益气活血通窍汤治疗气虚血瘀型皮层下动脉硬化性脑病的疗效观察  

Clinical Observation of Yiqi Huoxue Tongqiao Decoction for the Treatment of Subcortical Arteriosclerotic Encephalopathy of Qi Deficiency and Blood Stasis Type

作　　者：陈曼逸 蔡艺贞 周嘉澄[2] 郭红[2] CHEN Man-Yi;CAI Yi-Zhen;ZHOU Jia-Cheng;GUO Hong(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Guangdong Second Hospital of Traditional Chinese Medicine,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2023年第12期2999-3005,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20212007)。

摘　　要：【目的】探讨中药自拟方益气活血通窍汤(通窍活血汤加减组成)治疗气虚血瘀型皮层下动脉硬化性脑病(subcortical arteriosclerotic encephalopathy,SAE)的临床疗效。【方法】将68例气虚血瘀型SAE患者随机分为治疗组和对照组,每组各34例。2组患者均给予常规基础疾病治疗,在此基础上,对照组给予丁苯酞软胶囊口服治疗,治疗组给予益气活血通窍汤联合丁苯酞软胶囊治疗,疗程为20 d。观察2组患者治疗前后血管性痴呆辨证量表(SDSVD)评分、临床痴呆评价量表(CDR)评分、长谷川痴呆量表(HDS)评分的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗20 d后,治疗组的总有效率为97.10%(33/34),对照组为61.76%(21/34);组间比较,治疗组的总有效率(χ^(2)检验)和总体疗效(秩和检验)均明显优于对照组,差异均有统计学意义(P<0.01)。(2)量表评分方面,治疗20 d后,2组患者的SDSVD评分和CDR评分均较治疗前明显降低(P<0.01),HDS评分均较治疗前明显升高(P<0.01),且治疗组对SDSVD评分和CDR评分的降低作用及对HDS评分的升高作用均明显优于对照组,组间治疗前后差值比较,差异均有统计学意义(P<0.05或P<0.01)。(3)安全性方面,治疗期间,2组患者均未出现明显不良反应和终止试验病例,具有较高的安全性。【结论】在常规西药治疗基础上联合益气活血通窍汤治疗气虚血瘀型SAE患者疗效确切,可有效改善患者临床症状,延缓患者认知、记忆及情感等各方面功能的衰退,提高患者的日常生活质量,其疗效优于单纯西药治疗。Objective To observe the clinical efficacy of Yiqi Huoxue Tongqiao Decoction(derived from the modified Tongqiao Huoxue Decoction)in treating subcortical arteriosclerotic encephalopathy(SAE)of qi deficiency and blood stasis type.Methods Sixty-eight patients with SAE of qi deficiency and blood stasis type were randomly divided into a treatment group and a control group,with 34 patients in each group.The patients in the two groups were given conventional treatment for underlying diseases,and additionally the control group was given oral use of Butylphthalide Soft Capsules while the treatment group was given Yiqi Huoxue Tongqiao Decoction combined with Butylphthalide Soft Capsules.The treatment course for the two groups covered 20 days.The changes in the scores of Scale for the Differentiation of Syndromes of Vascular Dementia(SDSVD),Clinical Dementia Rating(CDR)and Hasegawa Dementia Scale(HDS)in the two groups were observed before and after treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 20 days of treatment,the total effective rate of the treatment group was 97.10%(33/34),and that of the control group was 61.76%(21/34).The intergroup comparison showed that the total effective rate(tested by chi-square test)and the overall clinical efficacy(tested by rank-sum test)of the treatment group were significantly superior to those of the control group,and the differences were statistically significant(P<0.01).(2)After 20 days of treatment,the SDSVD scores and CDR scores of the two groups of patients were significantly decreased(P<0.01)and the HDS scores were significantly increased compared with those before treatment(P<0.01).The effects on lowering the SDSVD scores and the CDR scores and the effect on increasing the HDS scores in the treatment group were significantly superior to those in the control group,and the pre-and post-treatment difference of the scores between the groups exerted statistically significant differences(P<0.05 or P<0.01).(3)During the treatme

关 键 词：益气活血通窍汤 通窍活血汤 气虚血瘀 皮层下动脉硬化性脑病 临床疗效 安全性 

分 类 号：R277.7[医药卫生—中医学]