The emerging role of nitric oxide in the synaptic dysfunction of vascular dementia

With an increase in global aging,the number of people affected by cerebrovascular diseases is also increasing,and the incidence of vascular dementia-closely related to cerebrovascular risk-is increasing at an epidemic rate.However,few therapeutic options exist that can markedly improve the cognitive impairment and prognosis of vascular dementia patients.Similarly in Alzheimer’s disease and other neurological disorders,synaptic dysfunction is recognized as the main reason for cognitive decline.Nitric oxide is one of the ubiquitous gaseous cellular messengers involved in multiple physiological and pathological processes of the central nervous system.Recently,nitric oxide has been implicated in regulating synaptic plasticity and plays an important role in the pathogenesis of vascular dementia.This review introduces in detail the emerging role of nitric oxide in physiological and pathological states of vascular dementia and summarizes the diverse effects of nitric oxide on different aspects of synaptic dysfunction,neuroinflammation,oxidative stress,and blood-brain barrier dysfunction that underlie the progress of vascular dementia.Additionally,we propose that targeting the nitric oxide-sGC-cGMP pathway using certain specific approaches may provide a novel therapeutic strategy for vascular dementia.

Clinical Observation on Acupuncture Treatment of Cerebrovascular Dementia——A Report of 32 Cases

Cerebrovascular dementia is a common disease in the middle-aged and old people. Its incidence makes up about 10-20% of all kinds of dementia. It is mainly caused by general degeneration of the brain function resulted from cerebral arteriosclerosis and cerebral infarction. The author has treated 32 cases of cerebrovascular dementia with acupuncture in the recent years with satisfactory therapeutic results. A report follows.

Clinical Study on Treatment of Senile Vascular Dementia by Acupuncture

63 patients with senile vascular dementia were randomly divided into the treatment group (treated by acupuncture) and the control group (treated with piracetam). The authors observed the changes in the score of Hasegawa's dementia scale (HDS), p300, rheoencephalogram, topographic EEG, superoxide dismutase (SOD) activity in erythrocytes, and lipid peroxide (LPO) level in plasma before and after treatment. The statistical data showed that the total effective rate in the treatment group (80.6%) was significantly higher than that in the control group (25%), and the differences in the observed indexes before and after treatment were significant (P 0.05), indicating that the acupuncture treatment was superior in immediate therapeutic effect on senile vascular dementia to drug treatment.

CLINICAL STUDY ON TREATMENT OF VASCULAR DEMENTIA WITH ELECTROACUPUNCTURE OF "SISHENCHONG

Aim: To observe the therapeutic effect of electroacupuncture (EA) in the treatment of vascular dementia. Methods: A total of 46 cases of vascular dementia (VD) patients were divided into 3 classes according to the scores of the revised Hasegawa dementia scale (HDS), and then randomized into EA group (n=23) and medication (Nimodipine) group (n=23). The acupoints used were "Zhisanzhen" [Shenting (GV 24) and bilateral Benshen (GB 13)] and Sishenchong (EX HN 1) etc.. Scores of HDS, ability of daily life (ADL), neurofunctional defect and main symptoms were used as the indexes for assessing the therapeutic effect. Results: Following treatment, scores of HDS and ADL of two groups increased significantly, while those of neurofunctional defect and main symptoms decreased evidently (P<0.01), and the therapeutic effect of EA was obviously superior to that of medication (P<0.01). Conclusion: EA of "Zhisanzhen" and Sishenchong (EX HN 1) is a good approach for treatment of VD.

A COMPARATIVE STUDY ON THE TREATMENT OF VASCULAR DEMENTIA BY PUNCTURING BAIHUI (GV20), SHUIGOU (GV26) AND SHENMEN (HT7)

