补肾化痰祛瘀法治疗非痴呆性血管性认知障碍伴睡眠障碍临床观察

Clinical Observation on Method of Tonifying Kidney, Resolving Phlegm and Removing Blood Stasis in the Treatment of Non-demented Vascular Cognitive Impairment with Sleep Disorder

目的 观察补肾化痰祛瘀法对肾阴亏虚兼痰瘀阻窍型非痴呆性血管性认知障碍(VCIND)伴睡眠障碍患者的临床疗效。方法 将90例纳入患者随机分为对照组和治疗组,对照组予以支持治疗,治疗组加用醒神健脑方,疗程8周。分别评估简短精神状态量表(MMSE)、蒙特利尔认知评估(MOCA)、临床痴呆评定表(CDR)、匹兹堡睡眠质量指数量表(PSQI)、中医证型评分。结果治疗组MOCA评分在治疗4周、8周后均与对照组差异有统计学意义(P<0.05);MMSE评分在治疗8周后与对照组差异有统计学意义(P<0.05);CDR评分治疗前后差异有统计学意义(P<0.05);治疗组PSQI在治疗4周、8周后较治疗前有明显降低,与对照组差异有统计学意义(P<0.05);治疗组中医证型评分在治疗4周、8周后均较治疗前有明显降低,差异均具有统计学意义(P<0.05)。结论 补肾化痰祛瘀法可改善肾阴亏虚兼痰瘀阻窍型VCIND障碍伴睡眠障碍患者的认知功能和睡眠状况。

Objective To observe the clinical effect of method of to nifying kidney, resolving phlegm and removing blood stasis on non-demented vascular cognitive impairment(VCIND) with sleep disorder of deficiency of kidney-yin and obstruction of phlegm and blood stasis type. Methods 90 patients were randomly divided into control group and treatment group. The control group was treated with support therapy, while the treatment group was treated with Xingshen Jiannao prescription. The treatment course was eight weeks.Mini-mental state examination(MMSE), Montreal cognitive assessment(MOCA), clinical dementia rating scale(CDR), Pittsburgh Sleep Quality Index(PSQI) and TCM syndrome score were assessed. Results The MOCA score of the treatment group was significantly different from that of the control group after 4 and 8 weeks of treatment(P<0.05). After 8 weeks of treatment, the MMSE score was significantly different from that of the control group(P<0.05). There was significant difference in CDR score before and after treatment(P<0.05). The PSQI of the treatment group was significantly decreased after 4 and 8 weeks of treatment compared with that before treatment, and the difference was statistically significant(P<0.05). The TCM syndrome score of the treatment group was significantly decreased after 4 and 8 weeks of treatment compared with that before treatment, and the differences were statistically significant(P<0.05). Conclusion The method of tonifying kidney and resolving phlegm and removing blood stasis can improve the cognitive function and sleep status of the patients with VCIND disorder accompanied with sleep disorder.