活血化瘀补肾法联合针刺对血管性痴呆患者认知功能及血清IL-18、IFN-γ水平影响

Effects of huoxue huayu bushen formula and acupuncture on the cognitive function and the levels of serum LI-18 and IFN-γ in the patients of vascular dementia

目的研究活血化瘀补肾法联合针刺对血管性痴呆(VD)患者认知功能及血清白细胞介素-18(IL-18)、干扰素-γ(IFN-γ)水平影响。方法选择2015年3月至2017年1月间收治的112例VD患者,将其随机分为对照组和治疗组,每组56例。两组均进行西药治疗和常规护理。对照组患者加用针刺治疗,治疗组患者采用针刺联合活血化瘀补肾方治疗,4周为1个疗程,连续治疗2个疗程后,比较两组患者认知功能(MMSE评分),行为能力(BBS评分),血清IL-18、IFN-γ含量的变化,中医证候评分和不良反应,并评价疗效。结果治疗后,两组患者MMSE评分升高,BBS评分降低,其中治疗组MMSE评分高于对照组,BBS评分低于对照组,差异有统计学意义(P <0. 05)。两组患者血清IL-18、IFN-γ含量均减少,其中治疗组含量都低于对照组,差异有统计学意义(P<0. 05)。两组患者中医证候评分均降低,其中治疗组低于对照组,差异有统计学意义(P <0. 05)。治疗组有效率为87. 5%,高于对照组的71. 43%,差异有统计学意义(P <0. 05)。比较两组不良反应发生率,差异无统计学意义(P> 0. 05)。结论采用活血化瘀补肾法联合针刺治疗VD患者,疗效显著,能够明显提高患者认知功能和行为能力,改善临床症状,可能是通过抑制IL-18、IFN-γ的表达,减少炎症反应发挥作用。

Objective To explore the effects of huoxue huayu bushen formula(for activating blood circulation,resolving stasis and tonifying the kidney)and acupuncture on the cognitive function and the levels of serum LI-18and IFN-γin the patients of vascular dementia.Methods A total of112patients of vascular dementia were collected from the March2015to January2017and were randomized into a control group and a treatment group,56cases in each one.The routine western medicine and nursing care were applied in both of two groups.Additionally,the acupuncture was used in the control group and the combined therapy of acupuncture and huaxue huayu bushen formula was given in the treatment group.The treatment for4weeks was as1course.After consecutive2courses of treatment,the cognitive function(MMSE score),behavior ability(BBS score),the levels of serum LI-18and IFN-γ,TCM symptom score and adverse reactions were compared between the two groups.The therapeutic effects were evaluated.Results After treatment,MMSE score was increased and BBS decreased in the two groups(P<0.05).MMSE score in the treatment group was higher than the control group and BBS score was lower than the control group,indicating the significant difference(P<0.05).The levels of LI-18and IFN-γwere all reduced in the two groups(P<0.05).The levels in the treatment group were lower than the control group,indicating the significant difference(P<0.05).The effective rate was87.5%in the treatment group and was71.43%in the control group,indicating the significant difference(P<0.05).Conclusion The combined treatment of huoxue huayu bushen formula and acupuncture achieves the significant effects on vascular dementia in the patients.It obviously improves the cognitive function and behavior ability and relieves the clinical symptoms.The effects are probably obtained through inhibiting the expressions of LI-18and IFN-γand reducing the inflammatory reactions.