补肾活血方治疗脑小血管病变急性期疗效及对短时血压变异性、认知功能、神经功能的影响

Curative effect of Bushen Huoxue Decoction on acute cerebral small vessel disease and its influence on short-term blood pressure variability,cognitive function and nerve function

目的观察补肾活血方治疗脑小血管病变急性期患者的疗效及对短时血压变异性、认知功能、神经功能的影响。方法选择2018年5月—2019年4月在西安市中医医院治疗的肾虚血瘀证脑小血管病患者86例,按入院顺序随机分为2组,对照组43例根据《中国急性缺血性脑卒中诊治指南2018》给予常规治疗,研究组43例在对照组治疗基础上给予补肾活血方治疗,2组均治疗14 d。比较2组临床疗效,观察2组治疗前后中医症状积分、血压[收缩压(SBP)、舒张压(DBP)]、短时血压变异性指标[收缩压变异标准差(SBP-SD)、舒张压变异标准差(DBP-SD)]、认知功能[采用蒙特利尔认知评估量表(MoCA)评估]、神经电生理指标(腓总神经、腓神经、腓肠神经、腓浅神经传导速度)变化,记录2组不良反应发生情况。结果研究组和对照组治疗总有效率分别为93.0%(40/43)和74.4%(32/43),研究组明显高于对照组(P<0.05)。治疗后,2组各项中医症状评分、SBP、DBP、SBP-SD、DBP-SD均显著降低(P均<0.05),MoCA评分均显著升高(P均<0.05),腓总神经、腓神经、腓肠神经、腓浅神经传导速度均显著增快(P均<0.05),且治疗后研究组上述观察指标改善情况均显著优于对照组(P均<0.05)。研究组和对照组不良反应发生率分别为7.0%(3/43)和4.7%(2/43),2组比较差异无统计学意义(P>0.05)。结论补肾活血汤治疗肾虚血瘀证脑小血管病急性期疗效显著,认知功能和神经传导速度的改善可能与调节短时血压变异性有密切关系。

Objective It is to observe the curative effect of Bushen Huoxue Decoction in the treatment of acute cerebral small vessel disease and its influence on short-term blood pressure variability,cognitive function and neurological function.Methods Eighty-six patients with cerebral small vessel disease with kidney deficiency and blood stasis syndrome treated in Xi’an Hospital of Traditional Chinese Medicine from May 2018 to April 2019 were randomly divided into 2 groups according to the order of admission.43 cases in the control group was given conventional therapy according to“Stroke Diagnosis and Treatment Guide 2018”,and 43 cases in the study group was treated with Bushen Huoxue Decoction on the basis of the control group.Both groups were treated for 14 days.The clinical efficacy of the two groups was compared,and the changes of TCM symptom scores,blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],short-term blood pressure variability indexes[systolic blood pressure variation standard deviation(SBP-SD),diastolic blood pressure variation standard deviation(DBP-SD)],cognitive function[Montreal Cognitive Assessment Scale(MoCA)],neurophysiological indicators(conduction velocity of common peroneal nerve,peroneal nerve,sural nerve,superficial peroneal nerve)before and after treatment were observed before and after treatment in the two groups,the occurrence of adverse reactions in the 2 groups was recorded.Results The total effective rates of treatment in the study group and the control group were 93.0%(40/43)and 74.4%(32/43),respectively,the study group was significantly higher than the control group(P<0.05).After treatment,the scores of TCM symptoms,SBP,DBP,SBP-SD,and DBP-SD in the two groups were significantly reduced(P<0.05),MoCA scores and the conduction velocity of common peroneal nerve,peroneal nerve,sural nerve and superficial peroneal nerve were significantly increased(P<0.05),and the improvement of the above observation indicators in the study group was significantly better than that in the control group(P<0.05).The incidence of adverse reactions in the study group and the control group were 7.0%(3/43)and 4.7%(2/43),respectively,there was no statistically significant difference between the two groups(P>0.05).Conclusion Bushen Huoxue Decoction is effective in treating acute cerebral small vessel disease with kidney deficiency and blood stasis syndrome.The improvement of cognitive function and nerve conduction velocity may be closely related to the regulation of short-term blood pressure variability.