脑康颗粒联合西医常规治疗脑小血管病所致认知功能障碍临床研究

Clinical Study on Naokang Granules Combined with Conventional Western Therapy for Treatment of Cognitive Dysfunction Caused by Cerebral Small Vessel Disease

目的探讨脑康颗粒联合西医常规疗法治疗脑小血管病所致认知功能障碍髓海不足证患者的临床疗效及对炎性指标和神经因子的影响。方法采用随机数字表法将92例患者分为对照组和观察组各46例。对照组予西医常规疗法,观察组在对照组基础上予脑康颗粒,每日1剂,每日2次,口服。2组均连续治疗4周。观察2组临床疗效,比较2组治疗前后简易智能状态检查量表(MMSE)评分,血清前列环素(PGI2)、脑源性神经营养因子(BDNF)、血管内皮生长因子(VEGF),血浆超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy),脑血流平均通过时间(MTT)、平均血流速度(CBV)、脑血流量(CBF),监测2组肝功能异常、胃肠道反应、头晕、皮疹、肾功能损伤等不良反应。结果观察组总有效率为93.48%(43/46),对照组为73.91%(34/46),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后MMSE评分明显下降(P<0.05);2组治疗后比较,观察组MMSE评分明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后PGI2、BDNF、VEGF、CBF、CBV明显升高,hs-CRP、Hcy、MTT明显降低(P<0.05);2组治疗后比较,观察组上述指标明显优于对照组(P<0.05)。观察组不良反应发生率为26.09%(12/46),对照组为21.74%(10/46),2组比较差异无统计学意义(P>0.05)。结论脑康颗粒联合西医常规疗法治疗脑小血管病所致认知功能障碍髓海不足证患者疗效显著,可减轻炎症反应,促进神经功能,改善智能水平。

Objective To explore the clinical efficacy of Naokang Granules combined with conventional Western therapy for the treatment of patients with cognitive dysfunction caused by cerbral small vessel disease;To observe its effects on inflammatory indexes and neurokines.Methods Totally 92 patients were divided into control group and observation group according to random number table method,with 46 cases in each group.The control group was given conventional Western medicine therapy,and the observation group was given Naokang Granules on the basis of the control group,one dosage a day,twice a day,orally.The treatment for both groups lasted for 4 weeks.The Clinical efficacy was observed.The MMSE scores,serum prostacyclin(PGI2),brain-derived neurotrophic factor(BDNF),vascular endothelial growth factor(VEGF),plasma hypersensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),mean transit time(MTT),mean blood flow velocity(CBV)and cerebral blood flow(CBF)before and after treatment were compared.Adverse reactions such as abnormal liver function,gastrointestinal reactions,dizziness,rash,and renal impairment were monitored.Results The total effective rate was 93.48%(43/46)in the observation group and 73.91%(34/46)in the control group,with statistically significance(P<0.05).Compared with before treatment,the MMSE score of the two groups decreased significantly after treatment(P<0.05);after treatment,the MMSE score of the observation group was significantly lower than that of the control group(P<0.05).Compared with before treatment,the levels of PGI2,BDNF,VEGF,CBF,and CBV increased significantly after treatment in the two groups,and the levels of hs-CRP,Hcy,and MTT decreased significantly(P<0.05);after treatment,the above laboratory indexes of the observation group were significantly better than the control group(P<0.05).The incidence of adverse reactions was 26.09%(12/46)in the observation group and 21.74%(10/46)in the control group,without statistically significance(P>0.05).Conclusion Naokang Granules combined with conventional Western therapy for the treatment of patients with cognitive dysfunction caused by cerbral small vessel disease has confirmed efficacy,and can reduce inflammatory response,promote neural function,improve intelligence.