健脾养心益智汤治疗老年血管性痴呆临床研究

Clinical Study on Jianpi Yangxin Yizhi Tang for Senile Vascular Dementia

目的:观察健脾养心益智汤治疗老年血管性痴呆(VD)的临床效果。方法:选取80例老年VD患者,按随机数字表法分为对照组和观察组各40例。2组均给予脑血管病基础治疗,对照组给予尼莫地平片治疗,观察组给予健脾养心益智汤治疗。比较2组治疗前后蒙特利尔认知评估量表(MoCA)评分、简易智能状态量表(MMSE)评分、日常生活活动能力量表(ADL)评分、血清基质金属蛋白酶-9(MMP-9)和脑源性神经营养因子(BDNF)水平,并评价临床疗效。结果:观察组总有效率为87.50%,高于对照组67.5%,差异有统计学意义(P<0.05)。治疗前,2组MMSE评分、MoCA评分及ADL评分比较,差异无统计学意义(P>0.05)。治疗后,2组MMSE评分及MoCA评分较治疗前升高,ADL评分较治疗前降低;且观察组MMSE评分及MoCA评分高于对照组,ADL评分低于对照组;差异均有统计学意义(P<0.05)。治疗前,2组血清MMP-9及BDNF水平比较,差异无统计学意义(P>0.05)。治疗后,2组血清MMP-9水平较治疗前降低,BDNF水平较治疗前升高;且观察组血清MMP-9水平低于对照组,BDNF水平高于对照组;差异均有统计学意义(P<0.05)。结论:健脾养心益智汤治疗老年VD患者效果优于单纯西药,能够明显改善患者智能与认知水平,提高生活质量,无不良反应,具有较好的临床应用价值。

Objective: To observe the clinical effect of Jianpi Yangxin Yizhi tang for senile vascular dementia(VD).Methods:A total of 80 cases of senile VD patients were divided into the control group and the observation group according to the random number table method, 40 cases in each group. Both groups were given basic treatment for cerebrovascular disease;the control group was additionally treated with nimodipine tablets, and the observation group was additionally treated with Jianpi Yangxin Yizhi tang. Before and after treatment, the scores of Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE) and Activities of Daily Living Scale(ADL),and the levels of matrix metalloproteinase-9(MMP-9) in serum and brain-derived neurotrophic factor(BDNF) in the two groups were compared. The clinical effect was evaluated. Results:The total effective rate was 87.50% in the observation group,higher than that of 67.5% in the control group, the difference being significant(P<0.05). Before treatment, there was no significant difference being found in the comparison of scores of MMSE,MoCA and ADL between the two groups(P>0.05). After treatment,the scores of MMSE and MoCA in the two groups were increased when compared with those before treatment, and the ADL scores were decreased;the scores of MMSE and MoCA in the observation group were higher than those in the control group,and the ADL score was lower;differences being significant(P<0.05). Before treatment, there was no significant difference being found in the comparison of levels of MMP-9 and BDNF between the two groups(P>0.05). After treatment, the MMP-9 levels in the two groups were decreased when compared with those before treatment, and the BDNF levels were increased;the MMP-9 level in the observation group was lower than that in the control group, and the BDNF level was higher;differences being significant(P<0.05). Conclusion:Jianpi Yangxin Yizhi tang for senile VD patients has better effect than simple western medicine and better clinical value,which can significantly improve their intelligence,cognitive levels and quality of life with no adverse reaction.