补肾益智汤联合丁基苯酞对老年血管性痴呆血液流变学及自由基损伤的影响

发布时间：2018-07-20 15:47

【摘要】：目的:观察补肾益智汤联合丁基苯酞治疗老年血管性痴呆的临床疗效及对血液流变学、自由基损伤的影响。方法:将医院2013年1月—2015年1月收治的70例血管性痴呆患者按随机数字表分为研究组和对照组各35例,对照组患者单纯口服丁基苯肽0.2 g/次,3次/d,研究组在对照组的基础上再口服自拟补肾益智汤,3个月为1个疗程,治疗2个疗程,治疗前、治疗后3个月、治疗后6个月进行简易精神状态检查(MMSE-R)、韦氏记忆量表(WMS)、痴呆程度量表(CDR)、日常生活自理能力量表(ADL)评估及中医证候评分,治疗前、治疗后6个月空腹抽血进行血液流变学指标[全血高切黏度(HS)、全血低切黏度(LS)、血浆黏度(PV)、红细胞沉降率(ESR)]及超氧化物歧化酶(SOD)活性、丙二醛(MDA)检测,治疗结束后进行临床疗效评估。结果:研究组和对照组治疗后3个月、治疗后6个月的MMSE-R、WMS明显升高(P0.05),CDR、ADL明显降低(P0.05);组间比较,研究组治疗后6个月的MMSE-R、WMS明显高于对照组(P0.05),CDR、ADL明显低于对照组(P0.05)。研究组治疗后善忘、善误、神情恍惚、善恐易怒、头晕、耳鸣、失眠较治疗前明显改善(P0.05),且善忘、善误、神情恍惚、头晕、耳鸣、失眠的改善效果优于对照组(P0.05)。组内比较,研究组和对照组治疗后HS、LS、PV、ESR较治疗前明显降低(P0.05);组间比较,研究组治疗后HS、LS、PV、ESR明显低于对照组(P0.05)。研究组和对照组治疗后SOD明显高于治疗前(P0.05),MDA明显低于治疗前(P0.05);组间比较,研究组治疗后SOD明显高于对照组(P0.05),MDA明显低于对照组(P0.05)。研究组总有效率为77.14%,明显高于对照组48.57%(χ2=6.668,P0.05)。结论:自拟补肾益智汤联合丁基苯酞能够协同减轻自由基损伤,改善微循环,从而改善行为能力、认知功能、中医证候,值得临床推广使用。
[Abstract]:Objective: to observe the clinical effect of Bushen Yizhi decoction combined with Ding Ji phthalide in the treatment of senile vascular dementia and its effect on hemorheology and free radical injury. Methods: from January 2013 to January 2015, 70 patients with vascular dementia were randomly divided into study group (n = 35) and control group (n = 35). The patients in the control group were treated with Ding Ji phenylpeptide 0.2g / d for three times a day. The study group took the self-made Bushen Yizhi decoction again on the basis of the control group, 3 months as a course of treatment, 2 courses of treatment, 3 months before and 3 months after treatment. Six months after treatment, mini-mental state examination (MMSE-R), Wechsler memory scale (WMS), dementia degree scale (CDR), self-care ability in daily life (ADL) and TCM syndrome score were evaluated. The indexes of hemorheology [whole blood high shear viscosity (HS), whole blood low shear viscosity (LS), plasma viscosity (PV), erythrocyte sedimentation rate (ESR)], superoxide dismutase (SOD) activity and malondialdehyde (MDA) activity were measured 6 months after treatment. Clinical efficacy was evaluated after treatment. Results: after 3 months of treatment and 6 months after treatment, the MMSE-RN WMS in the study group and the control group were significantly increased (P0.05), and the levels of MMSE-RN WMS in the study group were significantly higher than those in the control group (P0.05) at 6 months after treatment (P0.05), and those in the study group were significantly lower than those in the control group (P0.05). After treatment, the study group was better than the control group (P0.05) in the improvement of good memory, good mistake, trance, fear easily irritability, dizziness, tinnitus and insomnia (P0.05), and the improvement effect of good memory, good mistake, trance, dizziness, tinnitus and insomnia was better than that of the control group (P0.05). Compared with the control group, the ESR of the study group and the control group was significantly lower than that of the control group after treatment (P0.05), and the ESR of the study group after treatment was significantly lower than that of the control group (P0.05). After treatment, SOD in study group and control group was significantly higher than that before treatment (P0.05) and MDA in study group was significantly lower than that before treatment (P0.05); after treatment, SOD in study group was significantly higher than that in control group (P0.05) and MDA in control group was significantly lower than that in control group (P0.05). The total effective rate of the study group was 77.14, which was significantly higher than that of the control group (48.57%, 蠂 2 6.668 P 0.05). Conclusion: Bushen Yizhi decoction combined with Ding Ji phthalide can reduce free radical damage, improve microcirculation, and improve behavioral ability, cognitive function and TCM syndromes, which is worth popularizing in clinic.
【作者单位】：莱芜市人民医院神经内科;
【基金】：莱芜市科学技术局项目([2013]第111号,[2014]第086号)
【分类号】：R749.13

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