天麻钩藤饮联合依那普利叶酸片、维生素B12治疗血管性痴呆合并H型高血压患者的临床疗效分析

Clinical efficacy of Tianma Gouteng decoction combined with enalapfil maleate folate tablets and vitamin B12 in the treatment of vascular dementia with H-type hypertension

目的:探讨天麻钩藤饮联合依那普利叶酸片(Enalapfil maleate folate tablets,EMFT)、维生素B12(Vitamin B12,VB12)治疗血管性痴呆(Vascular dementia,VD)合并H型高血压(H-type hypertension,HHT)患者的临床疗效。方法:选取2019年2月至2022年3月我院收治的116例VD合并HHT患者作为研究对象,根据药物治疗方案不同,分为常规组和中药联合组,各58例。常规组采用EMFT、VB12进行常规治疗,中药联合组在常规组基础上增加温服天麻钩藤饮进行联合治疗。治疗3 m后,对比两组总有效率、认知功能、精神状态、舒张压、收缩压、血清同型半胱氨酸(Homocysteine,Hcy)、炎性因子和血管内皮功能指标。结果:治疗3 m后,中药联合组总有效率明显高于常规组(P<0.05);中药联合组蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)和简易智能精神状态检查量表(Mini-mental state examination,MMSE)评分、血清基质细胞衍生因子-1α(Stromal cell-derived factor-1α,SDF-1α)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平明显高于常规组(P<0.05),舒张压、收缩压、血清Hcy、白细胞介素-1β(Interleukin-1β,IL-1β)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)水平明显低于常规组(P<0.05)。结论:天麻钩藤饮联合EMFT、VB12治疗VD合并HHT患者可进一步提升疗效,调节血清Hcy及血压水平,减轻机体炎性反应,改善血管内皮功能,提高患者的认知功能及精神状态。

Objective:To explore the clinical efficacy of Tianma Gouteng decoction combined with enalapril malete folate tablets(EMFT)and Vitamin B12(VB12)in the treatment of vascular dementia(VD)with H-type hypertension(HHT).Methods:One hundred and sixteen patients with VD and HHT admitted to our hospital from Feb.2019 to Mar.2022 were collected as research objects.According to different drug treatment schemes,all patients were divided into the conventional group and the traditional Chinese medicine(TCM)combined group,58 cases in each group.The conventional group was treated with EMFT and VB12,while the TCM combined group was treated with warm clothing Tianma Gouteng decoction on the basis of the conventional group.After 3 months of treatment,the total effective rate,cognitive function,mental state,diastolic blood pressure,systolic blood pressure,serum level of homocysteine(Hcy),inflammatory factors,vascular endothelial function indexes were compared between the two groups.Results:After 3 months of treatment,the total effective rate in the TCM combined group was significantly higher than that in the conventional group(P<0.05);montreal cognitive assessment scale(MoCA),mini mental state examination(MMSE)scores,serum levels of stromal cell-derived factor-1α(SDF-1α)and vascular endothelial growth factor(VEGF)in the TCM combined group were significantly higher than those in the conventional group(P<0.05),diastolic blood pressure,systolic blood pressure,serum levels of Hcy,interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)were significantly lower than those in conventional group(P<0.05).Conclusion:Tianma Gouteng decoction combined with EMFT and VB12 in the treatment of VD with HHT can further improve the curative effect,regulate the serum level of Hcy and blood pressure,reduce the inflammatory reaction of the body,improve the vascular endothelial function,and improve the cognitive function and mental state of the patients.