通窍活血汤联合康复训练治疗老年脑卒中后血管性痴呆(瘀血内阻证)疗效及对患者血管内皮活性物质的影响  

Efficacy of Using Tongqiao Huoxue Decoction Combined with Rehabilitation Training in the Treatment of Senile Patients with Vascular Dementia after Stroke and Its Effect on Vascular Endothelial Active Substances

作　　者：赵桂荣 于存娟 张义松 康玲玲 王孝理 ZHAO Guirong;YU Cunjuan;ZHANG Yisong(Fangshan Hospital of Beijing University of Traditional Chinese Medicine,Beijing 102400,China)

机构地区：[1]北京市中医药大学房山医院,北京102400

出　　处：《四川中医》2021年第3期145-148,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:观察通窍活血汤联合康复训练治疗老年脑卒中后血管性痴呆(瘀血内阻证)对患者疗效及血管内皮活性物质的影响,为临床治疗提供参考。方法:选取我院2017年10月~2020年6月收治的老年脑卒中后血管性痴呆(瘀血内阻证)患者116例,根据治疗方法分为两组,每组58例。两组患者均给予常规对症治疗,对照组给予康复训练治疗,观察组给予通窍活血汤联合康复训练治疗。记录两组治疗前后中医证候积分、简易精神状态检查(MMSE)评分、临床痴呆评定量表(CDR)的变化,检测两组治疗前后血管内皮活性物质、脑循环动力学参数的变化,统计两组疗效。结果:观察组的总有效率为93.10%,高于对照组的79.31%,组间比较发现,有统计学意义(P<0.05)。治疗后两组头晕、健忘、语言不利、反应迟钝、表情呆板及乏力积分逐渐下降(P<0.05),进一步组间比较发现,观察组各项中医证候积分低于对照组(P<0.05)。治疗后两组内皮素(ET)逐渐下降(P<0.05),且观察组ET低于对照组(P<0.05)。治疗后两组平均血流速和血流量逐渐上升(P<0.05),血管搏动指数逐渐下降(P<0.05),进一步组间比较发现,观察组平均血流速和血流量高于对照组(P<0.05),血管搏动指数低于对照组(P<0.05)。治疗后两组MMSE评分逐渐上升(P<0.05),CDR评分逐渐下降(P<0.05),进一步组间比较发现,观察组MMSE评分高于对照组(P<0.05),CDR评分低于对照组(P<0.05)。结论:通窍活血汤联合康复训练治疗老年脑卒中后血管性痴呆(瘀血内阻证)可改善脑循环动力学,减少血管内皮活性物质的表达,改善痴呆症状,提高认知功能。Objective: To observe the effect of Tongqiao Huoxue Decoction combined with rehabilitation training on vascular dementia(internal obstruction of blood stasis) in elderly patients after stroke and the effect of vascular endothelial active substances on clinical treatment.Methods: A total of 116 patients with vascular dementia(internal obstruction of blood stasis) after stroke in our hospital(October 2017~ June 2020) were selected, divided into 2 groups according to the treatment method, 58 cases in each group.Both groups were given routine symptomatic treatment.The controlled group was given rehabilitation training, and the observation group was treated with Tongqiao Huoxue Decoction combined with rehabilitation training.Recorded the changes of TCM symptom score, simple mental state examination(MMSE) score, clinical dementia rating scale(CDR) before and after treatment.The changes of vascular endothelial active substance and cerebral circulation kinetic parameters were detected before and after treatment.Results: The total effective rate of the observation group was 93.10%,which was higher than 79.31% of the controlled group.The comparison between the groups was found to be statistically significant(P<0.05).The scores of dizziness, amnesia, unfavorable language, slow response, dull expression and fatigue decreased gradually in the two groups after treatment(P<0.05).After treatment, endothelin(ET) in the two groups decreased gradually(P< 0.05),and ET in the observation group was lower than that in the controlled group(P<0.05).The mean blood flow rate and blood flow in the two groups increased gradually(P<0.05) and the vascular pulsation index decreased gradually(P<0.05).The average blood flow rate and blood flow in the observation group were higher than those in the controlled group(P<0.05) and the vascular pulsation index was lower than that in the controlled group(P<0.05).The MMSE score of the two groups increased gradually(P<0.05) and the CDR score decreased gradually(P<0.05).The MMSE score of the observation gr

关 键 词：通窍活血汤 康复训练 脑卒中 血管性痴呆 瘀血内阻证 血管内皮活性物质 

分 类 号：R743[医药卫生—神经病学与精神病学]