通窍活血汤治疗血管性痴呆的疗效及对血脂与同型半胱氨酸的影响

Effect of Tongqiao Huoxue Decoction on vascular dementia and its effect on blood lipid and homocysteine

目的观察通窍活血汤治疗血管性痴呆(VD) 的临床疗效及对血脂、同型半胱氨酸的影响。方法选取2017年6月-2018年9月瘀血内阻证血管性痴呆患者66例,随机分为治疗组与对照组,各33例。对照组在调控血脂、控制血压、血糖等一般治疗基础上给予奥拉西坦4.0 g,静脉滴注,每日1次。治疗组在对照组基础上加用通窍活血汤治疗。2组分别于治疗前后进行简易精神状态量表(MMSE) 评分、生活能力评分(ADL),同时对2组患者治疗前后进行血脂、同型半胱氨酸(hcy)等检测,评定治疗效果。结果治疗4周后,治疗组MMSE评分(23.60±3.10)分、ADL评分(51.60±7.10)分均显著高于对照组的MMSE评分(20.23±2.15)分、ADL评分(45.14±4.51)分(P<0.05);治疗组血脂TC(3.24±0.16)mmol.L-1,TG(1.51±0.07)mmol.L-1、同型半胱氨酸(11.14±1.26)μmol.L-1显著低于对照组的血脂TC(4.39±0.87)mmol.L-1,TG(1.89±0.14)mmol.L-1、同型半胱氨酸(15.05±1.83) μmol.L-1(P<0.05),结论通窍活血汤能够显著提高瘀血内阻型血管性痴呆患者的生活能力和认知功能,降低患者血脂、同型半胱氨酸水平,减轻动脉粥样硬化程度。

Objective To observe the clinical effect of Tongqiao Huoxue Decoction on vascular dementia(VD)and its effect on blood lipid and homocysteine.Methods A total of 66 patients with vascular dementia were randomly divided into treatment group(33 cases)and control group(33 cases).On the basis of general treatment(including regulating blood lipid and controlling blood pressure,blood sugar,etc.),the control group was given 4.0 g of oxiracetam by intravenous drip once a day.The treatment group was treated with Tongqiao Huoxue Decoction on the basis of the control group.Before and after treatment,each patient was assessed with MMSE and ADL.Meanwhile,blood lipid and homocysteine(Hcy)were measured before and after treatment.Results After 4 weeks of treatment,MMSE(23.60±3.10)and ADL(51.60±7.10)in the observation group were significantly higher than MMSE(20.23±2.15)and ADL(45.14±4.51)in the control group(P<0.05);blood lipid TC(3.24±0.16)mmol·L^-1,TG(1.51±0.07)mmol·L^-1 and homocysteine(11.14±1.26)μmol·L^-1 in the observation group were significantly lower than blood lipid TC(4.39±0.87)mmol·L^-1,TG(1.89±0.14)mmol·L^-1 and homocysteine(15.05±1.83)μmol·L^-1 in the control group(P<0.05).Conclusion Tongqiao Huoxue Decoction can significantly improve the living ability and cognitive function of vascular dementia patients with blood stasis,reduce the level of blood lipid and homocysteine,and reduce the degree of atherosclerosis.