Objective: To observe the relative specialty of the therapeutic effect of acupuncture of Baihui (百会 GV 20), Shuigou (水沟 GV 26) a nd Shenmen (神门 HT 7) in the treatment of vascular dementia (VD) patients. Methods: F ifty VD patients were randomly divided into routine treatment group (control gro up), Baihui (GV 20) group (GV 20 group), Shuigou (GV 26) group (GV 26 gr oup), Shenmen (HT 7) group (HT 7 group) a nd GV 20+GV 26+HT 7 group (joint treatment group), with 10 cases in ea ch group. In control group, acupoints used were Jianyu (肩NFDA1 LI 15), Quchi (曲池 L I 11), Waiguan (外关 TE 5), etc. (which were also used in the other four groups) on the paralyzed side. The treatment was conducted once a day except weekends, 20 session s all together. Clinical Dementia Rating Scale (CDR), Mini-Mental State Examin at ion (MMSE) test, Blessed Dementia Rating Scale (BDR) and Clinical Neurological D eficit Rating (CNDR) were used to assess the patients’ intelligence state befor e and after acupuncture treatment. Results: After acupuncture tr eatment, the VD patients’ intelligence in all the five groups was improved at different degrees . Additional acupuncture of each of GV 20, GV 26 and HT 7 had a remarkable e ffec t in improving the VD patients’ fluid intelligence, and could obviously promote their abilities of temporal orientation, spatial orientation and figure drawing ; and additional joint acupuncture of the three acupoints could improve their co gnitive and non-cognitive functions, such as reducing the severity of dementia , raising the temporal orientation, spatial orientation, calculation, short-term m emory and figure drawing abilities, and improving their activities of daily livi ng and personality. Besides, acupuncture of GV 20 could improve the abilities of calculation and short term memory, and correct the personality change of VD pat ients, while acupuncture of GV 26 could improve the abilities of naming and sh or t-term memory. Conclusion: Acupuncture of GV 20, GV 26 and HT 7 all had a certai n therapeutic effect in improving VD; the therapeutic effects of acupuncture of GV 20 and GV 26 were better than that of acupuncture of HT 7; and the effica cy of the three points used in combination was the best.

Moxibustion therapy improving delayed memory deficits via promoting neurogenesis and angiogenesis of hippocampus in a vascular dementia rat model

Objective:To investigate the alteration of delayed memory and its relationship with neurogenesis and angiogenesis in vascular dementia(VD)rats after moxibustion therapy.Methods:Two hundred adult male SPF Wistar rats were chosen for the experiment.Thirty-six rats were randomly selected as the sham operation group.Except for rats in the sham operation group(n=36),the others were made into VD models by bilateral comm on carotid arteries occlusi on(BCCAo).After modeli ng,the 108 survived rats were ran domly divided into 3 groups:a model group,a neural stem cells(NSCs)plus endothelial progenitor cells(EPCs)moxibustion group and a NSCs moxibustion group.Co-transplanted implant was transplanted into the rats in the NSCs plus EPCs moxibustion group,and the rats in the NSCs moxibustion group were transplanted by NSCs only.The NSCs plus EPCs moxibustion group and the NSCs moxibustion group received suspended moxibustion therapy at Baihui(GV 20),Dazhui(GV 14)and Shenting(GV 24),(each group was divided into 3 subgroups by the treatment course as 1,2 and 3 courses).Every group was measured by Morris water maze to evaluate its delayed memory after 3 treatment courses and the rat's brain was taken out after perfusion of 4%paraformaldehyde one day after 1,2 and 3 treatment courses,respectively.Marker protein expression was detected by laser con focal microscope to an a lyze the effect on neuroge nesis and an gioge nesis.Results:VD rats showed delayed memory in Morris water maze test 3 d after ischemic injury.After 3 courses of moxibustion therapy,VD-induced delayed memory deficits were improved in the NSCs plus EPCs moxibustion group and the NSCs moxibustion group.The expressions of nestin,doublecortin(DCX)and CD34 increased significantly in the two moxibusiton groups after every treatment course(all P<0.05),which might contribute to the neurogenesis and angiogenesis in hippocampus.In addition,compared with the rats in the NSCs moxibustion group,the expressions of nestin,DCX and CD34 increased significantly in the NSCs plus EPCs moxibustion group(P<0.05).Conclusion:Moxibustion can reverse VD-induced delayed memory deficits,which may be related to the promotion of neurogenesis and angiogenesis.

Therapeutic efficacy and mechanism of heat-sensitive moxibustion for vascular dementia

Objective:To observe the clinical efficacy of heat-sensitive moxibustion for vascular dementia and explore its mechanism.Methods:A total of 70 patients with vascular dementia were randomized into an observation group and a control group,with 35 cases in each group.The control group was treated with piracetam,and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment of the control group.The treatment lasted for 8 weeks.Before and after the treatment,the mini-mental state examination(MMSE),activity of daily living(ADL)and traditional Chinese medicine(TCM)symptom scores were assessed,and the levels of acetyl choline(Ach)and homocysteine(Hcy)were measured.The efficacy was evaluated after treatment.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the MMSE and ADL scores in the observation group decreased significantly,and were lower than those in the control group(all P<0.05);the TCM symptom score of the observation group decreased significantly(P<0.05),while that of the control group had no significant change(P>0.05);the plasma Ach level in the observation group increased significantly(P<0.05),and the Hcy level decreased significantly(P<0.05),which were statistically different from those in the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus piracetam is effective in treating vascular dementia.It can significantly improve dementia symptoms and ADL,which may be related to the correction of plasma Ach and Hcy levels.

