五脏温阳化瘀汤治疗肾阳虚衰兼痰瘀型血管性痴呆的临床疗效观察
发布时间：2019-01-05 13:37
【摘要】：目的:通过对五脏温阳化瘀汤治疗肾阳虚衰兼痰瘀型血管性痴呆(vascular dementia,VaD)临床疗效的观察,并探讨其部分作用机制,从而为本方治疗VaD的临床应用打下坚实基础。方法:将符合VaD诊断72例患者采用随机对照试验的设计方法,分为中药治疗组(37例)和西药对照组(35例)。治疗组予五脏温阳化瘀方水煎剂口服,对照组予尼莫地平片口服,治疗周期60天,观察两组患者治疗前后的认知功能积分,日常生活能力积分、中医症候积分及脑神经递质水平的变化情况,并对药物的安全性和临床疗效进行评价。结果:(1)临床疗效比较:治疗组与对照组的总有效率分别是89.19%和80%。两组患者总有效率相比有显著差异(P0.05)。说明五脏温阳化瘀汤对VaD患者的治疗总疗效优于尼莫地平片;(2)MMSE积分和ADL积分比较:治疗组和对照组治疗后,MMSE积分和ADL积分均有不同程度提高,两组治疗前后组内比较均有显著差异(P0.05),提示两组患者认知功能、日常生活能力明显改善。治疗后,治疗组的MMSE积分和ADL积分与对照组比较有明显差异(P0.05),说明五脏温阳化瘀方在改善VaD患者的认知功能及日常生活能力方面优于尼莫地平片;(3)中医证候积分比较:临床试验后两组中医证候在形寒肢冷、肥胖、下利清谷、舌淡、脉沉或迟等症上,治疗组优于对照组,有统计学差异(P0.05),从而说明在治疗后五脏温阳化瘀汤对肾阳虚衰兼痰瘀型VaD患者的中医症候改善上优于尼莫地平片;(4)脑内神经递质变化情况比较:脑神经递质在两组间进行比较,在Ach、DA、NE等递质方面,治疗组优于对照组,有显著差异(P0.05),从而说明五脏温阳化瘀汤对肾阳虚衰兼痰瘀型VaD患者的脑内神经递质改善上优于尼莫地平片。结论:通过分析两组治疗前后MMSE积分、ADL积分、中医证候积分的观察,说明五脏温阳化瘀汤对肾阳虚衰兼痰瘀型VaD患者的疗效优于尼莫地平胶囊,作用机制可能与改善Ach、DA、NE等脑内递质含量有关。并且本方无明显毒副作用,具有较好的临床应用价值。
[Abstract]:Objective: to observe the clinical effect of Wuzangwenyang Huayu decoction in treating vascular dementia (vascular dementia,VaD) with deficiency of kidney yang and phlegm stasis, and to explore its mechanism, so as to lay a solid foundation for its clinical application in the treatment of VaD. Methods: 72 patients diagnosed by VaD were divided into Chinese medicine treatment group (37 cases) and western medicine control group (35 cases) by randomized controlled trial. The treatment group was treated with Wuzangwenyang Huayu decoction and the control group was treated with nimodipine tablets for 60 days. The cognitive and daily life scores of the two groups were observed before and after treatment. The changes of TCM symptom score and the level of brain neurotransmitters, and the safety and clinical efficacy of drugs were evaluated. Results: (1) comparison of clinical efficacy: the total effective rates of treatment group and control group were 89.19% and 80% respectively. There was significant difference in the total effective rate between the two groups (P0.05). It shows that the total curative effect of Wuzangwenyang Huayu decoction on VaD patients is better than that of nimodipine tablet. (2) comparison of MMSE integral and ADL integral: after treatment, MMSE score and ADL score increased in different degree in the treatment group and control group, and there were significant differences between the two groups before and after treatment (P0.05), which indicated that the cognitive function of the two groups was higher than that of the control group. The ability of daily life has improved markedly. After treatment, the MMSE scores and ADL scores in the treatment group were significantly different from those in the control group (P0.05), indicating that Wuzangwenyang Huayu recipe was superior to nimodipine tablets in improving the cognitive function and daily living ability of VaD patients. (3) comparison of TCM syndromes integral: after clinical trial, the two groups of TCM syndromes were superior to the control group (P0.05). It shows that after the treatment of Wuzangwenyang Huayu decoction for kidney yang deficiency and phlegm stasis type of VaD patients improve the traditional Chinese medicine symptoms better than nimodipine tablets; (4) comparison of the changes of neurotransmitters in brain: compared between the two groups, the treatment group was superior to the control group in terms of Ach,DA,NE and other neurotransmitters (P0.05). The results showed that Wuzang Wenyang Huayu decoction was superior to Nimodipine tablets in improving neurotransmitters in brain of VaD patients with deficiency of kidney yang and phlegm stasis. Conclusion: by analyzing the observation of MMSE integral, ADL integral and TCM syndrome integral before and after treatment, it is concluded that Wuzangwenyang Huayu decoction is superior to nimodipine capsule in treating VaD patients with deficiency of kidney yang and phlegm stasis, and the mechanism may be related to the improvement of Ach,DA,. The content of NE and other transmitters in brain is related. And this prescription has no obvious side effects, and has good clinical application value.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7
