Size-dependent Biological Effects on Vascular Endothelial Cells Induced by Different Particulate Matters

Summary： The contribution of particles to cardiovascular mortality and morbidity has been enlightened by epidemiologic and experimental studies. However, adverse biological effects of the particles with different sizes on cardiovascular cells have not been well recognized. In this study, sub-cultured human umbilical vein endothelial cells （HUVECs） were exposed to increasing concentrations of pure quartz particles （DQ） of three sizes （DQPM1, 〈1 μm; DQPM3-5, 3-5 μm; DQPM5, 5 μm） and carbon black particles of two sizes （CB0.1, 〈0.1 μm; CB 1, 〈 1 μm） for 24 h. Cytotoxicity was estimated by measuring the activity of lactate dehydrogenase （LDH） and cell viability. Nitric oxide （NO） generation and cyto- kines （TNF-α and IL-1β） releases were analyzed by using NO assay and enzyme-linked immunoabsorbent assay （ELISA）, respectively. It was found that both particles induced adverse biological effects on HUVECs in a dose-dependent manner. The size of particle directly influenced the biological activity. For quartz, the smaller particles induced stronger cytotoxicity and higher levels of cytokine responses than those particles of big size. For carbon black particles, CB0.1 was more capable of inducing adverse responses on HUVECs than CB 1 only at lower particle concentrations, in contrast to those at higher concentrations. Meanwhile, our data also revealed that quartz particles performed stronger cell damage and produced higher levels of TNF-α than carbon black particles, even if particles size was similar. In conclusion, particle size as well as particle composition should be both considered in assessing vascular endothelial cells injury and inflammation responses induced by particles.

Kongsheng Zhenzhong pill's effect on the learning and memory ability and its neuroprotective effects in vascular dementia rats

Clinical reports have demonstrated that the Kongsheng Zhenzhong pill （KSZZP）, a classical prescription deriving from Valuable Prescription for Emergencies, has good therapeutic effects on vascular dementia. However, the mechanisms that mediate its effects remain unclear. In this study, the expression of N-methyI-D-aspartate receptor 1 mRNA, the content of nitric oxide, and the concentration of calcium in neurons was determined with in situ hybridization, spectrophotometry and flow cytometry, respectively. In addition, the expressions of N-methyI-D-aspartate receptor 1, nerve growth factor protein, and glial cell line-derived neurotrophic factor protein were detected with immunohistochemistry. We found that KSZZP could significantly decrease the expression of N-methyI-D-aspartate receptor 1 mRNA and protein, the content of nitric oxide, and the concentration of calcium in neurons. KSZZP also increased the expression of nerve growth factor and glial cell line-derived neurotrophic factor protein in the hippocampus CA1 region and in the cerebral cortex. Morris water maze and passive avoidance tests verified that KSZZP ameliorated the cognitive impairments of vascular dementia rats. Moreover, the KSZZP-induced improvements in the cognitive functions of vascular dementia rats were correlated with both inhibition of N-methyl-D-aspartate-induced excitable neurotoxicity and elevation of neurotrophic factor expression.

Protective effects of sodium ferulate in vascular endothelial function during cardiopulmonary bypass

Objective Cardiopulmonary bypass (CPB) and its related ischemia reperfusion injury may cause endothelial cell injury. To study the protective effects of sodium ferulate in vascular endothelial function during CPB by testing the changes of vascular endothelial cell(CEC) ,nitric oxide(NO) and endothelin-1 (ET-1) in children with congenital heart disease. Methods Sixty patients

Observation of curative effects of human growth factor on vascular dementia

Objective To explore the treatment effect of human growth factor(NGF)on vascular dementia.Method47cases with vascular dementia were randomly div ided into two groups(study and control).The study group(24cases)were treated with NGF,the control group(23cases)were treated with ordinary medicines.Results The intelligence and cognitive abil ity in the study group were obviously higher than those in the control group(P <0.01).Conclusion Compared with other methods,NGF has a significant curative effect.

