Clinical Effect of Modified Tongqiao Huoxuetang Combined with 'Huiyang Jiuzhen’ in Treating Post-stroke Cognitive Impairment

Jun LI; Xiao-jun HU; Qing WANG; Lu ZI; Yao CHEN

doi:10.13422/j.cnki.syfjx.20190431

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Clinical Effect of Modified Tongqiao Huoxuetang Combined with 'Huiyang Jiuzhen’ in Treating Post-stroke Cognitive Impairment

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- Clinical Effect of Modified Tongqiao Huoxuetang Combined with 'Huiyang Jiuzhen’ in Treating Post-stroke Cognitive Impairment
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 4, Pages: 75-80(2019)
- 作者机构：
  
  武汉市普仁医院，武汉　 430000)
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20190431
  CLC： R245;R25;R59;R592;R743.1
- Received：25 July 2018，
  
  Published Online：29 October 2018，
  
  Published：20 February 2019
- 稿件说明：
移动端阅览
Jun LI, Xiao-jun HU, Qing WANG, et al. Clinical Effect of Modified Tongqiao Huoxuetang Combined with 'Huiyang Jiuzhen’ in Treating Post-stroke Cognitive Impairment[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(4): 75-80.
DOI：

Jun LI, Xiao-jun HU, Qing WANG, et al. Clinical Effect of Modified Tongqiao Huoxuetang Combined with 'Huiyang Jiuzhen’ in Treating Post-stroke Cognitive Impairment[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(4): 75-80. DOI： 10.13422/j.cnki.syfjx.20190431.

摘要

目的：

探讨通窍活血汤加减联合“回阳九针”治疗卒中后认知障碍(PSCI)的临床效果，并从抗炎、抗氧化应激和改善血液流变学方面观察了其作用机制。

方法：

将122例符合要求的患者随机分为对照组和观察组各61例。两组患者均口服盐酸多奈哌齐片，10 mg/次，1次/d；口服尼麦角林片，20 mg/次，3次/d。对照组采用“回阳九针”，1次/d，6次/周。观察组在对照组治疗的基础上给予通窍活血汤加减，1剂/d。两组疗程均为连续治疗8周。主要疗效指标采用简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)，分别于治疗前、治疗后4和8周各评价1次。次要指标包括治疗前后的日常生活能力(ADL)，瘀阻脑络证评分；治疗前后白细胞介素-6(IL-6)，C-反应蛋白(CRP)，肿瘤坏死因子-

(TNF-

)，氧化低密度脂蛋白(Ox-LDL)，超氧化物歧化酶(SOD)，丙二醛(MDA)水平的检测；和治疗前后血液流变学检测。

结果：

经秩和检验，观察组临床疗效优于对照组(

＝1.976，

0.05)；在治疗后4和8周观察组患者的MMSE评分均高于对照组(

0.05)，观察组MMSE评分上升的幅度多于对照组(

0.05)；在治疗后4和8周观察组患者的MoCA评分均高于对照组(

0.05)，观察组MoCA评分上升的幅度大于对照组(

0.05)；观察组患者ADL和瘀阻脑络证评分均低于对照组(

0.01)；观察组患者血清IL-6，TNF-

和CRP水平均低于对照组(

0.01)；观察组MDA和Ox-LDL水平均低于对照组，SOD水平高于对照组(

0.01)；观察组全血黏度(高切、低切)、血浆黏度、红细胞聚集指数、血小板聚集性、纤维蛋白原和血沉等血液流变学指标均低于对照组(

0.01)。

结论：

在西医常规治疗的基础上，通窍活血汤联合“回阳九针”治疗PSCI患者，能提高患者的认知功能和日常生活能力，并具有抗炎、抗氧化和改善血液流变学作用，有利于促进认知功能的恢复。

Abstract

Objective:

To discuss the clinical efficacy of modified Tongqiao Huoxuetang combined with 'Huiyang Jiuzhen' in treating post-stroke cognitive impairment (PSCI) and its mechanisms in resisting inflammation and oxidant stress and ameliorating hemorheology.

Method:

One hundred and twenty-two patients were randomly divided into control group (61 cases) and observation group (61 cases) by random number table. Both groups got Donepezil tablets

10 mg/time

1 time/day

and Nicergoline tablets

20 mg/time

3 times/days. Patients in control group got 'Huiyang Jiuzhen'

1 time/day

6 times/week. In addition to the therapy in control group

patients in observation group got modified Tongqiao Huoxuetang

1 dose/day. And a course of treatment was 8 weeks. Before treatment and at the 4

week and 8

week after treatment

scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were discussed. And activity of daily living scale (ADL)

syndrome of blood stasis and cerebral collaterals were graded. And levels of Interleukin-6 (IL-6) before and after treatment

C-reactive protein (CRP)

tumor necrosis factor-

(TNF-

)

oxidized low density lipoprotein (Ox-LDL)

superoxide dismutase (SOD)

malondialdehyde (MDA)

hemorheology were detected.

Result:

According to the rank sum test

the clinical efficacy in observation group was better than that in control group (

=1.976

0.05). At the 4

week and 8

week after treatment

score of MMSE and MoCA were higher than that in control group (

0.05)

and the extent of the rise were more than that in control group (

0.05). And scores of ADL and syndrome of blood stasis and cerebral collaterals were lower than those in control group (

0.01). Levels of IL-6

TNF-

CRP

DA and Ox-LDL were lower than those in control group (

0.01)

and level of SOD was higher than that in control group (

0.01). Levels of whole blood viscosity (high-cut

low-cut)

plasma viscosity

erythrocyte aggregation index

platelet aggregation

fibrinogen and erythrocyte sedimentation rate (ESR) were lower than those in control group (

0.01).

Conclusion:

In addition to the routine therapy of western medicine

modified Tongqiao Huoxuetang combined with 'Huiyangjiuzhen' can improve patients cognitive function and daily life ability

have effects in resisting inflammation and oxidation and ameliorating hemorheology

and can promote the recovery of cognitive function.

关键词

Keywords

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