养生益智汤治疗血管性痴呆的效果及对血清TNF-α和Caspase-3水平的影响

Effect of Yangsheng Yizhi decoction on serum TNF-α and Caspase-3 of vascular dementia patients

目的评价养生益智汤治疗血管性痴呆(VD)的效果及对血清TNF-α和Caspase-3水平的影响。方法共纳入68例肾精亏虚、气虚血瘀型VD患者,随机分为对照组和观察组,各34例,对照组采用长春西汀和吡拉西坦静脉滴注,观察组采用养生益智汤,15d为1个疗程,间隔1个月,再进行下一个疗程,共进行了3个疗程后比较2组中医证候积分、总有效率、不良反应和血清TNF-α、Caspase-3水平。结果 2组患者治疗前中医证候积分比较差异无统计学意义(P>0.05),治疗后均较前降低,且观察组明显低于对照组,减分率高于对照组,差异均有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05),2组患者均无严重并发症发生(P>0.05)。2组患者治疗前血清TNF-α和Caspase-3水平比较差异无统计学意义(P>0.05),治疗后均较前降低,且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论养生益智汤治疗VD安全有效,可降低血清TNF-α和Caspase-3水平。

Objective To study the clinical effect of Yangsheng Yizhi decoction for patients with vascular dementia （VD） and influence of serum TNF-α and Caspase-3. Methods A total of 68 VD patients with Kidney essence deficiency and Qi deficiency and blood stasis were divided randomly into control and obser-vation groups （34 cases for each group）. The patients in control group received vinpocetine and piracetam with intravenous drip, and the patients in observation group adopted Yangsheng Yizhi decoction orally, 15 d for one period, one month for apart, then proceed with the next course of treatment, a total of 3 courses were performed for the 2 groups. The scores of TCM syndrome score, total effective rate, adverse reac-tions, serum TNF-α and Caspase-3 levels were compared between the 2 groups. Results There were no significant differences in TCM syndrome scores between the 2 groups before treatment （ 〉0.05）. After treatment, the TCM syndrome score was significantly lower than before, and that in the observation groupwas lowere than that in the control group, and the reduced fraction of TCM syndrome score was higher than that of the control group （P 〈0.05）. The total effective rate in the observation group was high than that in the control group （P 〈0.05） , and there were no severe complications in the two groups. The serum TNF-αand Caspase-3 levels in the observation group were both significantly less than that in the control group （P〈0.05）. Conclusion Yangsheng Yizhi decoction is safe and effective for VD, which could reduce serum TNF-a and Caspase-3.