To explore the regulatory effect of Modified Ditan Decoction (涤痰汤加减) on brain neurotransmitters in elderly dementia patients with phlegm-turbidity obstructing orifices type.

A total of 122 elderly dementia patients in the hospital from January 2021 to December 2024 divided into control group (61 cases) and an observation group (61 cases) according to the medication plan. The control group took orally donepezil hydrochloride tablets and vitamin E soft capsules, while the observation group Modified Ditan Decoction on the basis of control group. Two groups were evaluated for 12 weeks of treatment. It compared the therapeutic effects of two groups, the changes in cognitive function, daily living ability, traditional Chinese medicine syndrome, brain neurotransmitters and quality of life before and after treatment and safety evaluation.

The effective rate of the observation group (91.80%) was higher than that of the control group (77.05%) (P<0.05). After treatment, Alzheimer's disease assessment scale-cognitive (ADAS-cog) score [(19.86±3.78) points] of the observation group was lower that of the control group [(28.74±4.69) points], while the mini-mental state examination (MMSE) score [(23.42±2.14) points] and Montreal cognitive assessment (MoCA) score [(23.19±2.45) points] were higher than those of the control group [(20.16±2.53) points and (20.08±2.76) points] (P<0.05). After treatment, activity daily living (ADL) score of the observation group [(64.52±6.84) points] was higher than that of the control group [(56.79±7.17) points], while the TCM syndrome score [(7.74±2.13) points] was lower than that of the control group [13.28±2.97) points] (P<0.05). After treatment, the serum levels of dopamine (DA) [(245.13±29.47) pg/mL], acetylcholine (ACh) [(323.15±35.47) pmol/mL] and gamma-aminobutyric acid (GABA) [(169.35±16.54) pg/mL] of the observation group were higher than those of the control group [(210.35±26.52) pg/mL, (282.56±26.26) pmol/mL and (145.29±14.67) pg/mL] (P<0.05). After treatment, interpersonal environment score [(12.38±2.43) points], physiological function score [(10.07±1.56) points], psychological state score [(9.42±1.43) points] and behavioral ability score [(9.86±1.63) points] of the observation groupwere higher than those of the control group [(9.97±2.31) points, (8.32±1.42) points, (7.48±1.56) points and (7.94±1.54) points] (P<0.05). Neither group experienced significant adverse reactions.

Modified Ditan Decoction has a good therapeutic effect on the elderly dementia patients with phlegm-turbidity obstructing orifices type, and its mechanism may be related to the regulation of brain neurotransmitter levels, which has important clinical research value.