荣脑通络益智颗粒配合盐酸氟桂利嗪胶囊对慢性脑供血不足认知功能的影响

Clinical study on the treatment of chronic cerebral insufficiency with Rongnao-Tongluo-Yizhi decoction combined with flunarizine hydroehloride capsules

目的观察荣脑通络益智汤配合盐酸氟桂利嗪胶囊对慢性脑供血不足（chronic cerebral circulation insufficiency,CCCI）患者认知功能的影响。方法将符合入选标准的90例CCCI患者采用随机数字表法分为2组，每组45例。对照组在西医常规治疗基础上口服盐酸氟桂利嗪胶囊，观察组在对照组基础上加服荣脑通络益智汤。2组均治疗1个月。采用经颅多普勒检测基底动脉（basilar artery,BA）和椎动脉（vertebral artery，VA）平均血流速度；采用蒙特利尔认知评估量表（Montreal Cognitive Assessment，MoCA）评估患者的认知功能；采用ELISA法检测血清TNF-α、IL-8及hs-CRP，评价临床疗效。结果治疗组总有效率为93．3％（42／45）、对照组为71．1％（32／45），2组比较差异有统计学意义印=6．157，P=0．013）。治疗后，治疗组血清TNF．Cc[（0．7l±0．13）ng／ml比（1．02±0．15）ng／ml，t=3．652]、IL-8I（1．94±0．12）ng／ml比（4．51±0．54）ng／ml，t=3．367]、hs-CRPl（1．01±0．14）mg／L比（2．15±0．29）mg／L，t=3．701]水平低于对照组（P〈0．05）；治疗组BA[（47．51±3．63）cm／s比（42．21±4．21）cm／s，t=7．385]和左侧VA[（42．12±7．36）cm／s比（35．23±2．23）cm／s，t=6．940]、右侧VA[（43．21±6．18）cm／s比（38．46±7．16）cm／s，t=3．890]平均血流速度高于对照组（P〈0．01）；治疗组MoCA总分[（28．1±6．3）分比（25．0±6．4）分，t=2．316]高于对照组（P〈0．05）。结论荣脑通络益智汤配合盐酸氟桂利嗪胶囊可改善CCCI患者的临床症状，强化其认知水平，提高生活质量。

Objective To observe the Rongnao-Tongluo-Yizhi decoction combined with flunarizine hydrochloride capsules for chronic cerebral circulation insufficiency （CCCI） patients with the cognitive dysfunction. Methods A total of 90 patients with CCCI in our hospital from October 2015 to December 2017 were enrolled in this study. The subjects were randomly divided into the control group （n=45） and the treatment group （n=45）. The control group were given conventional western medicine treatment, oral Fluorine Hydro chloride Capsules. The observation group received Rongnao-Tongluo-Yizhi decoction combined with notifying kidney and essence method treatment on the basic treatment of control group. The clinical effect rates of two groups were compared. Results The total effective rate of the treatment group was 93.3%, and the control group was 71.1%. There was significant difference between groups （2,2=6.157, P=0.013）. After treatment, the serum TNF-α （0.71 ± 0.13 ng/ml vs. 1.02 ± 0.15 ng/ml, t=3.652）, IL-8 （1.94 ± 0.12 ng/ml vs. 4.51 ± 0.54 ng/ml, t=3.367）, hs-CRP （1.01 ± 0.14 mg/L vs. 2.15± 0.29 mg/L, t=3.701） of the observation group were significantly lower than the control group （P〈0.05）. The average blood flow velocity of basal artery （47.51±3.63 cm/s vs. 42.21 ± 4.21 cm/s, t=7.385）, the left side of the vertebral artery （42.12 ± 7.36 cm/s vs. 35.23 ± 2.23 cm/s, t=6.940）, the right side of the vertebral artery （43.21± 6.18 cm/s vs. 38.46 ± 7.16 cm/s, t=3.890） in the treatment group were significantly higher than the control group （P〈0.01）. The treatment group total score （28.1 ± 6.3 vs. 25.0 ± 6.4, t=2.315） was higher than the control group （P〈0.01）. Conclusions The Rongnao-Tongluo-Yizhi decoction combined therapy could improve the symptoms, cognitive level, and quality of life of patients.