补阳还五汤治疗脑小血管病认知障碍临床研究OA
Clinical Study on Buyang Huanwu Tang in the Treatment of Cerebral Small Vessel Disease-Related Cognitive Impariment
目的:观察补阳还五汤对脑小血管病认知障碍的临床疗效.方法:将2022年10月—2024年9月于滨州市中心医院神经内科就诊的气虚血瘀型脑小血管病认知障碍患者85例,按随机数字表法分为对照组43例,中药组42例.对照组患者给予基础治疗;中药组在对照组治疗方案的基础上加用补阳还五汤配方颗粒治疗.采用简易智能精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评估认知功能,计算中医证候积分,检测血清超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、血清同型半胱氨酸(Hcy)水平,采用Fazekas视觉评定量表评估脑白质高信号负荷量,分析比较上述指标治疗前后的变化.结果:治疗后,中药组MMSE评分、MoCA评分均较治疗前升高,中医证候各项积分、Fazekas评分均较治疗前降低,差异均有统计学意义(P<0.05).治疗后,中药组MMSE评分、MoCA评分均较对照组升高,中医证候积分中头晕、自汗症状积分均较对照组降低,差异均有统计学意义(P<0.05);中药组Fazekas评分与对照组比较,差异无统计学意义(P>0.05).治疗后,2组IL-6、hs-CRP、Hcy水平均较治疗前降低,差异均有统计学意义(P<0.05);中药组IL-6、hs-CRP水平均较对照组降低,差异均有统计学意义(P<0.05),Hcy水平与对照组比较,差异无统计意义(P>0.05).不良反应发生率对照组13.95%(6/43),中药组16.67%(7/42),2组不良反应发生率比较,差异无统计学意义(P>0.05).结论:在基础治疗的方案之上加用补阳还五汤治疗脑小血管病认知障碍,可降低中医证候积分、降低患者的炎症水平,有助于改善患者的认知功能.
Objective:To observe the clinical effect of Buyang Huanwu Tang in the treatment of cerebral small vessel disease-related cognitive impairment.Methods:A total of 85 patients with cerebral small vessel disease-related cognitive impairment of qi deficiency and blood stasis type who were treated in the Department of Neurology,Binzhou Central Hospital from October 2022 to September 2024 were randomly divided into the control group(43 cases)and the Chinese medicine group(42 cases)using the random number table method.Patients in the control group were given conventional treatment;the Chinese medicine group was treated with Buyang Huanwu Tang Dispensing Granules based on the treatment plan of the control group.The cognitive function was evaluated by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA).The traditional Chinese medicine syndrome scores were calculated.The serum levels of hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),and homocysteine(Hcy)were detected.The Fazekas visual rating scale was used to evaluate the load of white matter hyperintensity.The changes of the above indexes before and after treatment were analyzed and compared.Results:After treatment,the MMSE score and MoCA score in the Chinese medicine group were increased when compared with those before treatment,and each traditional Chinese medicine syndrome score and the Fazekas score were decreased when compared with those before treatment,differences being significant(P<0.05).After treatment,the MMSE score and MoCA score in the Chinese medicine group were higher than those in the control group,and the symptom scores for dizziness and spontaneous sweating in the traditional Chinese medicine syndrome score were lower than those in the control group,differences being significant(P<0.05);there was no significant difference being found in the comparison of Fazekas score between the Chinese medicine group and the control group(P>0.05).After treatment,the levels of IL-6,hs-CRP,and Hcy in the two groups were decreased when compared with those before treatment,differences being significant(P<0.05);the levels of IL-6 and hs-CRP in the Chinese medicine group were lower than those in the control group,differences being significant(P<0.05);there was no significant difference being found in the comparison of Hcy level between the Chinese medicine group and the control group(P>0.05).The incidence of adverse reactions was 13.95%(6/43)in the control group and 16.67%(7/42)in the Chinese medicine group,there being no significance in the difference(P>0.05).Conclusion:In addition to the conventional treatment plan,Buyang Huanwu Tang in the treatment of cerebral small vessel disease-related cognitive impairment can reduce the traditional Chinese medicine syndrome scores,reduce the inflammatory factor levels,and help to improve the cognitive function of patients.
贾岩辉;崔真真;李浩;尤丽萍;张玉倩
滨州市中心医院,山东 滨州 251700滨州市中心医院,山东 滨州 251700滨州市中心医院,山东 滨州 251700滨州市中心医院,山东 滨州 251700滨州市中心医院,山东 滨州 251700
医药卫生
脑小血管病认知障碍气虚血瘀证补阳还五汤简易智能精神状态检查量表蒙特利尔认知评估量表同型半胱氨酸脑白质高信号
Cerebral small vessel diseaseCognitive impairmentQi deficiency and blood stasis syndromeBuyang Huanwu TangMMSEMoCAHcyWhite matter hyperintensity
《新中医》 2026 (12)
20-27,8
山东省中医药科技项目(M-2022134)山东省医药卫生科技项目(202403071201)
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