摘要
目的探讨补肾生髓益智汤辅助多奈哌齐治疗血管性痴呆(Vascular dementia,VaD)的临床价值。方法选取2019年2月—2021年2月期间河北北方学院附属第二医院收治的106例VaD患者作为研究对象,采用随机数字表法分为对照组与治疗组,每组各53例。两组患者均积极处理卒中病因与血管危险因素,给予对症治疗与常规康复训练,在此基础上,对照组给予多奈哌齐治疗,治疗组给予多奈哌齐+补肾生髓益智汤治疗。两组患者均治疗3个月后,观察比较两组患者临床疗效、安全性,对比治疗前后痴呆评分[长谷川痴呆量表(Hasegawa dementia scale,HDS)评分]、中医证候积分、凋亡因子[可溶性凋亡分子sFas、sFasL、抗凋亡分子(Livin)]水平变化。结果治疗后治疗组临床总有效率94.23%(49/52)高于对照组80.39%(41/51),差异有统计学意义(P<0.05)。两组患者治疗后HDS记忆功能、定向力、计算、常识、物体铭记命名回忆各维度评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组明显高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后中医证候主症、次症及总积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组明显低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后血清sFas、sFasL水平较治疗前降低,Livin水平较治疗前升高,差异有统计学意义(P<0.05);且研究组血清sFas、sFasL水平明显低于对照组,Livin水平明显高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论补肾生髓益智汤辅助多奈哌齐治疗VaD安全、有效,有利于改善患者痴呆症状,调节凋亡因子表达。
Objective To explore the clinical value of BushenShengsuiYizhi Decoction assisting donepezil in the treatment of vascular dementia(VD).Method A total of 106 VD patients admitted to the Second Affiliated Hospital of Hebei North University from February 2019 to February 2021 were divided into a control group and a treatment group by random number table method,with 53 cases in each group.Patients in both groups were actively treated with the causes of stroke and vascular risk factors,and received symptomatic treatment and conventional rehabilitation training.On this basis,patients in the control group weregiven donepezil,and those in the treatment group were given donepezil+BushenShengsuiYizhiDecoction.Both groups were treated for 3 months.The clinical efficacy and safety of the two groups were compared,and the changes in dementia score,namely Hasegawa Dementia Scale(HDS)score,traditional Chinese medicine(TCM)syndrome scores,and apoptotic factors including soluble apoptotic molecules soluble Fas(sFas)and soluble Fas ligand(sFasL)and anti-apoptotic molecule Livin before and after treatment were compared.Result After treatment,the total clinical efficacy in the treatment group was 94.23%(49/52),higher than 80.39%(41/51)in the control group(P<0.05).The HDS scores of memory function,orienting force,calculation,common sense,and object recall in the two groups were increasedafter treatment(P<0.05),and the scores in the treatment group were higher than those in the control group(P<0.05).The TCM syndrome primary,secondary,and total scores in the two groups were all decreased after treatment(P<0.05),and the scores in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of serum sFas and sFasL in the two groups were decreased,and the level of Livin was increased(P<0.05).Moreover,the levels of sFas and sFasL in the treatment group were lower than those in the control group,whereas the level of Livin in the treatment group was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion BushenShengsuiYizhi Decoction combined with donepezil is safe and effective in the treatment of VD,which improves the symptoms of dementia and regulates the expression of apoptotic factors.
作者
肖志娟
刘敏肖
唐进松
赵鹏
陈兰英
李鑫
沈文
XIAO Zhi-juan;LIU Min-xiao;TANG Jin-song;ZHAO Peng;CHEN Lan-ying;LI Xin;SHEN Wen(Second Department of Neurology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075100;Department of Chinese Acupuncture,the Second Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075100)
出处
《世界中西医结合杂志》
2022年第6期1190-1194,共5页
World Journal of Integrated Traditional and Western Medicine
基金
河北省中医药管理局中医药类科研计划项目(2020238)。
