通脑益智颗粒联合西药治疗血管性认知障碍肾虚痰瘀证疗效研究  

Study on curative effect of Tongnao Yizhi granules combined with western medicine on syndrome of kidney deficiency and phlegm stasis of vascular cognitive impairment

作　　者：姜文 胡洁玲[1] 蒋小娟 常诚 JIANG Wen;HU Jieling;JIANG Xiaojuan;CHANG Cheng(Nantong Hospital Affiliated to Nanjing University of Chinese Medicine,Nantong 226000,China)

机构地区：[1]南京中医药大学南通附属医院,江苏南通226000 [2]南京中医药大学附属医院,江苏南京210004

出　　处：《陕西中医》2024年第11期1481-1485,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82201586);江苏省中医临床医学创新中心项目(K2021j17-5);江苏省南通市社会民生科学研究基金资助项目(MS22022048);江苏省南通市中医联盟项目(TZYK202102)。

摘　　要：目的:探讨通脑益智颗粒对血管性认知障碍(VCI)肾虚痰瘀证患者的临床疗效及安全性。方法:将64例VCI肾虚痰瘀证患者随机分为对照组、观察组,每组32例。对照组采用常规治疗,观察组在此基础上加服通脑益智颗粒,疗程12周。观察患者临床疗效、中医证候积分(SDSVD)、神经心理学评分(MMSE、MoCA、ADL)、脑血流动力学指标(ACA-PI、ACA-Vm、MCA-PI、MCA-Vm)、细胞焦亡相关血清炎症因子(NLRP3、IL-1β)、不良反应发生率。结果:观察组总有效率高于对照组(P<0.05)。治疗后两组患者MMSE、MoCA、ADL评分升高,SDSVD评分、MCA-PI、ACA-PI、NLRP3、IL-1β降低,且观察组变化程度大于对照组,差异有统计学意义(均P<0.05)。两组均未发现严重不良反应。结论:通脑益智颗粒联合常规治疗可安全有效地改善VCI肾虚痰瘀证患者的认知功能,提高临床疗效,其机制可能是抑制细胞焦亡介导的炎症反应及对脑血流动力学有所改善。Objective:To observe clinical efficacy and safety of Tongnao Yizhi granules in treatment of patients with vascular cognitive impairment(VCI)of kidney deficiency and phlegm stasis type.Methods:64 cases of VCI with kidney deficiency and phlegm stasis syndrome were randomly divided into control group and observation group,32 cases in each group.The control group were treated with conventional therapy,and the observation group additionally treated with Tongnao Yizhi granules on the basis of it,for 12 weeks.Clinical efficacy,TCM syndrome score(SDSVD),neuropsychological score(MMSE,MoCA,ADL),cerebral hemodynamic parameters(ACA-PI,ACA-Vm,MCA-PI,MCA-Vm),pyropsis-related serum inflammatory factors(NLRP3,IL-1)and incidence of adverse reactions were observed.Results:The total effective rate of the observation group was higher than that in the control group(P<0.05).After treatment,MMSE,MoCA and ADL scores increased,SDSVD score,MCA-PI,ACA-PI,NLRP3 and IL-1βdecreased in the two groups,and the degree of change in the observation group was higher than that in the control group,difference statistically significant(all P<0.05).No serious adverse effects were found in either group.Conclusion:Tongnao Yizhi granule combined with conventional therapy can safely and effectively improve cognitive function and clinical efficacy in patients with VCI of kidney deficiency and phlegm stasis type,which may be related to inhibiting inflammation mediated by apoptosis and improving cerebral hemodynamics.

关 键 词：血管性认知障碍 通脑益智颗粒 细胞焦亡 肾虚痰瘀 炎症反应 核苷酸结合寡聚化结构域样受体蛋白3 炎症小体 

分 类 号：R74[医药卫生—神经病学与精神病学]