参乌益智胶囊治疗肾精亏虚型卒中后轻度认知障碍临床疗效观察

Clinical efficacy of Shenwu Yizhi Capsule in treating mild cognitive impairment after stroke with kidney essence deficiency type

[目的]观察参乌益智胶囊治疗肾精亏虚型轻度卒中后认知障碍(PSMCI)临床疗效及对血清炎症因子、脑部血流情况的影响。[方法]纳入2022年9月—2023年3月共96例肾精亏虚型PSMCI患者,按随机数字表法分为对照组和治疗组,各48例。两组均给予控制血压、血糖等基础治疗,在此基础上,对照组采用尼莫地平片治疗,治疗组予以参乌益智胶囊联合尼莫地平片治疗。两组均治疗8周,比较两组治疗前后简易精神状态评估量表(MMSE)、蒙特利尔认知检查量表(MoCA),日常生活能力量表(ADL)、中医证候积分量表评分、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、超敏c反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)含量、脑动脉血流平均流速(Vm)和不良反应差异。[结果]治疗后,治疗组总有效率89.58%(43/48),对照组总有效率为66.67%(32/48),治疗组疗效明显优于对照组(P<0.05);两组治疗后MMSE评分、MoCA评分,ADL评分均上升(P<0.01),中医证候总积分下降(P<0.01);治疗组上述评分均优于对照组(P<0.05);治疗后,治疗组血清炎症因子IL-6、TNF-α、hs-CRP、Hcy水平明显低于对照组(P<0.05)。治疗后治疗组大脑前动脉(ACA)、大脑中动脉(MCA)、椎动脉(VA)的血流速度明显增加(P<0.05)。[结论]参乌益智胶囊可降低炎症因子水平,提高血流速度良性增加脑部灌流,显著改善肾精亏虚型轻度卒中后认知障碍患者的临床症状,提高患者记忆和认知功能,改善生存质量。

[Objective] Observation on the clinical efficacy of Shenwu Yizhi Capsules in the treatment of post-stroke mild cognitive impairment(PSMCI) of kidney essence deficiency type and its effect on serum inflammatory factor and cerebral blood flow condition. [Methods] Ninety-six patients with renal essence deficiency type PSMCI were included from September 2022 to March 2023,and were divided into a control group and a treatment group of 48 cases each according to the randomized numerical table method. Both groups were given basic treatments such as controlling blood pressure and blood glucose,on the basis of which,the control group was treated with nimodipine tablets,and the treatment group was treated with Shenwu Yizhi Capsules combined with nimodipine tablets. Both groups were treated for 8 weeks. The scores of mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),ability to perform activities of daily living(ADL),traditional Chinese medicine evidence points scale,IL-6,TNF-α,hs-CRP,Hcy,average cerebral arterial flow velocity,and the difference of adverse effects were compared between the two groups before and after treatment. [Results] After treatment,the total effective rate was 89.58%(43/48) in the treatment group and 66.67%(32/48) in the control group. The curative effect of the treatment group was significantly better than that of the control group(P<0.05). After treatment,MMSE score. MoCA score and ADL score of the two groups increased(P<0.01). The total score of traditional Chinese medicine syndrome decreased(P<0.01). The above scores of the treatment group were better than those of the control group(P<0.05). The levels of serum inflammatory factors IL-6,TNF-α,hs-CRP and Hcy in the treatment group were lower than those in the control group(P<0.05) after treatment. Compared with the control group,the blood flow velocity of the anterior cerebral artery(ACA),middle cerebral artery(MCA),and vertebral artery(VA) of the treatment group was significantly increased after treatment(P<0.05). [Conclusion] Shenwu Yizhi Capsules can reduce the level of inflammatory factors,improve blood flow rate benignly increase cerebral perfusion,significantly improve the clinical symptoms of patients with mild post-stroke cognitive impairment in the kidney essence deficiency type,improve the memory and cognitive function of the patients,and improve their quality of life.