参乌益智胶囊联合尼莫地平片治疗肾精亏虚型卒中后认知障碍临床疗效观察  

Clinical Observation on Therapeutic Effect of Shenwu Yizhi Capsules Combined with Nimodipine Tablets for Post-Stroke Cognitive Impairment of Kidney Essence Depletion Type

作　　者：孙悦 班文明 刘秀芳 倪代梅 尹慧敏 孙媛媛 郭灿 赵莉莉 SUN Yue;BAN Wen-Ming;LIU Xiu-Fang;NI Dai-Mei;YIN Hui-Min;SUN Yuan-Yuan;GUO Can;ZHAO Li-Li(Graduate School of Anhui University of Chinese Medicine,Hefei 230012 Anhui,China;Taihe Hospital of Traditional Chinese Medicine,Anhui University of Traditional Chinese Medicine,Fuyang 236607 Anhui,China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230012 [2]安徽中医药大学附属太和中医院,安徽阜阳236607

出　　处：《广州中医药大学学报》2024年第2期322-328,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：安徽省2022年度中医药传承创新科研项目(编号:2022CCYB16);安徽省红十字会中医药传承创新发展研究项目(编号:2021ZYYB23)。

摘　　要：【目的】观察参乌益智胶囊联合尼莫地平片治疗肾精亏虚型卒中后认知障碍(post-stroke cognitive impairment,PSCI)的临床疗效及对患者脑部血流情况的影响。【方法】将90例肾精亏虚型PSCI患者随机分为治疗组和对照组,每组各45例。对照组给予尼莫地平片口服,治疗组在对照组的基础上加用参乌益智胶囊治疗,疗程为28 d,并随访3个月。观察2组患者治疗前后简易精神状态评估量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分、日常生活能力量表(ADL)评分、中医证候积分及脑动脉平均血流流速(Vm)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,经随访3个月,治疗组的总有效率为88.89%(40/45),对照组为64.44%(29/45),组间比较,治疗组的临床疗效明显优于对照组(P<0.01)。(2)量表评分方面,治疗后,2组患者的MMSE、MoCA、ADL评分均较治疗前升高(P<0.05),且治疗组的升高幅度均明显优于对照组(P<0.05)。(3)中医证候积分方面,治疗后,2组患者的的近事遗忘(或远事遗忘)、腰膝酸软、耳鸣、齿发、舌苔和脉象评分及总分均较治疗前降低(P<0.05),且治疗组的降低幅度均明显优于对照组(P<0.05)。(4)脑动脉血流方面,治疗后,2组患者的大脑前动脉(ACA)、大脑中动脉(MCA)、椎动脉(VA)的平均血流流速值均较治疗前提高(P<0.05),且治疗组的提高幅度均明显优于对照组(P<0.05)。(5)安全性方面,治疗和随访过程中,2组患者均无明显不良反应情况发生,且患者的肝肾功能等安全性指标均无异常变化。【结论】参乌益智胶囊联合尼莫地平片能改善肾精亏虚型PSCI患者的临床症状,良性增加脑部灌流,提高血流速度,从而提高患者的记忆和认知功能,使患者的生活质量得到改善。Objective To investigate the clinical efficacy of Shenwu Yizhi Capsules combined with Nimodipine Tablets in treating patients with post-stroke cognitive impairment(PSCI)of kidney essence depletion type and to observe their effects on the cerebral blood flow.Methods Ninety patients with PSCI kidney of essence depletion type were randomly divided into the treatment group and the control group,with 45 patients in each group.The control group was given oral use of Nimodipine Tablets,and the treatment group was treated with Shenwu Yizhi Capsules orally on the basis of treatment for the control group.Both groups were treated for a period of 28 days and then were followed up for 3 months.Before and after the treatment,the two groups were observed in the changes of Minimental State Examination(MMSE)score,Montreal Cognitive Assessment Scale(MoCA)score,activities of daily life(ADL)score,traditional Chinese medicine(TCM)syndrome score and mean blood flow velocity(Vm)of cerebral artery.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 3-month follow-up,the total effective rate of the treatment group was 88.89%(40/45)and that of the control group was 64.44%(29/45).The intergroup comparison showed that the clinical efficacy of the treatment group was significantly superior to that of the control group(P<0.01).(2)After treatment,the MMSE scores,MoCA scores,and ADL scores of the two groups were higher than those before treatment(P<0.05),and the increase in the treatment group was significantly superior to that in the control group(P<0.05).(3)After treatment,the overall TCM syndrome scores and the scores of symptoms of recent amnesia(or remote amnesia),lumbar and knee soreness and weakness,tinnitus,teeth and hair,tongue image,and pulse condition in the two groups were all lower than those before treatment(P<0.05),and the decrease in the treatment group was significantly superior to that in the control group(P<0.05).(4)After treatment,the mean blood flow velocity of the anterior cere

关 键 词：参乌益智胶囊 尼莫地平片 肾精亏虚 卒中后认知障碍 生活质量 临床疗效 

分 类 号：R277.7[医药卫生—中医学]