Clinical Study on Treatment of Vascular Dementia with Scalp Acupuncture

Objective： To explore a treatment method for vascular dementia. Methods： Sixty patients were randomly allocated into two groups. The observation group was treated with long-term needle-retaining method of scalp acupuncture and the control group was treated by medications. Evaluation was made respectively before and after the treatment by means of Hasegawa dementia scale （HDS）, neurological function deficit （NFD） score and main symptom （MS） score. Results： There were statistically significant differences in HDS, NFD score and MS score in both groups （P〈0.01） before and after the treatment. There were statistically significant differences in HDS, NFD score and MS score between the two groups （P〈0.05） before and after the treatment. The total effective rate was 86.8% in the observation group and 80.0% in the control group. There was a statistically significant difference in the effects between the two groups （P〈0.05）. Conclusion： This long-term needle-retaining method of scalp acupuncture is precisely effective for vascular dementia.

Effects of electroacupuncture of different frequencies on free radicals in hippocampus of mice with vascular dementia

Objective:To observe the effects of electroacupuncture (EA) of three different frequencies (2 Hz,80 Hz and 2 Hz/80 Hz) on the free radicals in hippocampus of vascular dementia (VD) model mice.Methods:A total of 100 Kunming mice were randomly divided into a sham operation group,a model group,a 2 Hz EA group,an 80 Hz EA group and a 2 Hz/80 Hz EA group,with 20 mice in each group.The ischemia-reperfusion VD model was established by repeated blockade of bilateral common carotid arteries.Mice in EA groups began EA treatment on the 4th day after the operation.Baihui (GV 20),Dazhui (GV 14),Geshu (BL 17) and Zusanli (ST 36) were punctured and then connected to EA instrument,with different waves of 2 Hz,80 Hz or 2 Hz/80 Hz (10 min/time) applied accordingly,once a day.During the jumping stand experiment,the learning performance,memory performance and hippocampal calcitonin gene-related peptide (CGRP),nitric oxide synthase (NOS),malondialdehyde (MDA),changes in superoxide dismutase (SOD) and true choline esterase (TChE) were observed.In hippocampus,the CGRP level was determined by radioimmunoassay;the MDA level was determined by thiobarbituric acid colorimetric method;the activities of NOS and TChE were determined by spectrophotometry;the activity of SOD was determined by xanthine oxidase method.Results:Compared with the sham operation group,the performances of learning and memory decreased significantly in the model group (P＜0.01);in hippocampus,the CGRP level decreased,the MDA level increased,the activities of NOS and TChE increased,and the activity of SOD decreased in the model group.Compared with the model group,the learning and memory performances of the EA groups were significantly improved (P＜0.05 or P＜0.01);in hippocampus,the CGRP level increased,the MDA level decreased,the NOS and TChE activities decreased,and the SOD activity increased (P＜0.05 or P＜0.01).Among EA groups,the 2 Hz/80 Hz EA group was superior to the 2 Hz EA group and the 80 Hz EA group (P＜0.05 or P＜0.01).Conclusion:EA can improve the cognitive impairment of mice with ischemia-reperfusion VD.The mechanism may be related to the improvement of cerebral blood circulation,regulation of the central neurotransmitters,fighting lipid peroxidation and promoting nerve cell repair.The therapeutic effects of EA with different frequencies were different,and the intervention effect by EA at 2 Hz/80Hz is the most significant.

Effect of Electroacupuncture on Learning and Memory in Rats with Vascular Dementia

Objective：To observe the effect of electroacupuncture on learning and memory in rats with vascular dementia.Methods：Seventy-two SD rats were randomly divided into 4 groups,a normal group,a sham operation group,a model group and an electroacupuncture （EA） pretreatment group.Modified intraluminal embolism method with nylon thread was applied to make rat model of vascular dementia,and the ability of learning and memory was observed in Morris water maze.Results：The average time of escape and latency in the rats of model group in the water maze test was prolonged,with significant difference compared with that in the sham group （P〈0.01）.The average time of escape and latency and navigation test results of rats pretreated by EA had statistically significant difference compared with those of the model group （P〈0.01）.Conclusion：EA pretreatment can significantly improve the ability of learning and memory of the rats with vascular dementia.

