化瘀通络合剂对脑小血管病合并认知功能障碍患者血清中枢神经特异蛋白、白细胞介素-8水平的影响

Effect of Huayu Tongluo Mixture on Serum S100βand IL-8 Levels in Patients with Cerebrovascular Disease Complicated with Cognitive Impairment

目的 探讨化瘀通络合剂对脑小血管病合并认知功能障碍患者血清中枢神经特异蛋白(S100beta, S100β)、白细胞介素-8(Interleukin-8,IL-8)水平的影响。方法 选取2019年1月—2020年1月期间广州中医药大学附属中山中医院收治的165例脑小血管病合并认知功能障碍患者作为研究对象,采用随机信封法分为对照组82例和观察组83例。对照组给予常规治疗,观察组在对照组的基础上给予化瘀通络合剂治疗,共治疗12周。评价两组患者临床疗效、脑电图改善率及安全性,观察两组患者治疗前后血清S100β、IL-8水平的变化,采用蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)及简易精神状态量表(Mini-Mental state examination, MMSE)评估患者认知功能,日常生活能力量表(Activities of daily living, ADL)评估患者日常生活能力。结果 治疗后观察组总有效率92.77%(77/83)高于对照组80.49%(66/82),差异有统计学意义(P<0.05)。治疗后观察组脑电图改善率38.55%(32/83)优于对照组17.07%(14/82),差异有统计学意义(P<0.05)。治疗后两组患者MoCA评分、MMSE评分及ADL评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组MoCA评分、MMSE评分及ADL评分高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清S100β、IL-8水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组血清S100β、IL-8水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率3.61%与对照组6.10%比较,差异无统计学意义(P>0.05)。结论 化瘀通络合剂对脑小血管病合并认知功能障碍的疗效具有积极作用,能明显改善患者认知功能及日常生活能力,可能与调节血清S100β、IL-8水平有关,且不增加用药风险值得临床推广使用。

Objective To investigate the effect of Huayu Tongluo Mixture on serum levels of S100βand interleukin-8(IL-8)in patients with cerebrovascular disease complicated with cognitive dysfunction.Methods From January 2019 to January 2020,165 patients with cerebrovascular disease complicated with cognitive dysfunction in our hospital were selected as the research objects,and randomly divided into control group(82 cases)and observation group(83 cases)by random envelope method.The control group was given conventional treatment,on this basis,the observation group was given Huayu Tongluo Mixture treatment,a total of 12 weeks.The efficacy,EEG improvement rate and safety of the two groups were evaluated.The changes of serum S100βand IL-8 levels in the two groups before and after treatment were observed.The Montreal Cognitive Assessment Scale(MOCA)and the Simple Mental State Scale(MMSE)were used to evaluate the cognitive function of the patients,and the Daily Living Ability Scale(ADL)was used to evaluate the daily living ability of the patients.Results The total effective rate of observation group(92.77%)was significantly higher than that of control group(80.49%)(P<0.05).After treatment,the improvement rate of EEG in the observation group was 38.55%(32/83)higher than that in the control group 17.07%(14/82)(P<0.05).After treatment,MoCA score,MMSE score and ADL score of 2 groups were higher than before treatment(P<0.05).The MoCA score,MMSE score and ADL score of the observation group were higher than those of the control group(P<0.05).After treatment,serum levels of S100βand IL-8 in 2 groups were decreased compared with before treatment(P<0.05).The levels of serum S100βand IL-8 in the observation group were lower than those in the control group(P<0.05).During the treatment period,the incidence of adverse reactions in the observation group was 3.61%compared with 6.10%in the control group,with no statistical significance(P>0.05).Conclusion Huayu Tongluo mixture has a positive effect on the efficacy of cerebrovascular disease combined with cognitive dysfunction,and can significantly improve the cognitive function and daily living ability of patients,which may be related to the regulation of serum S100βand IL-8 levels,and does not increase the risk of drug use,and is worthy of clinical promotion.