补肾祛痰消瘀汤联合盐酸多奈哌齐治疗轻中度血管性痴呆的疗效及对血管内皮功能、脑血流动力学指标的影响OA

Objective To investigate the clinical effect of Bushen Qutan Xiaoyu Decoction combined with Donepezil Hydrochloride in treating mild-to-moderate vascular dementia(VD),and to analyze its impact on vascular endothelial function and cerebral hemodynamic parameters.Methods One hundred and twenty-eight patients with mild-to-moderate VD of kidney deficiency with phlegm and blood stasis syndrome,treated at the Anhui Provincial Veterans Hospital from January 2024 to April 2025 were selected.Patients were randomly divided into a control group and a study group using block randomization,with 64 cases in each group.The control group received Donepezil Hydrochloride,while the study group received Bushen Qutan Xiaoyu Decoction combined with Donepezil Hydrochloride.The treatment course for both groups was 3 months.Changes in traditional Chinese medicine(TCM)syndrome scores,Mini-Mental State Examination(MMSE)scores for cognitive function,vascular endothelial function indicators,and cerebral hemodynamic parameters were observed before and after treatment in both groups.The clinical efficacy was compared between the two groups.Results(1)Regarding dropouts and loss to follow-up:During the study,5 cases were lost to follow-up in the control group,resulting in 59 cases being finally included;3 cases were lost to follow-up in the study group,resulting in 61 cases being finally included.(2)Regarding efficacy:After 3 months of treatment,the total effective rate was 93.44%(57/61)in the study group and 77.97%(46/59)in the control group.Intergroup comparison(by chi-square test)showed that the efficacy of the study group was significantly superior to that of the control group(P＜0.05).(3)Regarding TCM syndromes and cognitive function:After treatment,TCM syndrome scores decreased in both groups compared to before treatment(P＜0.05),while MMSE scores increased(P＜0.05).The decrease in TCM syndrome scores and the increase in MMSE scores were significantly greater in the study group than in the control group(P＜0.01).(4)Regarding vascular endothelial function:After treatment,serum levels of nitric oxide(NO)and vascular endothelial growth factor(VEGF)increased in both groups compared to before treatment(P＜0.05),while serum levels of endothelin-1(ET-1)and soluble intercellular adhesion molecule-1(sICAM-1)decreased(P＜0.05).The increase in serum NO and VEGF levels and the decrease in serum ET-1 and sICAM-1 levels were significantly greater in the study group than in the control group(P＜0.01).(5)Regarding cerebral hemodynamics:After treatment,the resistance index(RI)and end-diastolic velocity(Vmin)decreased in both groups compared to before treatment(P＜0.05),while the pulsatility index(PI)and peak systolic velocity(Vmax)increased(P＜0.05).The decrease in RI and Vmin and the increase in PI and Vmax were significantly greater in the study group than in the control group(P＜0.05 or P＜0.01).Conclusion Bushen Qutan Xiaoyu Decoction combined with Donepezil Hydrochloride in treating patients with mild-to-moderate VD of kidney deficiency with phlegm and blood stasis syndrome can significantly improve clinical efficacy,reduce TCM syndrome scores,enhance cognitive function,and improve vascular endothelial function and cerebral hemodynamics.