温脾通络开窍汤联合丁苯酞治疗老年血管性痴呆的疗效及对高血浆同型半胱氨酸、炎症因子的影响  

Effect of Wenpi Tongluo Kaiqiao Decoction Combined with Butylphthalide in Treatment of Patients with Senile Vascular Dementia and Influence on Hcy and Inflammatory Factors

作　　者：吕立峰[1] 亓爱芹[1] 李秀芹[1] LYU Lifeng, QI Aiqin, LI Xiuqin(Department of Neurology, Laiwu People＇ s Hospital, Laiwu 271100, Shandong, Chin)

机构地区：[1]莱芜市人民医院神经内科

出　　处：《中华中医药学刊》2018年第5期1262-1265,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：莱芜市卫生局科研基金项目(莱科鉴字[2012]030)

摘　　要：目的：观察温脾通络开窍汤联合丁苯酞治疗老年血管性痴呆的疗效及对Hcy、炎症因子的影响。方法：选择医院2014年1月—2015年10月收治的90例符合入组标准的老年血管性痴呆患者作为研究对象,按随机数字表分为研究组45例和对照组45例,两组患者均给予降压、降脂和抗血小板凝聚等基础治疗措施,对照组再口服丁苯酞胶囊,0.2 g/次,3次/d,研究组在对照组的基础上再口服温脾通络开窍汤,1剂/d,早晚分服,4周为1个疗程,治疗3个疗程,治疗前后进行中医症候积分评估,采用简易智力状态检查量表（MMSE）评分、长谷川痴呆量表（HDS）、MoCA认知功能量表评价认知功能,采用Barthel指数（BI）评价日常生活活动能力,抽清晨空腹血进行Hcy、炎症因子（hs-CRP、IL-6、TNF-a）检测,进行临床疗效评估,记录不良反应发生情况。结果：研究组和对照组治疗后中医症候积分均明显下降（P〈0.05）,研究组治疗后中医症候积分明显低于对照组（P〈0.05）。研究组和对照组治疗后MMSE、HDS、MoCA、BI均较治疗前明显升高（P〈0.05）,研究组治疗后MMSE、HDS、MoCA、BI明显高于对照组（P〈0.05）。研究组和对照组治疗后Hcy、TNF-α、IL-6、hs-CRP均较治疗前明显下降（P〈0.05）,研究组治疗后Hcy、TNF-α、IL-6、hs-CRP明显低于对照组（P〈0.05）。研究组的临床总有效率为86.67%,明显高于对照组55.56%,差异具有统计学意义（P〈0.05）。结论：温脾通络开窍汤联合丁苯酞是治疗老年血管性痴呆的有效方法,能够有效改善患者认知功能及日常生活能力,且能降低Hcy、炎症因子水平。Objective： To observe the effect of Wenpi Tongluo Kaiqiao Decoction combined with butylphthalide in the treatment of patients with senile vascular dementia and influence on Hcy and inflammatory factors. Methods： Ninety patients with senile vascular dementia who met the inclusion criteria from January 2014 to October 2015 in our hospital were enrolled in this study were randomly divided into study group（n = 45） and control group（n = 45）. Both groups received basic treatment containing antihypertensive,lipid lowering and antiplatelet aggregation. And then the control group were orally given butylphthalide capsules,0. 2 g/times,3 times/d. The study group were given Wenpi Tongluo Kaiqiao Decoction on the basis of the control group,1 dose/day. 4 weeks was a course of treatment and both were treated for 3 courses.The TCM syndrome score was evaluated before and after treatment. The MMSE,HDS and MoCA were used to evaluate the cognitive function and the activities of daily activities were evaluated by Barthel index（BI）. The fasting blood was extracted to detect the Hcy and inflammatory factors（hs-CRP,IL-6,TNF-α）,and the clinical efficacy was evaluated. The incidence of adverse events was recorded. Results： The TCM syndrome scores of the study group and the control group after treatment were significantly decreased（P〈0. 05）. The TCM syndrome score in the study group was significantly lower than that in the control group（P〈0. 05）. The MMSE,HDS,MoCA and BI in the study group and the control group after treatment were significantly higher than those before treatment（P〈0. 05）. The MMSE,HDS,MoCA and BI in the study group were significantly higher than those in the control group（P〈0. 05）. The levels of Hcy,TNF-α,IL-6 and hs-CRP in the study group and control group after treatment were significantly lower than those before treatment（P〈0. 05） and the levels of Hcy,TNF-α,IL-6 and hs-CRP in the study group were lower than those in the control group（P〈0. 05）. The total effe

关 键 词：老年血管性痴呆 温脾通络开窍汤 丁苯酞 高血浆同型半胱氨酸 炎症因子 

分 类 号：R749.16[医药卫生—神经病学与精神病学]