| 摘要: |
| 目的：观察醒神健脑方治疗非痴呆性血管性认知障碍（VCIND）伴高同型半胱氨酸血症（Hcy）的临床疗效。方法：将60例VCIND伴Hcy患者随机分成2组，每组各30 例。对照组予对症治疗，治疗组在其基础上加用醒神健脑方治疗，共治疗8周。比较2组患者治疗前、治疗4周和治疗8周的简易精神状态量表（MMSE）、蒙特利尔认知评估(MoCA)、临床痴呆评定表(CDR)、日常生活自理能力量表(ADL)评分及血浆同型半胱氨酸（Hcy）、中医证候积分。结果：治疗组MMSE、MoCA、CDR、ADL、Hcy、中医证候总积分治疗前后组内比较，差异均有统计学意义（P<0.05或P<0.01）；对照组仅ADL、Hcy治疗前后组内比较，差异有统计学意义（P<0.01）。治疗组治疗8周后MMSE、CDR、ADL、中医证候总积分与对照组比较，及治疗4周后、治疗8周后MoCA、Hcy与对照组比较，差异均有统计学意义（P<0.01或P<0.05）；治疗组治疗后中医证候积分中，思维呆滞、善忘无记、语言紊乱、性情改变、腰膝酸软、头晕耳鸣、肢体困重、唇甲紫暗、二便等均优于对照组（P<0.01或P<0.05）。结论：醒神健脑方可提高VCIND患者的认知功能和日常生活能力，其机制与降低高Hcy对血管的危害、减轻氧化应激反应对血管和神经元的损伤，进而改善脑部供血有关。 |
| 关键词: 非痴呆性血管性认知障碍 高同型半胱氨酸血症 中医药疗法 醒神健脑方 |
| DOI： |
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| Clinical effect of Xingshen Jiannao prescription in treatment of vascular cognitive impairment-no dementia with hyperhomocysteinemia：An analysis of 30 cases |
| GUO Yankui,JIA Yunyun,LU Wenwen |
| (Jinan Municipal Hospital of Traditional Chinese Medicine，Jinan 250012，Shandong，China;Linyi Traditional Chinese Medical Hospital,Linyi 276003) |
| Abstract: |
| Objective：To investigate the clinical effect of Xingshen Jiannao prescription in the treatment of vascular cognitive impairment-no dementia (VCIND) with hyperhomocysteinemia.Methods：A total of 60 patients with VCIND and hyperhomocysteinemia were randomly divided into treatment group and control group，with 30 patients in each group.The patients in the control group were given symptomatic treatment，and those in the treatment group were given Xingshen Jiannao prescription in addition to the treatment in the control group；the course of treatment was 8 weeks for both groups.The two groups were compared in terms of Mini-Mental State Examination (MMSE) score，Montreal Cognitive Assessment (MoCA) score，Clinical Dementia Rating (CDR) score，Activities of Daily Living (ADL) score，plasma homocysteine (Hcy) level，and traditional Chinese medicine (TCM) syndrome score before treatment and at weeks 4 and 8 of treatment.Results：After treatment，the treatment group had significant changes in MMSE，MoCA，CDR，ADL，Hcy，and total TCM syndrome score (P<0.05 or P<0.01)，while the control group only had significant changes in ADL and Hcy (P<0.01).After 8 weeks of treatment，there were significant differences in MMSE，CDR，ADL，and total TCM syndrome score between the treatment group and the control group，and after 4 and 8 weeks of treatment，there were significant differences in MoCA and Hcy between the two groups (P<0.01 or P<0.05).Compared with the control group after treatment，the treatment group had significantly greater improvements in the TCM syndrome scores of dull thinking，amnesia，language disorder，change in temperament，soreness and weakness of the waist and knees，dizziness and tinnitus，heavy limbs，cyanosis of lips and nails，and urination/defecation (P<0.01 or P<0.05).Conclusion：Xingshen Jiannao prescription can improve cognitive function and activities of daily living in patients with VCIND，possibly by reducing the harm of high Hcy to blood vessels，alleviating the damage of blood vessels and neurons caused by oxidative stress response，and thus improving the blood supply to the brain. |
| Key words: vascular cognitive impairment of non-dementia Hyperhomocysteinemia Traditional Chinese medicine treatment Xingshen Jiannao prescription |
