补肾益气活血方治疗气虚血瘀型轻度认知障碍的临床观察  

Clinical observation of the Bushen Yiqi Huoxue recipe in treating mild cognitive impairment of Qi deficiency and blood stasis type

作　　者：郭瑞雪 王琼 赵晨玲 田丽伟 孙伦燕 董婷[2] Guo Ruixue;Wang Qiong;Zhao Chenling;Tian Liwei;Sun Lunyan;Dong Ting(The First Clinical Medical College,Anhui University of Chinese Medicine,Hefei 230038,Anhui,China;Department of Encephalopathy,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,Anhui,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230038 [2]安徽中医药大学第一附属医院脑病科,安徽合肥230031

出　　处：《右江民族医学院学报》2023年第6期874-879,908,共7页Journal of Youjiang Medical University for Nationalities

基　　金：第七批全国老中医药专家学术经验继承工作项目(dqpqglzyyzjxsjyjcxm20220068);安徽省西学中高级人才研修项目(2019qgxxzggrcpxxm20220104);第二批全国西学中优才人才研修项目(spy20230088)。

摘　　要：目的观察补肾益气活血方治疗气虚血瘀型轻度认知障碍(mild cognitive impairment,MCI)的临床疗效。方法选取2022年1月至2022年10月就诊于安徽中医药大学第一附属医院脑病科的气虚血瘀型MCI患者60例为研究对象,采用随机对照的研究方法分为治疗组和对照组,每组各30例。两组在保持对症治疗基础疾病的前提下,给予治疗组补肾益气活血方口服,疗程为90 d。分别于治疗第30天、第60天、第90天,对两组患者的中医证候积分进行比较,同时评估两组治疗前后认知功能量表评分和血清炎性因子水平,并分析认知功能和血清炎性指标的相关性。结果与治疗前比较,治疗后治疗组蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、简易精神状态评估量表(Mini-mental State Examination,MMSE)评分明显升高(P<0.001),且明显高于对照组(P<0.001);治疗后治疗组血清同型半胱氨酸(homocycteine,HCY)、C反应蛋白(C-reaction protein,CRP)、白细胞介素6(interleukin-6,IL-6)及中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)水平明显下降(P<0.001),且明显低于对照组(P<0.05);治疗第30天、第60天、第90天,治疗组中医证候总积分、血瘀证候积分、气虚证候积分较治疗前均明显降低(P<0.05或P<0.01),且明显低于对照组(P<0.05或P<0.01);Pearson相关分析显示,血清HCY、CRP、IL-6、NLR水平与MoCA及MMSE评分呈现负相关性(P<0.05)。结论血清炎性因子的升高与认知功能损害密切相关,补肾益气活血方可显著改善气虚血瘀型MCI患者的中医证候评分,降低机体神经炎症水平,提高认知功能,临床疗效明确。Objective To observe the clinical efficacy of the Bushen Yiqi Huoxue recipe in treating mild cognitive impairment(MCI)of Qi deficiency and blood stasis type.Methods This study selected sixty MCI patients with Qi deficiency and blood stasis as study subjects who used to be treated in the Department of Encephalopathy,The First Affiliated Hospital of Anhui University of Chinese Medicine from January 2022 to October 2022.They were randomly divided into treatment and control groups(30 cases in each group).The treatment group received the Bushen Yiqi Huoxue recipe orally for 90 days on the premise of maintaining symptomatic treatment of underlying diseases for the two groups.On the 30th,60th and 90th day of treatment,the Traditional Chinese Medicine Syndrome Scores were compared between the groups.Additionally,Cognitive Function Scale Scores and serum inflammatory factor levels were evaluated before and after treatment,along with the analysis of the correlation between cognitive function and serum inflammatory indicators.Results After treatment,the treatment group exhibited significant increases in Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)scores compared to before treatment(P<0.001).These scores were also significantly higher than those in the control group(P<0.001).Furthermore,serum homocysteine(HCY),C-reactive protein(CRP),interleukin-6(IL-6),and neutrophil to lymphocyte ratio(NLR)levels significantly decreased in the treatment group(P<0.001),being notably lower than those in the control group(P<0.05).Moreover,the total scores of Traditional Chinese Medicine Syndrome,blood stasis syndrome scores,and Qi deficiency syndrome scores were notably lower in the treatment group after 30,60,and 90 days of treatment compared to before treatment(P<0.05 or P<0.01),and significantly lower than those in the control group(P<0.05 or P<0.01).Pearson correlation analysis showed that serum HCY,CRP,IL-6,NLR levels were negatively correlated with MoCA,MMSE scores(P<0.05).Conclusion The elevation of serum

关 键 词：补肾益气活血方 认知功能障碍 气虚血瘀 炎性因子 

分 类 号：R277.7[医药卫生—中医学]