癫狂梦醒汤治疗缺血性脑卒中合并轻度认知障碍患者的疗效观察  

Clinical Observation on Diankuang Mengxing Decoction in the Treatment of Patients with Ischemic Stroke Complicated by Mild Cognitive Impairment

作　　者：吴胜峰 宋雪云[1] WU Sheng-feng;SONG Xue-yun(The Seventh People′s Hospital of Hebei Province/The Second Affiliated Hospital of Hebei College of Chinese Medicine,Baoding Hebei 073000)

机构地区：[1]河北省第七人民医院(河北中医学院第二附属医院),河北保定073000

出　　处：《世界中西医结合杂志》2024年第4期737-740,745,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2021210)。

摘　　要：目的 观察癫狂梦醒汤治疗缺血性脑卒中合并轻度认知障碍患者的临床疗效。方法 选取2020年1月—2021年10月期间河北省第七人民医院(河北中医学院第二附属医院)收治的缺血性脑卒中合并轻度认知障碍患者78例,按随机数字表法分为对照组和观察组,每组各39例。对照组予以缺血性脑卒中常规治疗,观察组在对照组基础上予以癫狂梦醒汤治疗。以4周为1个疗程,持续治疗2个疗程。观察比较两组患者临床疗效及蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分,分析两组患者治疗前后炎症因子[白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-2(Interleukin-2,IL-2)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]及血小板源生长因子(Platelet-derived growth factor,PDGF)、脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)、血浆黏度、D-二聚体(D-dimer,D-D)水平。结果 治疗后观察组临床总效率92.31%(36/39)明显高于对照组74.36%(29/39),差异有统计学意义(P<0.05)。治疗后两组患者视觉网与执行、注意力、语言与抽象、延迟记忆及MoCA总分均较治疗前升高,差异有统计学意义(P<0.05);且观察组视觉网与执行、注意力、语言与抽象、延迟记忆及MoCA总分均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-2水平较治疗前升高,IL-6、TNF-α水平较治疗前降低,差异有统计学意义(P<0.05);且观察组IL-2水平明显高于对照组,IL-6、TNF-α水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者PDGF、血浆黏度及D-D水平均较治疗前降低,BDNF水平较治疗前升高,差异有统计学意义(P<0.05);且观察组PDGF、血浆黏度及D-D水平明显低于对照组,BDNF水平明显高于对照组,差异有统计学意义(P<0.05)。结论 癫狂梦醒汤对改善缺血性脑卒中合并轻度认知障碍患者认知功能具有重要临床价值。Objective To observe the clinical efficacy of Diankuang Mengxing Decoction in the treatment of patients with ischemic stroke complicated by mild cognitive impairment.Methods Seventy-eight patients with ischemic stroke and concurrent mild cognitive impairment admitted to the Seventh People′s Hospital of Hebei Province and the Second Affiliated Hospital of Hebei College of Chinese Medicine from January 2020 to October 2021 were selected.They were randomized into a control group and an observation group by random number table,each with 39 cases.The control group was given standard treatment for ischemic stroke,while the observation group was treated Diankuang Mengxing Decoction in addition to the standard treatment.Two treatment courses were performed,four weeks as one course.The two groups were evaluated for clinical efficacy and scored using the Montreal Cognitive Assessment(MoCA).Inflammatory markers[interleukin-6(IL-6),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)],platelet-derived growth factor(PDGF),brain-derived neurotrophic factor(BDNF),plasma viscosity,and D-dimer(D-D)were analyzed before and after treatment.Results The total effective rate in the observation group(92.31%,36/39)was higher than the control group(74.36%,29/39)after treatment(P<0.05).Post-treatment scores of visual networking and execution,attention,language and abstraction,delayed memory,and the total MoCA score were improved in both groups compared with the conditions before treatment(P<0.05),with the observation group scoring notably higher than the control group(P<0.05).IL-2 was increased while IL-6 and TNF-α were decreased after treatment in both groups(P<0.05),and the observation group showed higher IL-2 and lower IL-6 and TNF-α than the control group(P<0.05).After treatment,PDGF,plasma viscosity,and D-D were reduced,while BDNF was increased(P<0.05),with the observation group having lower PDGF,plasma viscosity,and D-D,and higher BDNF when compared with the control group(P<0.05).Conclusion Diankuang Mengxing Decoction is clinic

关 键 词：癫狂梦醒汤 缺血性脑卒中 认知障碍 蒙特利尔认知评估量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]