通络化痰汤联合依达拉奉治疗脑梗死后血管性认知障碍的临床效果  

Clinical effect of Tongluo Huatan Decoction combined with Edaravone in the treatment of vascular cognitive impairment after cerebral infarction

作　　者：李昌荣 黄伟 傅晓东 LI Changrong;HUANG Wei;FU Xiaodong(Department of Traditional Chinese Medicine,Shanghai Third Rehabilitation Hospital,Shanghai 200436,China;Department of Traditional Chinese Medicine,Dahua Hospital of Shanghai Xuhui District,Shanghai 200237,China;Department of Integrated Traditional Chinese and Western Medicine,Huashan Hospital Fudan University,Shanghai 200040,China)

机构地区：[1]上海市第三康复医院中医内科,上海200436 [2]上海市徐汇区大华医院中医内科,上海200237 [3]复旦大学附属华山医院中西医结合科,上海200040

出　　处：《医药前沿》2025年第10期88-91,95,共5页Journal of Frontiers of Medicine

摘　　要：目的分析通络化痰汤联合依达拉奉治疗脑梗死(CI)后血管性认知障碍(VCI)的临床效果。方法选取2023年1月—2024年2月上海市第三康复医院和上海市徐汇区大华医院收治的92例CI后VCI患者,根据用药方案不同分为观察组和对照组各46例,对照组予以依达拉奉治疗,观察组在对照组治疗基础上加用通络化痰汤治疗。比较两组的神经功能、认知功能、日常生活能力、生活质量、氧化应激指标、中医证候积分、临床疗效及不良反应。结果用药后,观察组美国国立卫生研究院卒中量表评分低于对照组,简易智能精神状态检查量表评分、日常生活活动能力量表评分、36条目简明健康状况调查问卷各维度评分均高于对照组;丙二醛水平和中医证候积分低于对照组,超氧化物歧化酶水平和总有效率高于对照组(P<0.05)。治疗过程中,两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论通络化痰汤联合依达拉奉治疗CI后VCI效果确切,可提高患者的神经功能、认知功能、日常生活能力及生活质量,改善临床症状和氧化应激指标,且不良反应少。Objective To analyze the clinical effect of Tongluo Huatan Decoction combined with Edaravone in the treatment of vascular cognitive impairment(VCI)after cerebral infarction(CI).Methods A total of 92 patients with VCI after CI admitted to Shanghai Third Rehabilitation Hospital and Dahua Hospital of Shanghai Xuhui District from January 2023 to February 2024 were selected and divided into control group and observation group with 46 cases in each group according to different medication regiments.The control group was treated with Edaravone,and the observation group was treated with Tongluo Huatan Decoction in addition to the treatment of the control group.Neurological function,cognitive function,ability of daily living,quality of life,oxidative stress index,traditional Chinese medicine syndrome score,clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,the scores of the National Institutes of Health Stroke Scale in the observation group were lower than those in the control group,and the scores of the Mini-Mental State Examination Scale,the Activity of Daily Living Scale,and the scores of each dimension of 36-Item Short Form Health Survey were higher than those in the control group;the level of malonic dialdehyde and traditional Chinese medicine syndrome score were lower than those in the control group,and the level of superoxide dismutase and total effective rate were higher than those in the control group(P<0.05).During the treatment,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusions Tongluo Huatan Decoction combined with Edaravone is effective in the treatment of VCI after CI,which can improve the neurological function,cognitive function,daily living ability and quality of life of patients,improve clinical symptoms and oxidative stress indicators,and have fewer adverse reactions.

关 键 词：通络化痰汤 依达拉奉 脑梗死 血管性认知障碍 神经功能 认知功能 日常生活能力 

分 类 号：R743[医药卫生—神经病学与精神病学]