脑络通浸膏治疗血管性帕金森综合征轻度认知障碍的回顾性研究  

Retrospective Study on the Treatment of Vascular Parkinsonism Mild Cognitive Impairment with Naoluotong Paste

作　　者：王欣彤 朱清 梁森 邓颖 吴文涛 WANG Xin-tong;ZHU Qing;LIANG Sen;DENG Ying;WU Wen-tao(Center for Brain Diseases,Jiangsu Province Hospital of Chinese Medicine,The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院/江苏省中医院脑病中心,江苏南京210029

出　　处：《南京中医药大学学报》2023年第1期16-20,共5页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函〔2018〕134号);江苏省名老中医药专家传承工作建设项目(苏中医科教〔2016〕6号)。

摘　　要：目的回顾性观察血管性帕金森综合征轻度认知障碍(Vascular Parkinsonism mild cognitive impairment,VP-MCI)的中医证型分布特点及分析脑络通浸膏治疗该病的痰浊阻窍证和瘀血阻络证的临床疗效。方法收集确诊的108例VP-MCI病例,分析其中医证型及分布特点。纳入符合痰浊阻窍证和瘀血阻络证的75例VP-MCI的病例按脑络通浸膏联合多奈哌齐治疗和多奈哌齐单药治疗分为治疗组和对照组,疗程为4周。观察2组治疗前后中医证候评分及简易精神状态量表(Mini mental state examination,MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)和统一帕金森病评分量表(Movement disorder society unified Parkinson's disease rating scale,MDS-UPDRS)评分情况;双侧头颈部血管血流速度的变化情况。结果108例VP-MCI患者中医辨证为痰浊阻窍证和瘀血阻络证者占69.44%。治疗后,治疗组主要中医证候积分明显减少(P<0.05,P<0.01),优于对照组(P<0.05,P<0.01);治疗组MoCA评分明显提高(P<0.01),优于对照组(P<0.05);治疗组双侧大脑前动脉(ACA)和大脑中动脉(MCA)的平均血流速度较治疗前明显提高(P<0.05),优于对照组(P<0.05)。结论VP-MCI的主要中医证型为痰浊阻窍证和瘀血阻络证。脑络通浸膏联合多奈哌齐可明显改善痰浊阻窍证和瘀血阻络证VP-MCI患者的脑血流和认知水平。OBJECTIVE To retrospectively observe the distribution characteristics of syndrome pattern in Chinese medicine of vascular Parkinsonism mild cognitive impairment(VP-MCI)and to analyze the clinical efficacy of Naoluotong paste in the treatment of brain blockage caused by phlegm and collateral blockage caused by blood stasis.METHODS A total of 108 cases of VP-MCI were collected and analyzed for their syndrome patterns in Chinese medicine and distribution characteristics.Among them,75 cases of VP-MCI with brain blockage caused by phlegm and collateral blockage caused by blood stasis were divided into treatment and control groups according to the treatment of Naoluotong paste combined with donepezil and donepezil alone.The treatment course was 4 weeks.The traditional Chinese medicine(TCM)syndrome scores,Mini MentalState Examination(MMSE),Montreal Cognitive Assessment(MoCA),Movement Disorder Society Unified Parkinson's Disease Rating Scale(MDS-UPDRS),as well as changes in blood flow velocity in the bilateral cephalic and cervical vessels were observed before and after treatment in both groups.RESULTS In 108 patients with VP-MCI,69.44%of them were identified as brain blockage caused by phlegm and collateral blockage caused by blood stasis.After treatment,the main TCM syndrome scores were significantly reduced in the treatment group(P<0.05,P<0.01),whose result was better than that in the control group(P<0.05,P<0.01).Besides,the MoCA score in the treatment group was significantly increased(P<0.01),whose result was better than that in the control group(P<0.05).The mean blood flow in the anterior cerebral artery(ACA)and middle cerebral artery(MCA)were significantly improved in the treatment group.The mean blood flow velocity of bilateral anterior cerebral artery(ACA)and middle cerebral artery(MCA)in the treatment group was significantly higher than that before treatment(P<0.05),and compared with the control group(P<0.05).CONCLUSION The main syndrome pattern in Chinese medicine of VP-MCI is brain blockage caused by phlegm an

关 键 词：血管性帕金森综合征 轻度认知障碍 中医证型 脑血流 中西医结合治疗 

分 类 号：R277.7[医药卫生—中医学]