通窍活血汤加减联合重复经颅磁刺激对血管性痴呆患者认知水平及Hcy的影响

Effect of Tongqiao Huoxue Decoction Modified Combined with Repetitive Transcranial Magnetic Stimulation on Cognitive Level and Hcy of Vascular Dementia Paients

目的:观察通窍活血汤加减联合重复经颅磁刺激(rTMS)治疗血管性痴呆的临床效果。方法:随机抽取2019年7月1日-2021年3月30日在漳州市中医院进行治疗的血管性痴呆患者76例,根据患者用药差异将其分为观察组、对照组,两组分别38例,所有患者均采用尼莫地平片治疗,对照组联合应用rTMS治疗,观察组联合应用rTMS及通窍活血汤加减治疗。比较两组治疗前后蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分、临床疗效、治疗前后中医症候积分及Hcy水平。结果:治疗前两组MoCA评分差异无统计学意义(P>0.05);治疗后两组MoCA评分较治疗前均有所升高,差异有统计学意义(P<0.05);治疗后观察组MoCA评分明显高于对照组,差异有统计学意义(P<0.05)。观察组临床总有效率明显更高,差异有统计学意义(P<0.05)。治疗前两组眩晕及智能减退评分差异无统计学意义(P>0.05);治疗后两组评分均下降,差异有统计学意义(P<0.05);治疗后观察组各项指标评分更低,差异有统计学意义(P<0.05)。治疗前两组Hcy差异无统计学意义(P>0.05);治疗后两组Hcy较治疗前均有所降低,差异有统计学意义(P<0.05);治疗后观察组Hcy水平低于对照组,差异有统计学意义(P<0.05)。结论:在血管性痴呆治疗工作中应用rTMS联合通窍活血汤加减能够改善患者Hcy、中医症候积分、MoCA评分,临床疗效确切,值得推广。

Objective:To observe the clinical effect of Tongqiao Huoxue Decoction modified combined with repeated transcranial magnetic stimulation(rTMS)in the treatment of vascular dementia.Method:Seventy-six patients with vascular dementia who were treated in Zhangzhou Hospital of Traditional Chinese Medicine from July 1,2019 to March 30,2021 were randomly selected and divided into the observation group and the control group according to the difference in medications of the patients,and the two groups were included respectively 38 cases.All patients were treated with Nimodipine Tablets.The control group was treated with rTMS,and the observation group was treated with rTMS and Tongqiao Huoxue Decoction modified.The Montreal cognitive assessment(MoCA)scores before and after treatment,clinical efficacy,and TCM syndrome scores,Hcy level before and after treatment were compared between the two groups.Result:There was no significant difference in MoCA scores between the two groups before treatment(P>0.05);after treatment,the MoCA scores of the two groups increased compared with before treatment,and the difference was statistically significant(P<0.05);after treatment,the MoCA score of the observation group was significantly higher than that of the control group,and the difference between the groups was statistically significant(P<0.05).The total clinical effective rate of the observation group was significantly higher,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of vertigo and mental retardation between the two groups before treatment(P>0.05);the scores decreased after treatment,and the difference was statistically significant(P<0.05);after treatment,the scores of various indexes in the observation group were lower,and the differences were statistically significant(P<0.05).There was no statistically significant difference in Hcy level between the two groups before treatment(P>0.05);after treatment,Hcy in the two groups was lower than before treatment,and the difference was statistically significant(P<0.05);after treatment,the Hcy level in the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion:The application of rTMS combined with Tongqiao Huoxue Decoction modified in the treatment of vascular dementia can improve patients’Hcy,TCM syndrome scores,and MoCA scores.The clinical effect is accurate and worthy of promotion.