七福饮合通窍活血汤对气血亏虚型血管性痴呆老年患者的治疗效果及其对神经功能、脑血流量的影响

Therapeutic effect of Qifuyin combined with Tongqihuoxue Decoction on elderly patients with vascular dementia due to deficiency of Qi and blood and its influence on nerve function and cerebral blood flow

目的:探究七福饮合通窍活血汤对气血亏虚型血管性痴呆(VD)老年患者的治疗效果及其对患者神经功能、脑血流量的影响。方法:选取80例气血亏虚型VD老年患者为研究对象,按照不同治疗方式分为观察组(n=41)和对照组(n=39)。观察组采用口服七福饮合通窍活血汤治疗;对照组采用口服尼麦角林片治疗。检测并比较两组患者治疗前后生理功能和认知能力等指标,并进行统计学分析。结果:观察组治疗总有效率高于对照组(P<0.05);治疗前后蒙特利尔认知评估量表(MoCA)差值均大于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,观察组中医证候(胸闷纳呆、舌黯淡、腰膝酸软及表情呆滞)评分均低于对照组(P<0.05);血管生成因子(VEGF)和脑源性神经营养因子(BDNF)及过氧化物酶(SOD)浓度均高于对照组(P<0.05),脑部超声检测结果脉动指数(PI)及大脑中动脉平均血流速度(Vm)均高于对照组(P<0.05)。结论:七福饮合通窍活血汤在气血亏虚型老年VD患者的治疗中具有良好的效果。七福饮合通窍活血汤能够通过改善患者脑血流量和神经系统功能,提高患者的认知能力。

Objective:To explore the therapeutic effect of Qifuyin combined with Tongqihuoxue Decoction on elderly patients with vascular dementia(VD)caused by Qi and blood deficiency,as well as the effect on nerve function and cerebral blood flow.Methods:80 elderly patients with Qi-blood deficiency VD were selected as the research subjects,and they were divided into observation group(n=41)and control group(n=39)according to different treatment methods.The observation group was treated with Qifu Decoction and Tongqiao Huoxue Decoction,and the control group was treated with niergoline tablet.The physiological function and cognitive ability indicators before and after treatment were detected and compared between the two groups,and statistical analysis was performed.Results:The total effective rate of observation group was higher than that of control group(P<0.05),the difference of Montreal Cognitive Assessment Scale(MoCA)before and after treatment was greater than that of control group(P<0.05),and the incidence of adverse reactions was not different(P>0.05).After treatment,the scores of TCM syndrome(chest tightness,dull tongue,waist and knee pain and dull expression)in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The concentrations of peripheral blood angiogenesis factor(VEGF),brain-derived neurotrophic factor(BDNF)and peroxidase(SOD)in the observation group were higher than those in the control group,and the pulsation index(PI)and mean blood flow velocity(Vm)of middle cerebral artery detected by brain ultrasound were higher than those in the control group(P<0.05).Conclusion:Qifu Decoction combined with Tongqiao Huoxue Decoction has a good effect in the treatment of elderly VD patients with Qi and blood deficiency.Qifu Decoction can improve cerebral blood flow,nervous system function and cognitive ability of patients.