补阳还五汤联合个体化认知训练对脑卒中后认知功能障碍及神经功能的影响

Effect of Buyang Huanwu Decoction combined with individual cognitive training on post-stroke cognitive dysfunction and neurological function

目的探讨经典方剂补阳还五汤联合个体化认知训练对脑卒中后认知功能障碍(PSCI)及神经功能的影响。方法选择2022年8月—2023年8月于延安大学附属医院康复医学科住院治疗的98例PSCI患者,使用随机数表法将患者分为对照组和治疗组,每组49例。对照组给予脑卒中后综合康复治疗,治疗组在对照组治疗基础上,进行个体化认知训练及对患者进行中医辨证,并以补阳还五汤为基础,加减辨治。比较2组患者治疗前后蒙特利尔认知评估量表(MoCA)、日常生活能力量表(ADL)、美国国立卫生院卒中量表(NIHSS)、简易精神状态检查表(MMSE)、非语言性神经心理测验量表(NLCA)评分。观察2组患者治疗过程中的药物不良反应率。结果治疗后,治疗组患者总有效率为95.92%(47/49),高于对照组[81.63%(40/49),χ^(2)=5.017,P=0.025]。治疗后,治疗组患者MoCA评分、ADL评分、MMSE评分、NLCA评分均高于对照组,NIHSS评分低于对照组,差异均有统计学意义(P<0.05)。2组不良反应发生率均为4.08%(2/49)。结论补阳还五汤联合个体化认知训练治疗PSCI患者,可显著增强患者认知功能效应,提升患者生活质量,且安全性高,可作为PSCI患者的良好治疗方案选择之一。

Objective To explore the effects of combing the classic formula Buyang Huanwu Decoction with personalized cognitive training on cognitive dysfunction and neurological function after stroke.Methods A total of 98 post stroke cognitive impairment(PSCI)patients were selected form those admitted to the Rehabilitation Medicine Department of Yan'an University Affiliated Hospital for treatment between August 2022 and August 2023.The patients were randomly divided into a control group and a treatment group using a random number table method,with 49 patients in each group.The control group received comprehensive rehabilitation treatment after stroke,while the treatment group received individualized cognitive training and traditional Chinese medicine syndrome differentiation on the basis of the control group's treatment.The treatment group also used Buyang Huanwu Decoction as the basis for modified syndrome differentiation.Compare the scores of Montreal cognitive assessment(MoCA),activities of daily living(ADL),National Institutes of Health stroke scale(NIHSS),mini mental state examination(MMSE),and nonverbal neuropsychiatric assessment(NLCA)between two groups of patients before and after treatment.Observe the incidence of adverse drug reactions in both patient groups during the treatment process.Results After treatment,the total effective rate of the treatment group was 95.92%(47/49),which was higher than that of the control group[81.63%(40/49),χ^(2)=5.017,P=0.025].Following treatment,the MoCA score,ADL score,MMSE score,and NLCA score of the treatment group were significantly higher than those of the control group,while the NIHSS score was lower than that of the control group(P<0.05).The incidence of adverse reactions in both groups was 4.08%(2/49).Conclusion The combination of Buyang Huanwu Decoction and personalized cognitive training can significantly enhance the cognitive function effect of PSCI patients,leading to a substantial improvement in their quality of life while ensuring high safety.Thus,it can be considered as a favorable treatment option for PSCI patients.