Clinical Study on Effect of Yuantong Capsule in Treating Vascular Dementia

Objective: To observe the clinical effect of Yuantong Capsule (YTC) in treating vascular dementia (VD). Methods: Eighty-three patients of VD were randomized on ratio of 2 : 1 into two groups, the 54 patients in the treated group were treated with YTC orally administered, 3 times a

Experimental study of the effect of adipose stromal vascular fraction cells on the survival rate of fat transplantation

Objective To investigate the effect of adipose stromal vascular fraction cells(SVFs)on the survival rate of fat ransplantation.Methods 0.5mL autologous fat tissue was mixed with: ① DiI-labeled autologous SVFs (Group A);②

Glycosylation-independent binding to extracellular domains 11-13 of mannose-6-phosphate/insulin-like growth factor-2 receptor mediates the effects of soluble CREG on the phenotypic proliferation of vascular smooth muscle cells

Background The present study aimed to investigate the detailed mode and specific sites for their binding as well as the functional relevance of this binding in the phenotypic proliferation of vascular smooth muscle cells(SMCs). Methods CREG knocked-down SMCs were employed to evaluate the biological activity of wtCREG and mCREG.Expressions of SMC differentiation markers SM myosin heavy chain(SM-MHC),SM-actin,heavy caldesmon and myocardin were determined by Western blotting using specific antibodies. Cellular growth of SMCs was assessed by bromide dewuridine (BrdU) incorporation and cell cycle analysis on fluorescence-activated cell sorting(FACS).A solid-phase binding assay was used to study the binding of CREG to extracellular domains of M6P/IGF2R.The cellular co-localization of the two recombinant CREGs with M6P/IGF2R was detected on SMC surface by immunoprecipitation and immunofluorescence analysis.Results The molecular weight of wtCREG was around 30 kD while that of the mCREG was～25 kD.Treatment of wtCREG with PNGase F reduced its molecular weight from～30 kD to～25 kD,whereas PNGase F treatment had no effect on the molecular weight of mCREG.Both wtCREG and mCREG proteins enhanced SMC differentiation,inhibited BrdU incorporation,and arrested cell cycle progression when added to the culture medium.In CREG knocked-down SMCs,the amount of CREG detected by immunoblotting in M6P/IGF2R immunoprecipitates was significantly reduced when compared to normal cells.Both recombinant CREGs co-immunoprecipitated with M6P/IGF2R, although slightly reduced amount of the mutant CREG was detected in M6P/IGF2R immunoprecipitates.Immunostaining revealed that His-tagged CREGs co-localized with IGF2R on the cell surface in a glycosylation-independent manner.In vitro binding assay showed that CREGs bound to M6P/ IGF2R extracellular domains 7-10 and 11-13 in a glycosylation -dependent and -independent manner,respectively.Further blocking experiments using soluble M6P/IGF2R fragments and M6P/IGF2R neutralizing antibody indicated that the biological activities of recombinant CREGs in SMC growth and the up-regulation of SMC differentiation markers were all abolished by treatment with the M6P/IGF2R neutralizing antibody. However,although the growth inhibitory effect of wtCREG was nearly abolished by D7-10 or D11-13,the effect of mCREG was only reversed by Dll-13,indicating that the binding to domains 11-13 is required for CREG to modulate the proliferation of SMCs.Conclusions These data suggest that solubleCREG proteins can exert their biological function via binding to the extracellular domains 7-10 and 11-13 of cell surface M6P/IGF2R in both a glycosylation-dependent and -independent manner.

