培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆的临床效果  

Peiyuan Guben and Huatan Quyu for vascular dementia after ischemic stroke

作　　者：刘晓丽[1] 姜永霞[1] 陈丽萍[1] 常辉[1] 符大勇[2] 周建国[2] 赵燕云 Liu Xiaoli;Jiang Yongxia;Chen Liping;Chang Hui;Fu Dayong;Zhou Jianguo;Zhao Yanyun(Department of Rehabilitation,Lianyungang Hospital Affiliated to Nanjing University of Chinese Medicine,Lianyungang 222004,China;Department of Radiology,Lianyungang Hospital Affiliated to Nanjing University of Chinese Medicine,Lianyungang 222004,China;Department of Pharmacy,Lianyungang Hospital Affiliated to Nanjing University of Chinese Medicine,Lianyungang 222004,China)

机构地区：[1]南京中医药大学连云港附属医院康复科,江苏222004 [2]南京中医药大学连云港附属医院放射科,江苏222004 [3]南京中医药大学连云港附属医院药学部,江苏222004

出　　处：《国际医药卫生导报》2021年第19期3024-3028,共5页International Medicine and Health Guidance News

基　　金：南京医科大学康达学院2018年度科研发展基金课题(KD2018KYJJYB051)。

摘　　要：目的分析培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆的临床效果。方法收集2018年11月至2020年12月南京中医药大学连云港附属医院康复科收治的缺血性脑卒中后血管性痴呆患者60例,男38例,女22例,年龄(54.8±12.6)岁。依据随机数字表法将其分为治疗组和对照组,各30例。对照组口服阿司匹林肠溶片0.1 g,每晚1粒,口服阿托伐他汀钙片20 mg,每晚1粒;治疗组在此基础上加用培元固本、化痰祛瘀的中药汤剂治疗;两组患者均进行一致的康复训练及基础疾病的治疗。治疗后1个月、6个月采用简易精神状态检查量表(Mini-Mental State Examination,MMSE)及蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)及日常生活能力评分量表(Activity of Daily Living Scale,ADL)评分,并比较两组中医症候临床有效率。两组患者在治疗前及治疗6个月均行磁共振磁敏感加权T2加权血管成像(T2 star weighted angiography,SWAN)序列检查,观察脑微出血(cerebral microbleeds,CMBs)数量变化。结果治疗组患者治疗后MMSE、MoCA、及ADL评分等明显优于对照组(均P<0.05)。治疗组痊愈4例,显效20例,有效5例,总有效率96.7%;对照组痊愈2例,显效10例,有效15例,总有效率90.0%;治疗组总有效率治疗组高于对照组(P<0.05);治疗组愈显率为80.0%,对照组为40.0%,差异有统计学意义(P<0.05)。SWAN序列检查显示,治疗组治疗前后CMBs数量差异无统计学意义(P>0.05),但对照组治疗后CMBs数量高于治疗前(P<0.05)。结论采用培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆疗效确切,安全可靠,并能在一定程度上延缓脑小血管病变所致的CMBs。Objective To analyze the clinical effect of Peiyuan Guben and Huatan Quyu for post-ischemic stroke vascular dementia.Methods A total of 60 patients with post-ischemic stroke vascular dementia admitted to Department of Rehabilitation,Lianyungang Hospital Affiliated to Nanjing University of Chinese Medicine from November 2018 to December 2020 were collected,including 38 males and 22 females,with an age of(54.8±12.6).They were divided into a treatment group and a control group by the random number table method,with 30 cases in each group.The control group orally took one aspirin enteric-coated tablet of 0.1 g and one atorvastatin calcium tablet of 20 mg every night;on this basis,the treatment group was treated with traditional Chinese medicine decoction of Peiyuan Guben and Huatan Quyu.Both groups received consistent rehabilitation training and treatment of basic diseases.Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),and Activity of Daily Living Scale(ADL)were used to evaluate the patients 1 and 6 months after the treatment.The clinical effective rates of TCM syndromes were compared between these two groups.Before and 6 months after the treatment,T2 star weighted angiography(SWAN)sequence examination was performed to observe the numbers of cerebral microbleeds(CMBs).Results The scores of MMSE,MoCA,and ADL in the treatment group was significantly better than those in the control group after the treatment(all P<0.05).In the treatment group,4 cases were cured,20 cases were significantly effective,and 5 cases were effective,and the total effective rate was 96.7%;while in the control group,2 cases were cured,10 cases were significantly effective,and 15 cases were effective,and the total effective rate was 90.0%;the total effective rate in the treatment group was higher than that in the control group(P<0.05).The cured and significantly effective rate was 80.0%in the treatment group and 40.0%in the control group(P<0.05).SWAN sequence examination showed that there was no statistical difference in

关 键 词：培元固本 化痰祛瘀 缺血性脑卒中 血管性痴呆 SWAN 疗效评价 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.13[医药卫生—临床医学]