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1.广州中医药大学,广州 510006
2.广州中医药大学 第一附属医院,广州 510405
李文颢,博士,从事中医养生及慢病调理研究,E-mail:379690693@qq.com
邝秀英,硕士,副主任中医师,从事中医内科疾病的防治研究,E-mail:781037821@qq.com
收稿日期:2021-04-30,
网络出版日期:2021-11-18,
纸质出版日期:2022-01-20
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李文颢,吴知凡,王凯等.归脾汤合血府逐瘀汤加减治疗脑梗死后轻度认知障碍的临床疗效[J].中国实验方剂学杂志,2022,28(02):147-153.
LI Wen-hao,WU Zhi-fan,WANG Kai,et al.Clinical Study on Modified Guipitang Combined with Xuefu Zhuyutang in Treating Mild Cognitive Impairment After Cerebral Infarction[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(02):147-153.
李文颢,吴知凡,王凯等.归脾汤合血府逐瘀汤加减治疗脑梗死后轻度认知障碍的临床疗效[J].中国实验方剂学杂志,2022,28(02):147-153. DOI: 10.13422/j.cnki.syfjx.20220299.
LI Wen-hao,WU Zhi-fan,WANG Kai,et al.Clinical Study on Modified Guipitang Combined with Xuefu Zhuyutang in Treating Mild Cognitive Impairment After Cerebral Infarction[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(02):147-153. DOI: 10.13422/j.cnki.syfjx.20220299.
目的
2
观察归脾汤合血府逐瘀汤加减治疗脑梗死后轻度认知障碍(MCI)心脾两虚,血瘀阻络证的临床疗效及抗炎、抗氧化损伤作用。
方法
2
将114例符合要求患者随机分为对照组和观察组,各57例。对照组,口服红鹿参片,4片/次,2次/d;观察组,口服归脾汤合血府逐瘀汤加减,1剂/d,均连续治疗8周。比较治疗前后蒙特利尔认知评估量表(MoCA),Rivermead行为记忆测验(RBMT),日常生活活动能力(ADL),连线测验-B(TMT-B),神经精神症状问卷(NPI)和中医证候(心脾两虚,血瘀阻络证)评分;检测治疗前后8-羟基脱氧鸟苷(8-OHDG),丙二醛(MDA),氧化低密度脂蛋白(ox-LDL),超氧化物歧化酶(SOD),同型半胱氨酸(Hcy),白细胞介素-8(IL-8),C-反应蛋白(CRP)和纤维蛋白原(FIB)水平。
结果
2
观察组认知功能疗效总有效率为92.98%(53/57),高于对照组的78.95%(45/57),差异有统计学意义(
χ
2
=4.653,
P<
0.05);观察组认知功能恢复正常率为54.39%(31/57),高于对照组的33.33%(19/57),差异有统计学意义(
χ
2
=5.130,
P<
0.05)。与对照组比较,观察组MoCA,RBMT和ADL评分均显著升高(
P
<
0.01);TMT-B时间显著缩短(
P
<
0.01);中医证候评分,NPI-1和NPI-2评分显著降低(
P
<
0.01);观察组SOD水平显著升高(
P
<
0.01),8-OHDG,ox-LDL,MDA,Hcy,IL-8,CRP和FIB水平显著降低(
P
<
0.01)。
结论
2
归脾汤合血府逐瘀汤加减治疗脑梗死后MCI心脾两虚,血瘀阻络证患者可显著改善认知功能,并具有抗炎和抗氧化损伤作用,临床疗效优于红鹿参片。
Objective
2
To observe the clinical efficacy and anti-inflammatory and anti-oxidant effect of modified Guipitang combined with Xuefu Zhuyutang in the treatment of mild cognitive impairment (MCI) after cerebral infarction with syndromes of heart and spleen deficiency and blood stasis blocking collateral.
Method
2
A total of 114 eligible patients were randomly divided into a control group and an observation group,with 57 cases in each group. Patients in the control group were given red deer ginseng tablets (
po
),4 tablets/time,2 times/day. Patients in the observation group were given modified Guipitang combined with Xuefu Zhuyutang (
po
,1 dose/day)for continuous 8 weeks. This study compared the scores of montreal cognitive assessment (MoCA) scale,Rivermead behavioral memory test (RBMT),activities of daily living (ADL),trail making test B (TMT-B),neuropsychiatric inventory questionnaire (NPI) and scores of traditional Chinese medcine(TCM) syndrome with syndromes of heart and spleen deficiency and blood stasis blocking collateral before and after treatment. Then we further detected the levels of 8-hydroxydeoxyguanosine (8-OHDG),malondialdehyde (MDA),oxidized low density lipoprotein (ox-LDL),superoxide dismutase (SOD),homocysteine (Hcy),interleukin-8 (IL-8),C-reactive protein (CRP) and fibrinogen (FIB) levels before and after treatment.
Result
2
The total effective rate for the treatment of cognitive function impairment in the observation group was 92.98% (53/57),which was higher than 78.95% (45/57) in the control group (
χ
2
=4.653,
P
<
0.05). The recovery rate of cognitive function in the observation group was 54.39% (31/57),which was higher than 33.33% (19/57) in the control group (
χ
2
=5.130,
P
<
0.05). The MoCA,RBMT and ADL scores of the observation group were higher than those of the control group (
P
<
0.01),and the TMT-B time of the former was shorter than that of the latter (
P
<
0.01). In addition, the observation group showed lower scores of TCM syndrome,NPI-1 and NPI-2 scores than the control group (
P
<
0.01). The SOD level of the observation group was higher than that of the control group (
P
<
0.01),and the levels of 8-OHDG,ox-LDL,MDA,Hcy,IL-8,CRP and FIB were lower than those of the control group (
P
<
0.01).
Conclusion
2
Modified Guipitang combined with Xuefu Zhuyutang can improve cognitive function in MCI patients after cerebral infarction with syndromes of heart and spleen deficiency and blood stasis blocking collateral, with anti-inflammatory and anti-oxidant effect, and yield superior efficacy than red deer ginseng tablets.
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