, in the investigator's opinion, could interfere with the
             analyses of safety and efficacy in this study.