姜黄益智胶囊联合丁苯酞对血管性痴呆患者氧化应激指标及p38 MAPK通路变化的影响

Intervention of Jianghuangyizhi capsule combined with butylphthalide on oxidative stress index and p38MAPK pathway in patients with vascular dementia

目的探究姜黄益智胶囊联合丁苯酞对血管性痴呆患者氧化应激指标及p38MAPK通路变化的干预作用.方法201例血管性痴呆患者作为研究对象,简单随机化分组,各67例.对照A组予丁苯酞软胶囊治疗,对照B组予姜黄益智胶囊治疗,观察组予姜黄益智胶囊联合丁苯酞软胶囊治疗.统计对比3组临床疗效、不良反应发生率,并对比治疗前、疗程结束后3组血管性痴呆中医证候积分(SDSVD)、认知功能(MMSE)评分、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]水平及p38MAPK通路相关蛋白表达水平.结果观察组临床疗效优于对照A、B组(P<0.05);疗程结束后,观察组SDSVD评分低于对照A、B组,MMSE评分高于对照A、B组(P<0.05);疗程结束后,观察组SOD水平高于对照A、B组,MDA水平低于对照A、B组(P<0.05);疗程结束后,观察组血清P-p38MAPK、P-p38MAPK/p38MAPK低于对照A、B组(P<0.05);3组不良反应发生率对比,差异无统计学意义(P>0.05).结论姜黄益智胶囊联合丁苯酞治疗血管性痴呆,可明显缓解患者症状,改善认知功能,抑制氧化应激,调节p38MAPK通路相关蛋白,效果显著,且安全性高.

Objective To investigate the intervention effect of Jianghuangyizhi capsule combined with butylphthalide on oxidative stress index and p38 MAPK pathway in patients with vascular dementia. Methods Two hundreds and one patients with vascular dementia were selected. They were randomly randomized into Group Control A, in which patients were treated with butylphthalide soft capsule;Group Control B, in which patients were treated with turmeric puzzle capsule;and Group Observation, in which patients were treated with turmeric puzzle capsule combined with butylphthalide soft capsule. The clinical efficacy and adverse reaction rate of the three groups were compared, and the TCM syndrome scores(SDSVD);cognitive function(MMSE) scores;inflammatory factors, including oxidative stress index, including superoxide dismutase(SOD) and malondialdehyde(MDA);and p38 MAPK pathway-associated protein expression levels were also compared. Results The clinical efficacy of the Group Observation was significantly better than those of the Group Control A and B(P<0.05). After the treatment, the SDSVD score of the Group Observation was significantly lower than those of Group Control A and B(P<0.05), and the MMSE score was significantly higher(P<0.05). After the end, the SOD level of the Group Observation was significantly higher than those of Group Control A and B(P<0.05);and the levels of MDA were significantly lower(P<0.05). The levels of P-p38 MAPK and P-p38 MAPK/p38 MAPK in Group Observation were significantly lower than those of Group Control A and B(P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05). Conclusion Jianghuangyizhi Capsule combined with butylphthalide in the treatment of vascular dementia can significantly alleviate the symptoms, improve cognitive function, inhibit oxidative stress and inflammatory response, and regulate the protein related to p38 MAPK pathway. The effect is remarkable and safe.