本文编号：2401841
[Abstract]:Objective: to observe the clinical effect of Wuzangwenyang Huayu decoction in treating vascular dementia (vascular dementia,VaD) with deficiency of kidney yang and phlegm stasis, and to explore its mechanism, so as to lay a solid foundation for its clinical application in the treatment of VaD. Methods: 72 patients diagnosed by VaD were divided into Chinese medicine treatment group (37 cases) and western medicine control group (35 cases) by randomized controlled trial. The treatment group was treated with Wuzangwenyang Huayu decoction and the control group was treated with nimodipine tablets for 60 days. The cognitive and daily life scores of the two groups were observed before and after treatment. The changes of TCM symptom score and the level of brain neurotransmitters, and the safety and clinical efficacy of drugs were evaluated. Results: (1) comparison of clinical efficacy: the total effective rates of treatment group and control group were 89.19% and 80% respectively. There was significant difference in the total effective rate between the two groups (P0.05). It shows that the total curative effect of Wuzangwenyang Huayu decoction on VaD patients is better than that of nimodipine tablet. (2) comparison of MMSE integral and ADL integral: after treatment, MMSE score and ADL score increased in different degree in the treatment group and control group, and there were significant differences between the two groups before and after treatment (P0.05), which indicated that the cognitive function of the two groups was higher than that of the control group. The ability of daily life has improved markedly. After treatment, the MMSE scores and ADL scores in the treatment group were significantly different from those in the control group (P0.05), indicating that Wuzangwenyang Huayu recipe was superior to nimodipine tablets in improving the cognitive function and daily living ability of VaD patients. (3) comparison of TCM syndromes integral: after clinical trial, the two groups of TCM syndromes were superior to the control group (P0.05). It shows that after the treatment of Wuzangwenyang Huayu decoction for kidney yang deficiency and phlegm stasis type of VaD patients improve the traditional Chinese medicine symptoms better than nimodipine tablets; (4) comparison of the changes of neurotransmitters in brain: compared between the two groups, the treatment group was superior to the control group in terms of Ach,DA,NE and other neurotransmitters (P0.05). The results showed that Wuzang Wenyang Huayu decoction was superior to Nimodipine tablets in improving neurotransmitters in brain of VaD patients with deficiency of kidney yang and phlegm stasis. Conclusion: by analyzing the observation of MMSE integral, ADL integral and TCM syndrome integral before and after treatment, it is concluded that Wuzangwenyang Huayu decoction is superior to nimodipine capsule in treating VaD patients with deficiency of kidney yang and phlegm stasis, and the mechanism may be related to the improvement of Ach,DA,. The content of NE and other transmitters in brain is related. And this prescription has no obvious side effects, and has good clinical application value.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7
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