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肾四味合通窍活血汤对卒中后认知障碍患者血清神经递质及神经功能的影响

Effect of four traditional Chinese drugs for reinforcing kidney combined with Tongqiao Huoxue Decoction on serum neurotransmitters and neurological function in patients with post-stroke cognitive impairment

    摘要
  • 摘要:
    目的 探讨肾四味合通窍活血汤对卒中后认知障碍(PSCI)患者血清神经递质及神经功能的影响。
    方法 将110例PSCI患者随机分为治疗组与对照组，每组55例。对照组口服多奈哌齐片，治疗组在对照组基础上采用肾四味合通窍活血汤治疗。比较2组治疗总有效率以及治疗前后的简易精神状态量表(MMSE)评分、蒙特利尔评估量表(MoCA)评分、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)、血清乙酰胆碱(ACh)、多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)、神经元特异性烯醇化酶(NSE)、视锥蛋白样蛋白-1(VILIP-1)、髓鞘碱性蛋白(MBP)、热休克蛋白70(HSP70)水平。记录2组不良反应。
    结果 治疗组总有效率为90.91%, 高于对照组的76.36%, 差异有统计学意义(P < 0.05)。治疗后，治疗组MMSE评分、MoCA评分、BI以及血清ACh、DA、NE、5-HT、HSP70高于对照组, NIHSS评分以及血清NSE、VILIP-1、MBP低于对照组，差异均有统计学意义(P < 0.05)。治疗组和对照组不良反应总发生率分别为12.73%和9.09%, 差异无统计学意义(P>0.05)。
    结论 肾四味合通窍活血汤治疗PSCI可促进认知相关神经递质的分泌，加速神经损伤修复，安全性较高。

     

    Abstract:
    Objective To investigate the effect of four traditional Chinese drugs for reinforcing kidney combined with Tongqiao Huoxue Decoction on serum neurotransmitters and neurological function in patients with post-stroke cognitive impairment (PSCI).
    Methods A total of 110 patients with PSCI were randomly divided into treatment group and control group, with 55 cases in each group. The control group was treated with donepezil tablet, while the treatment group was treated with four traditional Chinese drugs for reinforcing kidney and Tongqiao Huoxue Decoction on the basis of the control group. The total effective rate, the Mini-Mental State Examination (MMSE) score, the Montreal Cognitive Assessment (MoCA) score, the National Institutes of Health Stroke Scale (NIHSS) score and the Barthel Index (BI) as well as serum levels of acetylcholine (ACh), dopamine (DA), norepinephrine (NE), 5-hydroxytryptamine (5-HT), neuron-specific enolase (NSE), visinin-like protein-1 (VILIP-1), myelin basic protein (MBP), and heat shock protein 70 (HSP70) before and after treatment were compared between the two groups. Adverse reactions in both groups were recorded.
    Results The total effective rate was 90.91% in the treatment group, which was significantly higher than 76.36% in the control group (P < 0.05). After treatment, the MMSE score, MoCA score and BI as well as serum levels of ACh, DA, NE, 5-HT and HSP70 in the treatment group were significantly higher than those in the control group, while the NIHSS score and serum levels of NSE, VILIP-1 and MBP were significantly lower than those in the control group (P < 0.05). The total incidence rate of adverse reactions in the treatment group and the control group was 12.73% and 9.09% respectively, which showed no significant between-group difference (P>0.05).
    Conclusion Four traditional Chinese drugs for reinforcing kidney combined with Tongqiao Huoxue Decoction can promote the secretion of cognition-related neurotransmitters in patients with PSCI, accelerate the repair of neurological damage, and safety is relatively high.

     

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