Effects of caffeic acid phenethyl ester on proliferation of vascular smooth muscle cells in rats

Objective： To investigate the inhibitory effect of caffeic acid phenethyl ester（CAPE） on the proliferation of vascular smooth muscle cells （VSMC） activated by lipopolysaccharide （LPS） and to clarify its mechanism. Methods： VSMC activated by LPS （1 mg-L^-1） were treated with CAPE at different concentrations. The inhibitory effecfs of CAPE on the proliferation of VSMC were determined by methabenzthiazuron（MTT） colorimetry. The effects of CAPE on the expression of proliferating cell nuclear antigen （PCNA） and Survivin protein in VSMC were evaluated by immunocytochemistry staining technique （SABC method）. Cell cycle was analyzed by flow cytometry（FCM） with propidiumiodide （PI） labeling method. The relative expression level of Survivin mRNA was measured with real-time quantified RT-PCR technique. Results. CAPE exerted significant inhibitory effects on. proliferation of VSMC at concentrations ranging from 5 mg·L^-1 to 80 mg·L^-1, decreased the rate of cells positive for PCNA and Survivin protein and repressed the expressioh of Survivin mRNA in a dose- and time-dependent manner （P 〈 0.05）. FCM analysis displayed that CAPE up-regulated the ratio of G0/G1 stages and reduced the percentage of VSMC in S stage （P 〈 0.05）. Conclusion： CAPE can significantly inhibit the proliferation of VSMC activated by LPS in a dose- and time-dependent manner, which may be carded out through regulating cell cycle and repressing the expression of PCNA and Survivin.

Advances of Study on Recombinant Vascular Endothelial Growth Factor

血管内皮生长因子 (Vascularendothelialgrowthfactor,VEGF)是 1 989年Ferrara等在牛垂体滤泡星状细胞体外培养液中首先纯化出来的。到目前为止已经发现了六个VEGF异构体 ,包括VEGF1 2 1 ,VEGF1 45,VEGF1 6 5,VEGF1 83 ,VEGF1 89,VEGF2 0 6。已经发现高亲和力的VEGF受体有两类 ,分别为Flt 1 (Fms liketyrosinekinase)和KDR(kinasedomainregion)。重点介绍了VEGF两个方面的应用前景。一方面用于治疗下肢缺血和心脏病 。

A new cerebroside and its anti-proliferation effect on VSMCs from the radix of Cyperus rotundus L.

A new cerebroside,1-O-(β-D-glucopyranosyloxy)-(2S,3R,4E,8Z)-2-[(2′R)-2’-hydroxylignoceranoylamino]-4,8-tetradecene-3- diol was isolated from the 60%EtOH extract of traditional Chinese medical plant Cyperus rotundus L.Its structure was determined on the basis of spectroscopic data.This new compound showed anti-proliferation effect on vascular smooth muscle cells(VSMCs).

血管栓塞介入治疗脑动脉瘤的临床效果及其对并发症发生率的影响分析

目的:研究分析血管栓塞介入治疗脑动脉瘤的临床效果及对并发症发生率的影响。方法:选取2018年1月—2022年1月样本医院接诊的100例脑动脉瘤患者作为研究对象,按照治疗方法将其分为实验组和对照组,每组各50例,实验组选择血管栓塞介入治疗,对照组选择开颅夹闭的手术治疗形式。对比两组患者住院情况、手术的时间、并发症及预后情况。结果:实验组患者住院时间和手术治疗时间均短于对照组,差异有统计学意义(t=4.939、11.839,P<0.05);实验组患者并发症发生率明显少于对照组,差异有统计学意义(χ^(2)=7.162,P<0.05);使用Glasgow评分评价预后,实验组患者预后优秀率高于对照组,差异有统计学意义(χ^(2)=9.091,P<0.05)。结论:使用血管栓塞介入治疗脑动脉瘤效果较好,可改善患者预后、降低并发症、缩短住院时间和手术时间。

