开窍通络汤治疗脑小血管病致认知功能障碍效果及对热休克蛋白70和血管内皮生长因子的影响  

Effect of Kaiqiao Tongluo Decoction on cognitive dysfunction caused by cerebral small vessel disease and its influence on heat shock protein 70 and vascular endothelial growth factor

作　　者：张晓慧 宋彩霞[2] 王文艳[3] 李永章 赵红红 杨杰 尚杰雄 闫薪庭 陈国杰 焦小杰 ZHANG Xiaohui;SONG Caixia;WANG Wenyan;LI Yongzhang;ZHAO Honghong;YANG Jie;SHANG Jiexiong;YAN Xinting;CHEN Guojie;JIAO Xiaojie(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China;Xingtang County People’s Hospital,Xingtang 050600,Hebei,China;Xingtang County Hospital of Traditional Chinese Medicine,Xingtang 050600,Hebei,China;Linxi Hospital of Kailuan General Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]河北省中医院,河北石家庄050011 [2]行唐县人民医院,河北行唐050600 [3]行唐县中医医院,河北行唐050600 [4]开滦总医院林西医院,河北唐山063000

出　　处：《现代中西医结合杂志》2021年第25期2759-2763,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020295)。

摘　　要：目的探讨开窍通络汤治疗脑小血管病致认知功能障碍患者的效果及对血清热休克蛋白70(HSP70)和血管内皮生长因子(VEGF)水平的影响。方法选择2017年4月—2019年3月河北省中医院和行唐县人民医院诊治的脑小血管病致认知功能障碍患者109例,将患者随机分为2组,对照组43例和观察组46例完成研究。对照组患者采用阿司匹林、他汀类、胞磷胆碱钠、依达拉奉治疗,观察组患者在对照组治疗基础上采用开窍通络汤治疗3个月。记录2组治疗前及治疗3个月后蒙特利尔认知量表(MoCA)评分、美国国立卫生研究院卒中量表(NIHSS)评分及血清HSP70、VEGF水平,统计2组临床治疗效果及不良反应。结果治疗3个月后,2组MoCA量表评分及血清HSP70、VEGF水平均明显升高(P均<0.05),且观察组均明显高于对照组(P均<0.05);2组NIHSS评分均明显降低(P均<0.05),且观察组明显低于对照组(P<0.05)。对照组总有效率为81.4%(35/43),观察组总有效率为95.7%(44/46),2组比较差异有统计学意义(P<0.05)。2组均无严重不良反应发生。结论西医治疗基础上联合开窍通络汤治疗可明显改善脑小血管病致认知功能障碍患者认知功能及神经功能,其作用机制可能与调节善血清HSP70、VEGF有关。Objective It is to investigate the effect of Kaiqiao Tongluo Decoction on cognitive dysfunction caused by cerebral small vessel disease and its effect on the levels of serum heat shock protein 70(HSP70)and vascular endothelial growth factor(VEGF).Methods A total of 109 patients with cognitive dysfunction caused by cerebral small vessel disease diagnosed and treated in Hebei Provincial Hospital of Traditional Chinese Medicine and Xingtang County People’s Hospital from April 2017 to March 2019 were selected.They were randomly divided into 2 groups,43 cases in the control group and 46 cases in the observation group finally completed the study.The patients in the control group were treated with aspirin,statins,citicoline sodium,edaravone,the ones in the observation group were treated with Kaiqiao Tongluo Decoction for 3 months on the basis of the control group.The scores of Montreal Cognitive Scale(MoCA),National Institutes of Health Stroke Scale(NIHSS),and the levels of HSP70 and VEGF were recorded before and after treatment in the two groups.Results After 3 months of treatment,the scores of MoCA and the levels of HSP70 and VEGF were significantly increased(all P<0.05),and the observation was significantly higher than the control group(P<0.05);the scores of NIHSS was significantly decreased(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The total effective rate of the control group was 81.4%(35/43),that of the observation group was 95.7%(44/46),there was significant difference between the two groups(P<0.05).Conclusion Kaiqiao Tongluo Decoction can improve cognitive and neurological function in the treatment of cognitive dysfunction caused by cerebrovascular disease,its action mechanism may be related with improvement of serum HSP70 and VEGF.

关 键 词：开窍通络汤 脑小血管病致认知功能障碍 热休克蛋白70 血管内皮生长因子 

分 类 号：R743[医药卫生—神经病学与精神病学]