Effects of electroacupuncture with different frequencies on hippocampal neuronal apoptosis and JNK signaling pathway in rats with vascular dementia

Objective:To observe the effects of electroacupuncture(EA)with three frequencies(100 Hz,2 Hz,and 2 Hz/100 Hz)on the apoptosis of neurons and c-Jun N-terminal kinase(JNK)signaling pathway in the hippocampus of rats with vascular dementia(VD),and explore the mechanism of EA intervention for VD.Methods:Fifty male Sprague-Dawley rats were randomly divided into a model group,a sham operation group,a 100 Hz EA group,a 2 Hz EA group,and a 2 Hz/100 Hz EA group,with ten rats in each group.The VD model rats were established by repeated ischemia-reperfusion of bilateral common carotid arteries.The rats in the EA groups received EA intervention at Baihui(GV20),Dazhui(GV14),Geshu(BL17)and Zusanli(ST36),once a day for 14 d.Afterward,Morris water maze was used to examine the learning and memory performances of the rats in each group,hematoxylin-eosin staining to observe the histomorphological changes in the hippocampal CA1 region,terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling to test the apoptosis of neurons in the hippocampal CA1 region,and Western blot to detect the protein expression levels of JNK,phosphorylated JNK(p-JNK),Caspase-8,and Caspase-3 in the hippocampus tissue.Results:Compared with the sham operation group,the escape latency of the model group in water maze test was prolonged;the number of crossing the original platform was decreased(P<0.01);the hippocampal neurons were severely damaged and the number of surviving neurons was decreased(P<0.01),whereas the number of apoptotic neurons was increased(P<0.01);the protein expression levels of JNK,p-JNK,Caspase-8,and Caspase-3 in the hippocampus were significantly increased(P<0.01).Compared with the model group,the escape latency of each EA group was significantly shortened;the number of crossing the original platform was significantly increased(P<0.01);the damage of hippocampal neurons was alleviated,the number of surviving neurons was increased(P<0.01),and the number of apoptotic neurons was decreased(P<0.01);the protein expression levels of JNK,p-JNK,Caspase-8,and Caspase-3 in the hippocampus were decreased(P<0.01).The results in the 2 Hz EA group and the 2 Hz/100 Hz EA group were superior to those in the 100 Hz EA group.Conclusion:EA with the three frequencies(100 Hz,2 Hz,and 2 Hz/100 Hz)can improve the learning and memory performances in VD rats subjected to ischemia-reperfusion,its mechanism may be related to the inhibition of neuronal apoptosis and the regulation of the related protein expression of JNK signaling pathway,and the intervention effects of EA with 2 Hz and 2 Hz/100 Hz are more significant.

Clinical Observation on 30 Cases of Vascular Dementia Treated by Acupuncture plus Kidney-Reinforcing Herbal Preparation

Objective： To investigate the therapeutic effect of acupuncture plus herbal medicine on vascular dementia （VD）. Methods： Thirty cases of vascular dementia were treated by acupuncture plus Chinese herbal medicine for 2 months, in comparison with western medication （Nimodipine） in the control group, to observe the evaluation value of Hasegawa Dementia Scale （HDS） before and after the treatments between the two groups, the clinical therapeutic effect and changes of plasma atrial natriuretic peptide （ANP） before and after the treatments between the two groups. Results and Conclusion： There were significant differences in intelligence and therapeutic effect between the two groups （P〈0.01） before and after the treatment, but the therapeutic effect was better in the acupuncture plus medicine group than in the western medication group. Judging from content of atrial natriuretic peptide, there was no significant difference between VD patients and normal adults before the treatment （P〉0.05）. Plasma ANP significantly increased in the acupuncture plus medicine group and western medicine group after the treatment （P〈0.01）, more remarkably in the acupuncture plus medicine group （P〈0.01）.