芪苈强心胶囊对慢性心力衰竭的临床研究

目的观察芪苈强心胶囊治疗慢性心力衰竭患者的临床疗效。方法选择2021年10月—2022年10月在医院心血管内科住院治疗的120例慢性心力衰竭患者作为研究对象,按照不同治疗方法将患者平均分为常规治疗组和芪苈强心组,各组60例,常规治疗组患者予以西医常规治疗,芪苈强心组患者同时予以芪苈强心胶囊治疗。观察两组患者临床效果和不良反应,比较干预前后临床症状、心功能、血流动力学以及血管内皮功能变化。结果常规治疗组和芪苈强心组的总有效率分别为78.33%(47/60)、91.67%(55/60),芪苈强心组的总有效率相较于常规治疗组明显上升(P<0.05)。干预前,两组患者的中医证候积分水平无明显差异(P>0.05)。干预8周后,芪苈强心组患者的心悸、气短、乏力以及下肢水肿等证候积分水均明显下降(P<0.01)。干预8周后,芪苈强心组患者的左室射血分数(left ventricular e⁃jection fractions,LVEF)相较于常规治疗组明显升高,而左心室收缩末期内径(left ventricular end-systolic dimension,LVESD)和左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)水平则明显降低(P<0.01);与常规治疗组比较,芪苈强心组患者的血管内皮生长因子(vascular endothelial growth factor,VEGF)和一氧化氮(nitric oxide,NO)水平明显升高,而血浆内皮素-1(endothelin-1,ET-1)水平则明显下降(P<0.01)。干预8周后,与常规治疗组比较,芪苈强心组患者的CI、SV和CO水平均明显升高(P<0.01);与常规治疗组比较,芪苈强心组患者的6 min步行试验(6MWT)水平明显升高,而明尼苏达生活质量评分(MLHFQ)评分水平则明显下降(P<0.01)。两组患者干预过程中生命体征平稳,主要不良反应有恶心呕吐、消化不良、眩晕乏力等,两组总不良反应发生率分别为8.33%(5/60)和11.67%(7/60),差异不具有统计学意义(P>0.05)。结论芪苈强心胶囊联合西医常规治疗能够明显提高慢性心力衰竭患者的临床疗效,改善心功能和心力衰竭症状,调节血流动力学,保护血管内皮功能,且无不良反应增加,提高患者生活质量。

水蛭治疗脑小血管病所致认知功能障碍的疗效分析

目的探究水蛭饮片治疗脑小血管病(Cerebral Small Vessel Disease,CSVD)所致认知障碍患者的临床疗效。方法方便选取2020年10月—2023年6月广西壮族自治区民族医院神经内科收治的120例CSVD所致认知障碍患者为研究对象,以随机数表法分为对照组和观察组,各60例。对照组实施内科常规西药基础治疗,观察组在对照组治疗基础上增加中药水蛭口服治疗。观察并对比两组的治疗结果。结果治疗后与对照组相比,观察组最小量认知评估量表(Mini Mental State Examination,MMSE)评分、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分更高,差异有统计学意义(P均<0.05)。观察组临床治疗有效率(86.67%)显著高于对照组(71.67%),差异有统计学意义(χ^(2)=4.093,P<0.05)。治疗后与对照组相比,观察组的白细胞介素-6(Interleukin-6,IL-6)和超敏-C反应蛋白(High Sensitive C-reactive Protein,hs-CRP)水平更低,差异有统计学意义(P均<0.05)。结论水蛭能有效减轻CSVD所致认知障碍患者的临床症状,改善患者的认知功能障碍。

