祛瘀醒脑汤治疗缺血性脑卒中后非痴呆性血管性认知功能障碍临床研究
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Clinical Study on Quyu Xingnao Decoction for Vascular Cognitive Impairment No Dementia After Ischemic Stroke
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    摘要:

    目的:观察祛瘀醒脑汤治疗缺血性脑卒中后非痴呆性血管性认知功能障碍(VCIND) 痰瘀互结证 的临床疗效。方法:选取124例缺血性脑卒中后VCIND痰瘀互结证患者,采用随机数字表法分为祛瘀醒脑汤 组、对照组各62例。治疗期间,祛瘀醒脑汤组剔除2例,对照组剔除6例,最终纳入研究祛瘀醒脑汤组60例, 对照组56例。对照组给予西药联合认知功能训练治疗,祛瘀醒脑汤组在对照组基础上给予祛瘀醒脑汤治疗。 2组均连续治疗4周。比较2组临床疗效、蒙特利尔认知评估量表(MoCA) 评分、血液流变学指标及血清中枢 神经特异蛋白(S100β)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF) 水平。结果:治疗 后,祛瘀醒脑汤组总有效率96.67%,高于对照组83.93%,差异有统计学意义(P<0.05)。2组MoCA评分均较 治疗前升高,祛瘀醒脑汤组MoCA评分高于对照组,差异均有统计学意义(P<0.05)。2组血浆黏度、红细胞 比容、纤维蛋白原(FIB) 水平均较治疗前降低,祛瘀醒脑汤组血浆黏度、红细胞比容、FIB水平均低于对照 组,差异均有统计学意义(P<0.05)。2组血清S100β、NSE水平均较治疗前降低,血清BDNF水平均较治疗前 升高,差异均有统计学意义(P<0.05);祛瘀醒脑汤组血清S100β、NSE水平均低于对照组,血清BDNF水平 高于对照组,差异均有统计学意义(P<0.05)。结论:祛瘀醒脑汤治疗缺血性脑卒中后VCIND痰瘀互结证, 可有效改善患者的认知功能,其作用机制可能与改善血液流变学及修复受损神经元有关。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Quyu Xingnao Decoction for vascular cognitive impairment no dementia (VCIND) after ischemic stroke. Methods: A total of 124 cases of VCIND patients with binding of phlegm and stasis syndrome after ischemic stroke were selected and divided into the Quyu Xingnao Decoction group and the control group according to the random number table method , with 62 cases in each group. During the treatment period, two cases were excluded from the Quyu Xingnao Decoction group and six cases were excluded from the control group. Finally,60 cases were included in the Quyu Xingnao Decoction group and 56 cases were included in the control group. The control group was treated with western medicine combined with cognitive function training,and the Quyu Xingnao Decoction group was treated with Quyu Xingnao Decoction based on the treatment of the control group. Both groups were treated continuously for four weeks. The clinical effects, Montreal Cognitive Assessment Scale (MoCA) scores,hemorheological indexes,and levels of S100 calcium-binding protein B (S100β) ,neuron specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) in serum were compared between the two groups. Results:After treatment,the total effective rate was 96.67% in the Quyu Xingnao Decoction group, higher than that of 83.93% in the control group, the difference being significant (P<0.05). The MoCA scores in the two groups were increased when compared with those before treatment, and the MoCA score in the Quyu Xingnao Decoction group was higher than that in the control group, differences being significant (P<0.05). The levels of plasma viscosity, hematocrit, and fibrinogen (FIB) in the two groups were decreased when compared with those before treatment,and the levels of plasma viscosity, hematocrit, and FIB in the Quyu Xingnao Decoction group were lower than those in the control group, differences being significant (P<0.05). The levels of S100β and NSE in serum in the two groups were decreased when compared with those before treatment,and the serum BDNF levels were increased when compared with those before treatment, differences being significant (P<0.05); the levels of S100β and NSE in serum in the Quyu Xingnao Decoction group were lower than those in the control group, and the serum BDNF level was higher than that in the control group, differences being significant (P<0.05). Conclusion:Quyu Xingnao Decoction can effectively improve the cognitive function of VCIND patients with binding of phlegm and stasis syndrome after ischemic stroke, and its mechanism may be related to improving hemorrheology and repairing damaged neurons.

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刘爱珍,陈常周,刘瑞丽.祛瘀醒脑汤治疗缺血性脑卒中后非痴呆性血管性认知功能障碍临床研究[J].新中医,2024,56(12):46-51

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  • 在线发布日期: 2024-06-28
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