蛭龙活血通瘀胶囊对ICSVD合并VCI临床疗效观察

Clinical efficacy of Zhilong Huoxue Tongyu capsules for ischemic cerebral small-vessel disease comorbid with vascular cognitive impairment

目的:通过临床两种方案治疗缺血性脑小血管病(ischemic cerebral small vessel disease,ICSVD)合并血管性认知功能障碍(vascular cognitive impairment,VCI),评价蛭龙活血通瘀胶囊的临床疗效。方法:60例ICSVD合并VCI患者,随机均分A组(常规+尼莫地平缓释片治疗)、B组(常规+蛭龙活血通瘀胶囊治疗)。入组前分别进行日常生活能力评分(activities of daily living,ADL)、Hachinski缺血量表(hachinski ischemic scale,HIS)、蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)评分,血清C反应蛋白(c-reactive protein,CRP),血同型半胱氨酸(homocysteine,Hcy)含量检测;干预后1、6、12、18月再次行ADL、MoCA评分及血清CRP,HCY含量检测。结果:A、B两组治疗前各项指标均无统计学意义,A、B两组ADL、HIS、MoCA评分治疗后1月无统计学意义(P>0.05);6月、12月、18月,评分有统计学意义(P<0.05),随治疗时间延长两组评分均明显升高,且B组高于A组;A、B两组血清CRP、HCY含量治疗后1月无统计学意义(P>0.05);6月、12月、18月,含量有统计学意义(P<0.05),治疗后两组CRP、HCY水平均降低,且B组均低于A组。结论:蛭龙活血通瘀胶囊通过降低机体CRP、HCY表达,改善MoCA水平,提高ADL评分,对缺血性脑细胞有一定的保护作用,改善ICSVD致VCI的患者日常生活自理能力及提高认知功能。

Objective: To evaluate the clinical efficacy of Zhilong Huoxue Tongyu capsules in ischemic cerebralsmall-vessel disease(ICSVD) comorbid with vascular cognitive impairment(VCI) through comparing two clinicalregimens. Methods: Sixty patients with ICSVD comorbid with VCI were randomly divided into group A(routinetreatment combined with nimodipine sustained-release tablets) and group B(routine treatment combined with zhi-long Huoxue Tongyu capsules). Before treatment, the scores of activities of daily living(ADL), Hachinski IschemicScale(HIS), and Montreal Cognitive Assessment(MoCA) scale were assessed, and serum C-reactive protein(CRP)and homocysteine(Hcy) were determined. ADL and MoCA scores were re-assessed and serum CRP and HCY werere-measured at 1, 6, 12, and 18 months after treatment. Results: There were no significant differences in baselineindicators between group A and group B. ADL, HIS, and MoCA scores in both groups significantly increased over thecourse of treatment. These scores showed no significant differences between the two groups at 1 month after treat-ment(P > 0.05), but were significantly higher in group B than in group A at 6, 12, and 18 months after treatment(P < 0.05). Serum CRP and HCY levels in the two groups decreased after treatment. Group B had significantly lowerlevels of CRP and HCY than group A at 6, 12, and 18 months after treatment(P < 0.05), while there were no significant differences between the two groups at 1 month after treatment(P > 0.05). Conclusion: Zhilong Huoxue Tongyucapsules can reduce the expression of CRP and HCY and improve the scores of MoCA and ADL, suggesting that thisdrug has a certain protective effect on ischemic brain cells and can improve the self-care ability and cognitive func-tion of patients with VCI caused by ICSVD.