醒神益智饮协定方联合奥拉西坦治疗血管性痴呆临床研究
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R749.1

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中国博士后科学基金项目 (2013M542498)


Clinical Study on Xingshen Yizhi Yin Formula Combined with Oxiracetam for Vascular Dementia
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    摘要:

    目的:观察醒神益智饮协定方联合奥拉西坦治疗血管性痴呆的临床效果。方法:将86例血管性痴呆患者按随机数字表法分为对照组和观察组各43例。对照组给予奥拉西坦注射液静脉滴注,观察组在对照组基础上加醒神益智饮协定方内服。通过观察中医证候积分、认知能力、日常生活能力评分变化评价临床治疗效果,检测脑血流速度,监测外周血清中心型脂肪酸结合蛋白(H-FABP)、降钙素基因相关肽(CGRP)、天冬氨酸活化水解酶(Caspase-3)蛋白表达水平,评价用药安全性。结果:观察组总有效率为90.70%,显著高于对照组的72.09%(P<0.05)。治疗后,2组反应迟缓、耳鸣重听、腰膝酸软、智能减退、表情呆板等中医证候积分均低于治疗前,且观察组反应迟缓、耳鸣重听、腰膝酸软、智能减退、表情呆板等中医证候积分低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组简易智能状态量表(MMSE)、日常生活活动量表(ADL) 评分较治疗前升高,且观察组高于对照组(P<0.05)。治疗后,2组脑血流动力学指标大脑前动脉(ACA)、大脑后动脉(PCA)、大脑中动脉(MCA)、基底动脉(BA)、椎动脉(VA)等水平明显升高,且观察组脑血流动力学改善更明显,差异均有统计学意义(P<0.05)。治疗后,2组外周血H-FABP、Caspase-3水平较治疗前明显下降,CGRP水平较治疗前明显升高;且观察组外周血H-FABP、Caspase-3水平低于对照组,CGRP水平高于对照组;差异均有统计学意义(P<0.05)。结论:醒神益智饮协定方联合奥拉西坦利于缓解血管性痴呆患者的临床症状,提高认知能力、日常生活能力,其机制可能与提高脑血流动力学以增强脑组织血液灌注及调控血清中HFABP、CGRP、Caspase-3水平以修复受损神经功能密切相关。

    Abstract:

    To observe the clinical effect of Xingshen Yizhi Yin Formula combined with oxiracetam on vascular dementia.Methods:A total of 86 cases of patients with vascular dementia were divided into the control group and the observation group according to the random number table method,43 cases in each group.The control group was given intravenous drip of oxiracetam injection,and the observation group was additionally treated with the Xingshen Yizhi Yin Formula orally based on the treatment of the control group.The clinical effect was evaluated by the observation of the changes in Chinese medicine syndrome scores and the scores of cognitive ability and activities of daily living;cerebral blood flow velocity wasdetected; the protein expression levelsof heart-type fatty acid binding protein (H-FABP), calcitonin gene-related peptide(CGRP)and cysteine-aspartic acid protease(Caspase-3)in serum in peripheral blood were monitored;the medication safety was evaluated.Results:The total effective rate was 90.70%in the observation group,significantly higher than that of 72.09%in the control group(P < 0.05).After treatment,Chinese medicine syndrome scores including delayed response, tinnitus and hearing impairment, soreness and weakness of waist and knees, intelligent decline and witless expression in the two groups were lower than those before treatment,and the above scores in the observation group were lower than those in the control group,differences being significant(P < 0.05).After treatment,the scores of Mini-Mental State Examination(MMSE)and Activities of Daily Living Scale(ADL)in the two groups were increased when compared with those before treatment,and the scores in the observation group were higher than those in the control group(P < 0.05).After treatment,the levels of cerebral hemodynamic indexes including the anterior cerebral artery(ACA),the posterior cerebral artery(PCA),the middle cerebral artery(MCA),the basilar artery(BA)and the vertebral artery(VA)in the two groups were significantly increased,and the improvement of cerebral hemodynamics in the observation group was more significant,differences being significant(P < 0.05).After treatment,the levels of H-FABP and Caspase-3 in peripheral blood in the two groups were significantly decreased when compared with those before treatment,while the levels of CGRP were significantly increased;the levels of H-FABP and Caspase-3 in peripheral blood in the observation group were lower than those in the control group,while the level of CGRP was higher than that in the control group;differences being significant(P<0.05).Conclusion:The therapy of Xingshen Yizhi Yin Formula combined with oxiracetam can help relieve the clinical symptoms of patients with vascular dementia,improve their cognitive ability and activities of daily living,whose mechanism may be closely related to the improvement of cerebral hemodynamics for enhancing the blood perfusion in the cerebral tissue and the regulation of the levels of H-FABP,CGRP and Caspase-3 in serum for repairing the impaired neurological function.

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郑名武,余利军,许海.醒神益智饮协定方联合奥拉西坦治疗血管性痴呆临床研究[J].新中医,2019,51(10):93-98

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  • 在线发布日期: 2019-10-11
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