温肺降浊方联合盐酸多奈哌齐片治疗血管性痴呆的疗效及其机制

Efficacy and mechanism of Wenfei Jiangzhuo decoction combined with donepezil hydrochloride tablets in the treatment of vascular dementia

目的观察温肺降浊方联合盐酸多奈哌齐片治疗血管性痴呆的临床疗效,并从氧化应激角度探讨其作用机制。方法将60例血管性痴呆患者随机分为治疗组30例和对照组30例。对照组予盐酸多奈哌齐片口服,治疗组予盐酸多奈哌齐片和温肺降浊方口服,2组均用药2个月。观察2组患者治疗前后简易精神量表(MMSE)评分、日常生活活动量表(ADL)评分和血清超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量的变化,评价2组临床疗效,统计2组不良反应发生情况。结果治疗后2组患者MMSE评分和血清SOD活性均明显升高(P均<0.05),且治疗组均明显高于对照组(P均<0.05);2组患者ADL评分和血清MDA含量均明显降低(P均<0.05),且治疗组均明显低于对照组(P均<0.05)。治疗组临床总有效率为85.7%,对照组总有效率为72.4%,治疗组明显高于对照组(P<0.05)。2组患者用药过程中均未出现严重不良反应。结论温肺降浊方联合盐酸多奈哌齐片治疗血管性痴呆疗效明显优于单用盐酸多奈哌齐片,其机制可能与提高血清SOD活性及降低MDA含量有关。

Objective It is to observe the clinical efficacy of Wenfei Jiangzhuo decoction combined with donepezil hydrochloride tablets in the treatment of vascular dementia, and to explore its mechanism of action from the perspective of oxidative stress. Methods Sixty patients with vascular dementia were randomly divided into treatment group(n=30) and control group(n=30). The control group was treated with donepezil hydrochloride tablets. The treatment group was treated with donepezil hydrochloride tablets and Wenfei Jiangzhuo decoction. The two groups were treated for 2 months. The changes of the simple mental scale(MMSE) score, the daily living activity scale(ADL) score, the serum superoxide dismutase(SOD) activity and the malondialdehyde(MDA) content of the two groups were observed before and after treatment. The efficacy was assessed and the adverse reactions occurred were recorded in the two groups. Results After treatment, the MMSE score and serum SOD activity of the two groups were significantly increased(P<0.05), and the increase in the treatment group was more significant than those in the control group(P<0.05);The ADL score and serum MDA content of the two groups were significantly decreased(P<0.05), and decrease in the treatment group was more significant than those in the control group(P<0.05). The total effective rate was 85.7% in the treatment group and 72.4% in the control group, the rate in treatment group was significantly higher than that in the control group(P<0.05). No serious adverse reactions occurred in the two groups during the medication. Conclusion Wenfei Jiangzhuo decoction combined with donepezil hydrochloride tablets is better than dansone hydrochloride alone in treating vascular dementia. The mechanism may be related to increasing serum SOD activity and decreasing MDA content.