球囊压迫术与微血管减压术治疗原发性三叉神经痛的对比研究

目的:比较球囊压迫术(percutaneous balloon compression,PBC)与微血管减压术(microvascular decompression,MVD)治疗原发性三叉神经痛(primary trigeminal neuralgia,PTN)的临床疗效。方法:选取2018年7月至2020年12月在江西省人民医院接受住院治疗的119例PTN病人,其中接受MVD手术66例(MVD组),接受PBC手术53例(PBC组),并进行了至少2年的随访。每例病人在术前接受3.0 Tesla磁共振成像,以获得三维飞行时间序列(3D-TOF)。之后按照MRI的检查结果,通过3DSlicer软件对所有纳入研究的病人进行三维重建,并按照压迫程度分为I、II、III型,将其与性别、年龄、侧别、发病区域、是否有糖尿病、高血压、发病时长一起纳入MVD和PBC的术后COX比例风险回归模型进行多因素风险分析。通过ROC曲线验证风险因素与预后的相关性,对PTN病人进行亚组分析,根据COX回归模型和Kaplan-Meier曲线评估预后结果。结果:MVD组的立即缓解率为92.4%,复发率为11.5%,3年内总体缓解率为81.8%;PBC组的立即缓解率为96.2%,复发率为21.6%,3年内总体缓解率为75.5%;通过卡方检验比较,发现MVD和PBC在术后立即缓解率、复发率、3年内总体缓解率上差异均无统计学意义。MVD的多因素COX回归模型提示:血管压迫程度与MVD的预后明显相关;PBC的多因素COX回归模型结果显示:血管压迫程度与PBC的预后无关。基于血管压迫程度对PTN病人进行亚组分析,COX回归模型和Kaplan-Meier曲线结果显示:对于I型(无明确血管压迫)PTN病人来说,MVD和PBC的预后无明显差异,对于II+III型(有明确血管压迫)PTN病人来说,MVD的预后优于PBC。结论:血管压迫程度对上述两种手术方式所取得的手术效果有影响,对于I型PTN病人而言,PBC与MVD的术后无明显差异;对于II+III型PTN病人而言,MVD的预后明显优于PBC,对于不同病人的手术方式选择,血管压迫程度是一个重要因素。

CLINICAL OBSERVATION ON COMBINED TREATMENT OF VASCULAR DEMENTIA WITH ACUPUNCTURE, MOXIBUSTION AND CHINESE MEDICINAL HERBS

In the present study, the clinical effect of acupuncture, moxibustion plus Chinese medicinal herbs for treatment of 30 cases of vascular dementia (VD) was observed and their mechanisms were analyzed by determining the activity of SOD, LPO and GSH-Px. Results showed that after 2 months’combined treatment, of the 30 cases, 12 had marked improvement, 15 had improvement and 3 had not any improvement, with an effective rate of 90%; the activity of SOD and GSH-Px increased considerably while the content of LPO lowered strikingly. There were significant differences between pre-and post-treatment in the activity of SOD and GSH-Px and the content of LPO (P<0. 01). It reveals that this method is capable of improving VD patients’ clinical symptoms and signs such as headache, dizziness, hemi-paralysis or hemianesthesia, forced crying and laughing, etc.and also raising the ability of the body in removing oxygen free radical, and suppressing peroxidization of free radical to reduce its products, thereby alleviating the toxic effect of oxygen free radical on the brain tissues.

谷胱甘肽联合西地那非治疗勃起功能障碍患者临床疗效及对血管内皮功能的影响

目的探究谷胱甘肽联合西地那非治疗勃起功能障碍(ED)患者临床疗效及对血管内皮功能、炎性因子、勃起功能的影响。方法选取2022年10月—2023年10月新疆维吾尔自治区人民医院泌尿中心诊治ED患者89例作为研究对象,随机数字表法分为单药组44例和联合组45例。单药组给予西地那非口服治疗,联合组在单药组基础上给予还原型谷胱甘肽片口服治疗,2组患者均连续治疗1个月。观察2组患者治疗前、治疗结束时及治疗后1个月的血管内皮功能(NO、ET、VEGF、ES)、炎性因子(hs-CRP、IL-6、IL-8、IL-10)、勃起功能(IIEF-5、QEQ、EHS、PSV)变化,比较2组临床疗效、不良事件发生率。结果治疗结束后1个月,联合组临床治疗总有效率为91.11%,高于单药组的75.00%(χ^(2)/P=4.121/0.042);治疗结束时及治疗结束后1个月,联合组患者血清NO、VEGF水平显著高于单药组,ET水平显著低于单药组(治疗结束时:t/P=5.323/<0.001,3.808/<0.001,3.683/<0.001;治疗结束后1个月:t/P=2.615/0.011,3.197/0.002,3.089/0.003);血清hs-CRP、IL-6水平显著低于单药组(治疗结束时:t/P=8.323/<0.001,2.364/0.020;治疗结束后1个月:t/P=6.787/<0.001,2.662/0.009);IIEF-5、QEQ、EHS及PSV均显著高于治疗前,其中EHS及PSV也显著高于单药组(治疗结束时:t/P=6.410/<0.001,4.066/<0.001;治疗结束后1个月:t/P=8.928/<0.001,4.532/<0.001);2组患者不良事件发生率比较差异无统计学意义(P>0.05)。结论谷胱甘肽联合西地那非能够有效改善ED患者血管内皮功能及勃起功能,同时显著降低患者炎性因子水平,且对于ED患者具有显著临床疗效及安全性。

