通脉益智方治疗高同型半胱氨酸血症血管性认知障碍30例

Thirty Cases of Hyperhomocysteinemia with Vascular Cognitive Impairment Treated with Channel-Unblocking and Intelligence-Increasing Decoction

目的:观察通脉益智方治疗伴有高同型半胱氨酸血症(hyperhomocystinemia,HHcy)的血管性认知障碍(vascular cognitive impairment,VCI)的临床疗效。方法:将60例伴有HHcy的VCI患者随机分为对照组和治疗组,每组各30例。对照组口服奥拉西坦胶囊,治疗组在对照组的基础上加用自拟通脉益智方治疗,两组均连续治疗3个月。比较两组患者的临床疗效,观察两组患者治疗前后简易智力状态检查量表(mini mental state examination,MMS)MMSE及日常生活量表(activity of daily living scale,ADL)积分及Hcy水平变化情况。结果:对照组有效率为60.0%,治疗组有效率为70.0%,两组患者临床疗效比较,差异具有统计学意义(P<0.05)。两组患者治疗后MMSE评分均高于治疗前,差异具有统计学意义(P<0.05),治疗后,治疗组MMSE评分改善程度优于对照组,在时间定向、地点定向两个域得分比较,差异有统计学意义(P<0.05)。两组患者治疗后ALD评分高于治疗前,且治疗组高于对照组,差异有统计学意义(P<0.05)。两组治疗前血浆Hcy水平比较,差异无统计学意义(P>0.05),治疗后,两组血浆Hcy水平均较治疗前下降,但差异亦无统计学意义(P>0.05)。结论:通脉益智方汤治疗伴有HHcy的VCI患者临床疗效确切,可改善患者的临床症状,但对Hcy水平无明显改善。

Objective： To observe the clinical curative effect of Channel-Unblocking and Intelligence-Increasing Decoction on hyperhomocysteinemia with vascular cognitive impairment. Methods： Sixty patients with hyperhomocystinemia（ HHcy） vascular cognitive impairment（ VCI） were randomly divided into the control group and the treatment group,with 30 cases in each group. The ones in the control group were treated with Oxiracetam Capsules for oral administration,while the ones in the treatment group were added self-made Channel-Unblocking and Intelligence-Increasing Decoction based on the treatment of the control group. The two groups were treated for 3 months. Then the clinical curative effects of two groups were compared. Their mini mental state examination（ MMSE） and activity of daily living scale（ ADL） integrals and the changes of the level of Hcy before and after the treatment were observed. Results： The effective rate of the control group was 60%,while that of the treatment group was 70%,and the difference was statistically significant（ P 〈 0. 05）. After the treatment,MMSE scores of the two groups were higher than those before the treatment,and all the differences were statistically significant（ P 〈 0. 05）. After the treatment,the improvement of MMSE score of the treatment group was better than that of the control group,the differences in time and place orientations were statistically significant（ P 〈 0. 05）. After treatment,the scores of ALD in the two groups were higher than those before the treatment,and the treatment group was higher than the control group,the difference was statistically significant（ P 〈 0. 05）. There was no significant difference in plasma Hcy level between the two groups before the treatment（ P 〉 0. 05）. After the treatment,plasma Hcy level of the two groups decreased,but the difference was not statistically significant（ P 〉 0. 05）. Conclusion： Channel-Unblocking and Intelligence-Increasing Decoction has a remarkable clinical curative effect on hyperhomocysteinemia with vascular cognitive impairment,can improve the clinical symptoms of the patients,but there is no obvious improvement on the level of Hcy.