Therapeutic Efficacy Observation on Scalp Acupuncture for Vascular Dementia

Objective：To observe the clinical efficacy of scalp-acupuncture-based therapy for vascular dementia.Methods：Eighty patients with vascular dementia were randomly allocated into 3 groups by the visiting order,27 cases in the scalp acupuncture group were treated with needling scalp stimulation areas;25 cases in the body acupuncture group were treated with body acupoints;28 cases in the control group were given Duxil for oral administration.Themini-mental state examination （MMSE） and Barthel index （BI） were used to evaluate the differences between before and after treatments.Results：The total effective rate in the scalp acupuncture group was 92%,versus 89% in the body acupuncture group and 83% in the control group,showing a statistical significance （P0.01）.After the treatments,the MMSE and BI scores showed significant differences in all three groups （P0.01）.After the treatment,the MMSE and BI scores in the scalp acupuncture and body acupuncture groups showed statistical significances compared with the control group （P0.05）.There was also a statistical significance between the scalp acupuncture group and body acupuncture group （P0.05）.Conclusion：Scalp-acupuncture-based therapy can substantially improve MMSE and BI scores and thus obtain a more remarkable effect for vascular dementia.

Extraordinary Vessels Needling for Vascular Dementia

Purpose To observe the clinical efficacy of extraordinary vessels needling in treating vascular dementia.Method 39 cases vascular dementia were treated by acupoints selected from the eight extraordinary meridians and the time needling techniques such as eight methods of spiritual turtle, in accordance with time period and pattern identifition.Results 2 cases were cured, 30 cases improved and 7 cases failed; the total effective rate was 82.1%.Conclusion Extraordinary vessels needling has positive effects in treating vascular dementia. Key Words Dementia, Vascular - Acupuncture Therapy - Chronotherapeutics - Eight extra-meridians Foundation Item: Natural Science Fund of Guangdong Province (960548)Author: YU Jin (1972-), female, lecture and attending physicianTranslator: XIAO Yuan-chun

Clinical Observation of Vascular Dementia Treated by Surrounding-acupuncture of the CT-located Area

Purpose To observe the clinical effect of “Surrounding Needling Technigue through CT Location” in treating vascular dementia.Method Fifty cases of vascular dementia were randomly divided into surrounding Needling Technigue through CT location and routine acupuncture groups, 25 cases in each group, and were given surrounding Needling Technigue through CT location and routine acupuncture respectively.Results The effective rates in surrounding Needling Technigue through CT location and routine acupuncture groups were 88% and 60% respectively, and there was significant difference between the two groups,P<0.01.Conclusion Therapeutic effect of surrounding Needling Technigue through CT location in treating vascular dementia was satisfactory, and better than that of routine acupuncture. Key Words Acupuncture Therapy - Dementia, Vascular - Tomography, X-ray Computed Foundation Item: Scientific Fundation of Guangdong TCM BureauAuthor: Lun Xin(1964-), male, associate professor

经颅重复针刺对血管性痴呆模型大鼠认知功能及海马突触超微结构的影响

目的 观察经颅重复针刺对血管性痴呆(vascular dementia, VaD)大鼠认知功能及海马CA1区突触素(synaptophysin, SYN)、微管相关蛋白-2(microtubule associated protein-2, MAP-2)表达的影响。方法 将56只SD大鼠随机分为空白组(14只)和造模组(42只)。造模组建立VaD模型,将造模成功大鼠随机分为模型组(14只)、常规针刺组(14只)和经颅重复针刺刺激(repetitive transcranial acupuncture stimulation, rTAS)组(14只)。造模成功后第2天,rTAS组采用经颅重复针刺;常规针刺组仅给予常规针刺手法;模型组与空白组给予以同等条件抓取及固定,不予针刺。采用水迷宫评价大鼠学习记忆能力,采用旷场实验评价大鼠探索行为和自主活动能力,免疫印迹法检测海马CA1区SYP、MAP-2蛋白表达水平,透射电镜观察海马组织中突触超微结构。结果与空白组比较,模型组逃避潜伏时间明显增加(P<0.05),穿越平台次数明显减少(P<0.05);与模型组比较,常规针刺组与rTAS组逃避潜伏时间明显减少(P<0.05),穿越平台次数明显增加(P<0.05);与常规针刺组比较,rTAS组逃避潜伏时间与穿越平台次数改变不明显(P>0.05)。与空白组比较,模型组穿越格子数与后肢站立数明显减少(P<0.05);与模型组比较,常规针刺组与rTAS组穿越格子数与后肢站立数明显增加(P<0.05);与常规针刺组比较,rTAS组穿越格子数与后肢站立数明显增加(P<0.05)。与空白组比较,模型组SYP、MAP-2表达水平显著降低(P<0.05);与模型组比较,常规针刺组与rTAS组SYP、MAP-2表达水平显著增高(P<0.05);与常规针刺组比较,rTAS组SYP、MAP-2表达水平显著增高(P<0.05)。电镜下,模型组突触结构欠清晰,突触间隙模糊不清,突触小泡较少,突触前致密物质减少,胞浆内细胞器稀疏,线粒体变形肿大明显;而rTAS组突触结构较完整,突触间隙、突触前后膜分界清晰,突触前膜内囊泡较多,突触后膜均匀增厚,周边线粒体丰富、结构完整。结论 经颅重复针刺较常规针刺可能通过调控SYP、MAP-2表达,更有效促进突触再生,改善突触可塑性,修复受损神经元,从而改善认知功能。