注射用阿替普酶对不同血清非对称性二甲基精氨酸水平急性脑梗死患者的治疗效果

目的 分析注射用阿替普酶对不同血清非对称性二甲基精氨酸(ADMA)水平的急性脑梗死患者治疗效果。方法 选取2021年5月至2023年5月河北北方学院附属第一医院收治的106例急性脑梗死患者,以ADMA水平0.883μmol/L为临界值,将ADMA>0.883μmol/L的52例患者作为高表达组,ADMA≤0.883μmol/L的54例患者作为低表达组。2组患者均给予降低颅内压、保护神经、改善循环和调节血压等基础治疗,同时给予注射用阿替普酶0.9 mg/kg, 2组患者均在治疗2周后进行效果评价。检测和比较2组患者神经因子、炎症因子、纤溶功能、血管内皮功能指标、血液流变学指标、改良Rankin量表、美国国立卫生研究院卒中量表评分和临床疗效。结果 治疗后2组患者髓鞘碱性蛋白、中枢神经特异蛋白、神经元特异性烯醇化酶、高敏C反应蛋白、白细胞介素1β、肿瘤坏死因子α、Ⅰ型纤溶酶原激活抑制物、P-选择素、血管性血友病因子、内皮素1、低切全血黏度、高切全血黏度、血浆黏度水平和改良Rankin量表、美国国立卫生研究院卒中量表评分均低于治疗前,但高表达组均高于低表达组,差异均有统计学意义(均P<0.05)。治疗后2组患者组织型纤溶酶原激活物和一氧化氮水平均高于治疗前,但高表达组均低于低表达组,差异均有统计学意义(均P<0.05)。高表达组总有效率低于低表达组[78.8%(41/52)比92.6%(50/54)],差异有统计学意义(χ2=4.121,P=0.042)。多因素Logistic回归分析结果表明髓鞘碱性蛋白、中枢神经特异蛋白、神经元特异性烯醇化酶、Ⅰ型纤溶酶原激活抑制物、P-选择素、血管性血友病因子、低切全血黏度、高切全血黏度、血浆黏度、一氧化氮和内皮素1均是不同ADMA水平的急性脑梗死患者治疗效果的主要危险因素(均P=0.001)。结论 急性脑梗死患者采用注射用阿替普酶治疗后均取得较好效果,且ADMA低表达水平急性脑梗死患者治疗后神经功能、纤溶功能和血液流变学改善更为明显,炎症反应和血管内皮损伤较轻。

Vascular Trauma Registry Analysis in Sulaimani Province of Southern Kurdistan

Background: Vascular injury presents a great challenge to the trauma and vascular surgeons because it needs urgent diagnosis and intervention. Aims: Prospective cohort study is to determine management and outcome of peripheral vascular injuries in a tertiary centre with very poor facilities. Methods: Analysis of peripheral vascular injuries during August 2013 to August 2014. Results: Total of 47 patients (3.4%) from 1377 total trauma admissions had vascular injuries. Penetrating trauma was present in 93.6% of cases. Brachial artery injury was the highest (31.9%), followed by superficial femoral and popliteal arteries (each with 17% incidence). Vein injury occurred in 61.7% of cases. End-to-end anastomosis performed in 76.6% of cases;arterial ligation was done in 14.9% of cases;venous graft was harvested in 6.4% of cases;and arterial wall was repaired in 2.1% of cases. Conclusions: Early intervention is the most important determinant factor of outcome.

