盐酸多奈哌齐片联合养血清脑颗粒对脑小血管病所致血管性认知功能障碍患者hs-CRP、Hcy、脑血流灌注和电生理的影响

Effects of donepezil hydrochloride tablets combined with Yangxue Qingnao granule on hs-CRP,Hcy,cerebral perfusion and electrophysiology in patients with vascular cognitive dysfunction caused by cerebral small vessel disease

目的观察盐酸多奈哌齐片联合养血清脑颗粒治疗脑小血管病所致血管性认知功能障碍(VCI)的疗效及对患者血清超敏C反应蛋白(hsCRP)、同型半胱氨酸(Hcy)、脑血流灌注和电生理的影响。方法将95例脑小血管病所致VCI患者随机分为观察组48例和对照组47例。对照组给予盐酸多奈哌齐片治疗,观察组在对照组基础上给予养血清脑颗粒治疗,疗程均为8周。统计2组临床疗效,观察2组治疗前后蒙特利尔认知评估量表(MoCA)评分、hs-CRP、Hcy、脑血流灌注指标[平均通过时间(MTT)、脑血流量(CBV)、血流速度(CBF)]和电生理指标[(δ+θ)/(α+β)比值、P300潜伏期、P300振幅]及生活质量评分情况。结果观察组临床总有效率显著高于对照组(P <0. 05)。2组治疗后视空间/执行力、注意力与计算、延迟回忆、定向力、命名、语言、抽象能力评分和MoCA量表总分均显著升高(P均<0. 05),观察组前4项评分及总分均显著高于对照组(P均<0. 05)。2组治疗后血清hsCRP、Hcy水平及MTT、(δ+θ)/(α+β)比值、P300潜伏期均显著降低(P均<0. 05),且观察组均显著低于对照组(P均<0. 05); 2组治疗后CBV、CBF及P300振幅均显著升高(P均<0. 05),且观察组均显著高于对照组(P均<0. 05)。2组治疗后SF-36健康调查量表中生理功能、总体健康、生命活力、心理健康、社会功能、生理职能评分均较治疗前显著增高(P均<0. 05),且观察组治疗后前4项评分均显著高于对照组(P均<0. 05)。结论盐酸多奈哌齐片联合养血清脑颗粒治疗可显著改善脑小血管病所致VCI患者认知功能,降低hs-CRP和Hcy表达水平,改善脑血流灌注和神经电生理功能,提高临床疗效,有利于改善患者生活质量。

Objective It is to observe the efficacy of donepezil hydrochloride tablets combined with Yangxue Qingnao granule in the treatment of vascular cognitive impairment(VCI)caused by cerebral small vessel disease and its effect on serum high-sensitivity C-reactive protein(hs-CRP)and homocysteine.(Hcy),cerebral blood perfusion and electrophysiological.Methods Ninety-five patients with VCI caused by cerebral small vessel disease were randomly divided into observation group(48 cases)and control group(47 cases).The control group was treated with donepezil hydrochloride tablets,and the observation group was treated with Yangxue Qingnao granules on the basis of the control group.The courses of treatment were 8 weeks.The clinical efficacy of the two groups was statistically analyzed,the scores of Montreal Cognitive Assessment Scale(MoCA),hs-CRP,Hcy,and cerebral perfusion indicators[mean transit time(MTT),cerebral blood flow(CBV),and blood flow velocity(CBF)]and electrophysiological indicators[(δ+θ)/(α+β)ratio,P300 latency,P300 amplitude]and scores of quality of life were observed before and after treatment.Results The total clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the scores of visual space/exercise,attention and calculation,delayed recall,orientation,naming,language,abstract ability and total score of MoCA scale were significantly increased(P<0.05),and the scores of the first 4 items and total scores in the observation group were significantly higher than those in the control group(P<0.05).The levels of serum hs-CRP,Hcy,MTT,(δ+θ)/(α+β)ratio,and P300 latency were significantly decreased while the amplitudes of CBV,CBF and P300 were significantly increased in the two groups after treatment(P<0.05),and decrease or increase in the observation group was more significantly than the control group(P<0.05).The scores of physiological function,overall health,vitality,mental health,social function,and physiological function of the SF-36 Health Survey Scale were significantly higher than those before treatment(P<0.05),and the scores of the first 4 items after treatment in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Donepezil hydrochloride combined with Yangxue Qingnao granule can significantly improve the cognitive function,reduce the expression of hs-CRP and Hcy,improve cerebral blood perfusion and neurophysiological function,improve clinical efficacy,and is helpful for improving the quality of life in the patients VCI caused by cerebral small vessel disease.