补肾化痰祛瘀法对卒中后认知功能障碍患者神经功能、血液流变学及血清Hcy的影响

Effect of Tonifying Kidney,Dissolving Phlegm and Removing Blood Stasis on Neurological Function,Hemorheology and Serum Hcy in Patients with Post-Stroke Cognitive Dysfunction

目的:探索补肾化痰祛瘀法对卒中后认知功能障碍患者神经功能、血液流变学及血清Hcy的影响。方法:前瞻性研究的200例卒中后认知功能障碍患者均在2020年2月—2021年6月期间收治,根据随机数字表法分为两组,对照组99例采用常规西药治疗,观察组101例采用补肾化痰祛瘀法治疗,比较两组血液流变学、同型半胱氨酸(Hcy)、神经递质水平、日常生活质量量表(ADL)、简易智力状态检查(MMSE)评分、阿尔茨海默病认知量表(ADAS-cog)评分、功能综合评定量表(FCA)评分。结果:观察组治疗后各时间段FCA评分、ADL评分、MMSE评分、5-HT、NE、DA水平高于对照组(P<0.05),ADAS-cog评分、红细胞压积、血浆黏度、全血黏度、纤维蛋白原、Hcy水平低于对照组(P<0.05)。结论:对卒中后认知功能障碍患者实施补肾化痰祛瘀法,可改善血液流变学和Hcy,减轻神经功能受损。

Objective:To explore the effect of tonifying Kidney,dissolving phlegm and removing blood stasis on neurological function,hemorheology and serum Hcy in patients with post-stroke cognitive dysfunction.Methods:200 patients with post-stroke cognitive dysfunction in the prospective study were randomly divided into the control group(n=99)and the observation group(n=101).The control group was treated with conventional western medication,whereas the observation group was treated with the therapy of tonifying Kidney,dissolving phlegm and removing blood stasis.Hemorheology,homocysteine(Hcy),neurotransmitter levels,the scores of ADL,MMSE,ADAS-cog and FCA were compared between the two groups after the treatment.Results:The scores of FCA,ADL and MMSE,and the levels of 5-HT,NE and DA were higher(P<0.05),whereas the score of ADAS-cog and the levels of hematocrit,plasma viscosity,whole blood viscosity,fibrinogen and Hcy were lower in the observation group than those in the control group after two weeks and after four weeks of the treatment(P<0.05).Conclusion:The method of tonifying Kidney,dissolving phlegm and removing blood stasis can improve hemorheology and Hcy,and reduce neurological impairment for the patients with post-stroke cognitive dysfunction.