理性情绪疗法联合中医情志干预对血管性痴呆患者焦虑抑郁症状的影响

目的观察理性情绪疗法联合中医情志干预对血管性痴呆患者焦虑抑郁症状的影响。方法将80例血管性痴呆患者按照随机数字表法分为2组,对照组40例予常规基础干预,观察组40例在对照组干预基础上采用理性情绪疗法联合中医情志干预,2组均干预4周。比较2组干预前后简易智能状态检查表(MMSE)、日常生活能力量表(ADL)、老年痴呆患者生活质量量表(QOL-AD)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分变化;比较2组干预满意度。结果2组干预后MMSE评分均较本组干预前升高(P<0.05),干预后观察组高于对照组(P<0.05)。2组干预后ADL评分均较本组干预前降低(P<0.05),QOL-AD评分均较本组干预前升高(P<0.05);干预后观察组ADL评分低于对照组(P<0.05),QOL-AD评分高于对照组(P<0.05)。2组干预后HAMD评分、HAMA评分均较本组干预前降低(P<0.05),干预后观察组HAMD评分、HAMA评分均低于对照组(P<0.05)。观察组各项满意度均高于对照组(P<0.05)。结论理性情绪疗法联合中医情志干预,能有效改善血管性痴呆患者心理状态和认知功能,提高其日常生活能力、生活质量和干预满意度。

基于《灵枢·本神》探讨从“心-脾-肾”轴论治血管性痴呆

血管性痴呆的发生发展,可责之于心、脾、肾三脏功能失调并相互干扰所诱发的神失所养、气血瘀滞、痰蒙清窍、阳亢风动等一系列病理变化;通过古方分析,探究调气活血、补益养神、祛痰开窍、平熄肝风等从“心-脾-肾”轴论治血管性痴呆的思路。

血管性痴呆的研究进展

血管性痴呆(VaD)是因脑卒中后大脑血液供应减少引起脑细胞缺血缺氧,从而出现严重认知功能障碍的疾病。VaD是一种可以预防的病症,但因其病因复杂、诊断困难的特点,使得其在神经科学和老年医学领域中占据较高的地位。目前在治疗上,现代医学主要采取口服多奈哌齐等药物控制血管性危险因素以及改善认知功能等(非)药物治疗方案;中医学则通过望闻问切达到对疾病的整体了解,并根据辨证论治对不同个体采取不同的中医特色治疗措施。文章对VaD发病相关因素、发病机制和中西医治疗方案进行综述。

温胆汤合半夏泻心汤治疗轻中度血管性痴呆临床观察

目的:观察温胆汤合半夏泻心汤治疗轻中度血管性痴呆患者的临床疗效。方法:选取轻中度血管性痴呆患者70例,随机分为两组各35例。两组患者均予基础治疗,对照组予盐酸多奈哌齐片治疗,治疗组予温胆汤合半夏泻心汤治疗,1个月为1个疗程,治疗3个疗程。比较两组患者的临床疗效以及治疗前后简易智能状态检查量表(MMSE)、日常生活能力量表(ADL)评分、中医证候积分及血清MMP水平。结果:治疗组临床总有效率88.57%,明显高于对照组的71.43%(P﹤0.05);治疗后两组MMSE评分均升高(P﹤0.05),且治疗组高于对照组(P﹤0.05);两组ADL评分、中医证候积分及血清MMP-2、MMP-9水平均降低(P﹤0.05),且治疗组降低程度较对照组更明显(P﹤0.05)。结论:温胆汤合半夏泻心汤治疗轻中度血管性痴呆患者疗效明显,可有效改善患者的认知功能和日常生活能力。