人工真皮治疗创伤创面疗效评估及真皮血管化影响因素

目的评估人工真皮治疗创伤创面临床疗效及探析人工真皮血管化时间的影响因素。方法采用前瞻性研究方法,纳入佛山市中医院修复重建外科2020年1月至2023年5月收治的创伤致全层皮肤缺损患者130例作为研究对象,评估人工真皮治疗的临床效果;采用单因素方差分析、多重线性回归分析人工真皮血管化的影响因素。结果130例患者创面均愈合良好,有效率100%,人工真皮血管化时间平均为(14.36±2.40)d。多重线性回归分析结果显示,人工真皮血管化时间的影响因素包括年龄、吸烟、糖尿病及术前Bates-Jensen伤口评估工具(BWAT)得分(P<0.05)。结论人工真皮治疗创伤创面疗效明确,年龄、吸烟、糖尿病及术前BWAT得分是人工真皮血管化时间的重要影响因素。在临床工作中,留意高龄患者,劝解患者戒烟、控制饮食、养成良好的生活习惯,对不同患者实施针对性措施以促进人工真皮修复患者创面快速愈合。

涤痰汤加味方对血管性痴呆认知功能、相关炎性指标的改善及影响

目的观察涤痰汤加味方对血管性痴呆(vascular dementia, VaD或VD)患者认知功能、相关炎性指标的改善及影响作用。方法选择2020年11月—2022年11月于医院脑科住院治疗的符合纳排标准100例VD患者为研究对象,随机分为常规治疗组和联合组,各组50例,常规治疗组予以基础治疗的同时口服尼莫地平片,联合组在此基础上口服涤痰汤加味方治疗。比较两组患者的临床疗效和不良反应,以及治疗前后认知功能、血脂水平、炎症水平变化,评价涤痰汤加味方治疗VD临床疗效和作用机制。结果常规治疗组的总有效率为80.00%(40/50),联合组的总有效率为94.00%(47/50),联合组的总有效率明显优于常规治疗组(P<0.05)。干预前两组患者的认知功能和日常生活能力差异无统计学意义(P>0.05)。干预3个疗程后,联合组患者的简易精神状态检查量表(mini-mental state examinatio, MMSE)评分、痴呆简易筛查量表(brief screening scale for dementia, BSSD)评分以及日常生活能力评定量表(activities of daily living, ADL)评分水平相较于常规治疗组均明显升高;且联合组患者的血清脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)、神经生长因子(nerve growth factor, NGF)水平相较于常规治疗组明显升高,而同型半胱氨酸(homocysteine, Hcy)水平则明显下降(P<0.01)。干预前两组患者的血脂水平差异无统计学意义(P>0.05)。干预3个疗程后,与常规治疗组比较,联合组患者的甘油三酯(triglycerides, TG)、总胆固醇(total cholesterol, TC)以及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)水平均明显降低,而高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)水平明显升高(P<0.01,P<0.05);联合组患者血清C反应蛋白(C-reactive protein, CRP)、白细胞介素-6(interleukin-6,IL-6)以及肿瘤坏死因子(tumor necrosis factor, TNF)-α水平均明显降低(P<0.01,P<0.05)。结论涤痰汤加味方联合西医常规治疗能够改善VD患者认知功能,降低血脂水平,提高治疗效果,分析其机制与保护神经营养因子及抑制机体炎症反应有关,患者不良反应无明显增加,适宜推广。