自拟益智祛痰通窍汤辅助治疗老年血管性痴呆的效果观察

Effect of self-designed Yizhi Qutan Tongqiao decoction in adjuvant treatment of elderly patients with VD

目的探究自拟益智祛痰通窍汤辅助治疗老年血管性痴呆(Vascular dementia,VD)患者的效果。方法选择2018年8月至2020年8月本院收治老年VD患者128例,根据治疗方案不同分为西药组和中药组各64例。西药组给予茴拉西坦胶囊联合盐酸美金刚治疗,中药组在西药组基础上增加自拟益智祛痰通窍汤辅助治疗,3个月后,对比两组患者临床疗效、血脂水平、认知功能,不良反应。结果中药组临床总有效率高于西药组(P<0.05)。两组患者治疗3月末总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)水平较治疗前均降低,中药组低于西药组;高密度脂蛋白胆固醇(HDL-C)水平较治疗前均升高,中药组高于西药组(P<0.05)。两组患者治疗3月末Blessed痴呆量表(BDS)、阿尔兹海默症评定量表(ADAS-Cog)评分水平较治疗前均降低,中药组低于西药组;简易智能状态量表(MMSE)评分水平较治疗前均升高,中药组高于西药组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论自拟益智祛痰通窍汤通过拮抗内源性胆固醇的合成,调控老年VD患者的血脂水平,改善智能减退、腰膝酸软等临床症状,调控认知水平,提高临床疗效。

Objective To explore the efficacy of self-designed Yizhi Qutan Tongqiao decoction in adjuvant treatment of elderly patients with vascular dementia(VD).Methods A total 128 elderly patients with VD in our hospital from August 2018 to August 2020 were selected and divided into Western medicine group and Chinese medicine group according to different treatment regimens,with 64 cases in each group.The Western medicine group was treated with anisetam capsule combined with monantine hydrochloride,and the Chinese medicine group was treated with self-designed Yizhi Qutan Tongqiao decoction as adjuvant treatment on the basis of the Western medicine group.Three months later,the clinical efficacy,blood lipid levels,cognitive function and adverse reactions of the two groups were compared.Results The total effective rate of Chinese medicine group was higher than that of Western medicine group.The levels of total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in the two groups at the end of 3 months of treatment were lower than those before treatment,and the Chinese medicine group was lower than the Western medicine group.The level of high density lipoprotein cholesterol(HDL-C)in Chinese medicine group was higher than that in Western medicine group(P<0.05).The scores the Blessed Dementia Scale(BDS)and Alzheimer's Disease Rating Scale(ADAS-COG)in both groups were lower than those before treatment,and the Chinese medicine group were lower than those in the Western medicine group.The MMSE scores in the two groups were higher than those before treatment,and those in Chinese medicine group were higher than those in Western medicine group(P<0.05).There was no significant difference of adverse reaction rate between the two groups(P>0.05).Conclusion By antagonizing the synthesis of endogenous cholesterol,the self-designed Yizhi Qutan Tongqiao decoction can regulate the level of blood lipid in elderly VD patients,improve the clinical symptoms such as mental decline,waist and knee acid and softness,regulate the cognitive level,and improve the clinical efficacy.