益气活血法在脑小血管病认知障碍患者中的临床应用

Clinical application of supplementing Qi and activating blood in patients with cognitive impairment due to cerebral small vessel disease

目的 探究利用补阳还五汤进行益气活血法治疗脑小血管病认知障碍患者的临床疗效,观察患者认知功能、注意力、执行能力和炎性因子水平的变化。方法 选取2022年2月—2023年5月浙江中医药大学附属温州市中医院收治的脑小血管病认知障碍患者60例,采用随机数表法分为2组,对照组(30例)给予多奈哌齐片治疗,观察组(30例)在对照组治疗方案的基础上给予补阳还五汤进行益气活血法治疗。通过蒙特利尔认知评估量表(MoCA)、数字符号转换测验量表(DSST)和连线测验(TMT)评价患者的认知功能、注意力和执行功能,比较2组患者炎性因子水平[血同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)]。结果 与治疗前比较,治疗后2组患者MoCA、DSST评分显著升高(均P<0.05),且观察组的MoCA、DSST评分显著高于对照组(均P<0.05);与治疗前比较,治疗后2组患者TMT耗时显著下降(均P<0.05),且观察组的TMT耗时[TMT-A:(71.10±10.44)s;TMT-B:(222.63±30.84)s]显著低于对照组[TMT-A:(77.63±12.44)s;TMT-B:(241.53±38.03)s,均P<0.05];与治疗前比较,治疗后2组患者Hcy和hs-CRP水平显著降低(均P<0.05),且观察组Hcy和hs-CRP显著低于对照组(均P<0.05)。结论 益气活血法可显著提高脑小血管病认知障碍患者的认知功能、注意力和执行功能,并降低患者的炎性因子水平。

Objective The purpose of this study was to investigate the clinical effect of qi-supplementation and blood-activation therapy with Buyang Huanwu Decoction in the treatment of patients with cognitive impairment due to cerebral small vessel disease,focusing on the effects on cognitive function,attention,executive function and inflammatory factors.Methods A total of 60 patients with cerebral small vessel disease and cognitive impairment admitted to Wenzhou TCM Hospital of Zhejiang Chinese Medical University from February 2022 to May 2023 were selected.The random number table method was used in two groups.The control group(30 cases)was treated with donepezil tablets,and the observation group(30 cases)was treated with Buyang Huanwu decoction for qi-supplementation and blood-activation on the basis of the treatment scheme of the control group.The patients'cognitive function,attention and executive function were assessed by using Montreal cognitive assessment scale(MoCA),the digit symbol substitution test(DSST)and the trail making test(TMT).Levels of inflammatory factors[blood homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP)]were compared between the two groups.Results Compared before treatment,the MoCA and DSST scores in both groups were significantly increased after treatment(all P<0.05),and the MoCA and DSST scores in the observation group were significantly higher than those in the control group(all P<0.05).Compared with before treatment,the TMT time in both groups decreased significantly after treatment(all P<0.05),and the TMT time in the observation group[TMT-A:(71.10±10.44)s;TMT-B:(222.63±30.84)s]was significantly lower than that in the control group[TMT-A:(77.63±12.44)s;TMT-B:(241.53±38.03)s,all P<0.05].After treatment,the levels of Hcy and hs-CRP in both groups were significantly lower than those before treatment(all P<0.05),and Hcy and hs-CRP in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion Supplemening Qi and activating blood circulation can significantly improve the cognitive function and executive function of patients with cognitive impairment due to cerebral small vessel disease,and reduce the level of inflammatory factors in patients.