万氏清心化痰汤治疗脑小血管病所致血管性认知功能障碍的临床疗效及对低密度脂蛋白胆固醇、同型半胱氨酸的影响

Clinical efficacy of Wanshi Qingxin Huatan Decoction for vascular cognitive impairment due to cerebral small vessel disease and its effect on low-density lipoprotein cholesterol and homocysteine

目的观察万氏清心化痰汤治疗脑小血管病(CSVD)所致血管性认知功能障碍(VCI)的临床疗效及对低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)的影响。方法将80例CSVD所致VCI患者按照随机数字表法分为2组,对照组40例予西医常规治疗,治疗组40例在对照组治疗基础上加用万氏清心化痰汤治疗。2组均治疗50 d。比较2组疗效;比较2组治疗前后简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分、日常生活能力量表(ADL)评分及症状评分变化;比较2组治疗前后LDL-C、Hcy水平变化。结果治疗组总有效率95.0%(38/40),对照组总有效率75.0%(30/40),治疗组疗效优于对照组(P<0.05)。2组治疗后MMSE评分、MoCA评分、ADL评分均较本组治疗前升高(P<0.05)。治疗组治疗后各项症状评分均较本组治疗前降低(P<0.05);对照组治疗后健忘、表情淡漠评分较本组治疗前降低(P<0.05);治疗后治疗组烦躁、夜寐不安评分均低于对照组(P<0.05)。2组治疗后LDL-C、Hcy水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论万氏清心化痰汤可明显改善CSVD所致VCI患者的认知功能,提高日常生活能力,降低LDL-C、Hcy水平,提高生活质量。

Objective To observe the clinical efficacy of Wanshi Qingxin Huatan Decoction for vascular cognitive impairment(VCI) due to cerebral small vessel disease(CSVD) and its effect on low-density lipoprotein cholesterol(LDL-C)and homocysteine(Hcy).Methods Eighty patients with VCI due to CSVD were randomly divided into the two groups,40 cases in the control group received medicine western routine therapy,and 40 cases in the treatment group additionally received Wanshi Qingxin Huatan Decoction on the basis of the control group.Both groups were treated for 50 days,curative effect,mini mental state examination scale(MMSE) score,montreal cognitive assessment(MoCA) score,daily life ability scale(ADL),symptom score,LDL-C level,and Hcy level were compared between the two groups before and after treatment.Results Total effective rate in the treatment group was better than that in the control group [95.0%(38/40) vs 75.0%(30/40),(P < 0.05),respectively].Compared with before treatment,scores of MMSE,MoCA and ADL after treatment in both groups were increased(P < 0.05);symptom score and total scores after treatment in the treatment group were decreased(P < 0.05);forgetfulness score,apathia score and total scores after treatment in the control group were decreased(P < 0.05);dysphoria score,night insomnia score and total scores in the treatment group were lower than those in the control group after treatment(P < 0.05);levels of LDL-C and Hcy after treatment in both groups were decreased(P < 0.05),which in the treatment group were significantly decreased(P < 0.05).Conclusion For VCI due to CSVD,using Wanshi Qingxin Huatan Decoction can significantly improve the cognitive function of patients,improve their ability of daily life,reduce levels of LDL-C and Hcy,and improve the quality of life.