益肾活血中药联合多奈哌齐治疗脑梗死后记忆功能障碍的效果
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摘要
目的:评价益肾活血中药联合多奈哌齐治疗脑梗死后记忆功能障碍的效果。方法:按数字表法将笔者所在医院收治的84例脑梗死后记忆功能障碍患者分为对照组(42例,给予脑梗死西医常规治疗)及联合治疗组(42例,在对照组基础上加用益肾活血方联合多奈哌齐)。比较两组治疗后记忆量表评分、记忆商,中医证候积分,大脑动脉平均血流速度,血清MDA、SOD水平,临床疗效及不良反应等差异。结果:治疗后两组记图、再认、再生得分、总分及记忆商得分均高于治疗前,且联合治疗组治疗后记图、再认、再生、计数1-100、背数、总分及记忆商得分均高于对照组,差异均有统计学意义(P<0.05)。治疗后两组各项中医证候评分均低于治疗前,联合治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗后两组MCA、ACA、PCA和BA血流速度均优于治疗前,且联合治疗组明显优于对照组,差异均有统计学意义(P<0.05)。治疗后两组MDA水平均低于治疗前,SOD水平均高于治疗前,且联合治疗组MDA水平低于对照组,SOD水平高于对照组,差异均有统计学意义(P<0.05)。联合治疗组治疗总有效率(92.86%)高于对照组(71.43%),差异有统计学意义(P<0.05)。联合治疗组及对照组不良反应发生率分别为16.7%、26.2%,差异无统计学意义(P>0.05)。结论:益肾活血中药联合多奈哌齐是脑梗死后记忆功能障碍的安全、有效的治疗方法。
Objective:To investigate the efficacy of Yishen Huoxue Decoction combined with Donepezil on memory dysfunction after cerebral infarction.Method:According to the digital table method,84 patients with memory dysfunction after cerebral infarction were divided into control group(42 cases) treated with routine western medicine and Donepezil,and combined group(42 cases) treated with Yishenhuoxue Decoction combined with Donepezil on the basis of control group.The differences between memory scale score,memory quotient,TCM syndrome scores,mean blood flow velocity of cerebral arteries,serum MDA,SOD level,clinical efficacy and adverse reactions were compared between the two groups.Result:After treatment,the scores of map,recognition,regeneration,total score and memory quotient in the two groups were higher than those before treatment,and the scores of map,recognition,regeneration,count 1-100,back count,total score and memory quotient in the combined treatment group were significantly higher than those in the control group(P<0.05).After treatment,the scores of TCM syndromes in the two groups were lower than those before treatment,and those in the combined treatment group were lower than those in the control group(P<0.05).After treatment,the blood flow velocity of MCA,ACA,PCA and BA in the two groups was better than that before treatment,and the blood flow velocity in the combined treatment group was significantly better than that in the control group(P<0.05).After treatment,the level of MDA in both groups was lower than that before treatment,and the level of SOD was higher than that before treatment,and the level of MDA in the combined treatment group was lower than that of the control group,and the level of SOD was higher than that of the control group(P<0.05).The total effective rate of the combined treatment group(92.86%) was higher than 71.43% of the control group(P<0.05).The incidence of adverse reactions in the combined treatment group and the control group was 16.7% and 26.2%respectively,there was no significant difference(P>0.05).Conclusion:Yishenhuoxue Decoction combined with Donepezil is a safe and effective treatment for memory dysfunction after cerebral infarction..
Objective:To investigate the efficacy of Yishen Huoxue Decoction combined with Donepezil on memory dysfunction after cerebral infarction.Method:According to the digital table method,84 patients with memory dysfunction after cerebral infarction were divided into control group(42 cases) treated with routine western medicine and Donepezil,and combined group(42 cases) treated with Yishenhuoxue Decoction combined with Donepezil on the basis of control group.The differences between memory scale score,memory quotient,TCM syndrome scores,mean blood flow velocity of cerebral arteries,serum MDA,SOD level,clinical efficacy and adverse reactions were compared between the two groups.Result:After treatment,the scores of map,recognition,regeneration,total score and memory quotient in the two groups were higher than those before treatment,and the scores of map,recognition,regeneration,count 1-100,back count,total score and memory quotient in the combined treatment group were significantly higher than those in the control group(P<0.05).After treatment,the scores of TCM syndromes in the two groups were lower than those before treatment,and those in the combined treatment group were lower than those in the control group(P<0.05).After treatment,the blood flow velocity of MCA,ACA,PCA and BA in the two groups was better than that before treatment,and the blood flow velocity in the combined treatment group was significantly better than that in the control group(P<0.05).After treatment,the level of MDA in both groups was lower than that before treatment,and the level of SOD was higher than that before treatment,and the level of MDA in the combined treatment group was lower than that of the control group,and the level of SOD was higher than that of the control group(P<0.05).The total effective rate of the combined treatment group(92.86%) was higher than 71.43% of the control group(P<0.05).The incidence of adverse reactions in the combined treatment group and the control group was 16.7% and 26.2%respectively,there was no significant difference(P>0.05).Conclusion:Yishenhuoxue Decoction combined with Donepezil is a safe and effective treatment for memory dysfunction after cerebral infarction..
引文
[1]Wu L,Zhao Q S,Li T W,et al.Yifei Xuanfei Jiangzhuo formula,a Chinese herbal decoction,improves memory impairment through inhibiting apoptosis and enhancing PKA/CREB signal transduction in rats with cerebral ischemia/reperfusion[J].Mol Med Rep,2015,12(3):4273-4283.
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[6]中国中西医结合学会急救医学专业委员会.中国急性缺血性脑卒中中西医急诊诊治专家共识[J].中华危重病急救医学,2018,30(3):193(3):193-197.
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[8]Niwa F,Kondo M,Sakurada K,et al.Regional Cerebral Blood Flow in123I-IMP Single-photon Emission Computed Tomography and the Wechsler Memory Scale-revised in Nondemented Elderly Subjects with Subjective Cognitive Impairment[J].Intern Med,2016,55(24):3571-3578.
[9]国家中医药管理局脑病急症科研协作组.中风病中医诊断疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[10]Yu T S,Kim A,Kernie S G.Donepezil rescues spatial learning and memory deficits following traumatic brain injury independent of its effects on neurogenesis[J].Plos One,2015,10(2):e0118793.
[11]郭忠伟,陈杏丽.美金刚联合多奈哌齐治疗中重度阿尔茨海默病的研究[J].中华全科医学,2014,12(5):755-757.
[12]潘燕.益肾活血中药+多奈哌齐治疗脑梗死后记忆功能障碍疗效及对脑电位、氧化应激指标的影响[J].现代中西医结合杂志,2018,27(1):39-42.
[13]Kruk-Slomka M,Boguszewska-Czubara A,Slomka T,et al.Correlations between the Memory-Related Behavior and the Level of Oxidative Stress Biomarkers in the Mice Brain,Provoked by an Acute Administration of CB Receptor Ligands[J].Neural Plast,2015,2016:9815092.
[14]Li X L,Fan N X,Meng H Z,et al.Specific neuroprotective effects of manual stimulation of real acupoints versus non-acupoints in rats after middle cerebral artery occlusion[J].Afr J Tradit Complement Altern Med,2013,10(4):186-195.
[15]薛月芹.探讨益肾活血方联合电针穴位刺激对脑梗死后记忆功能障碍临床疗效及氧化应激指标的影响[J].中国医药科学,2018,8(13):39-43.
[2]Wu C X,Liu R,Gao M,et al.Pinocembrin protects brain against ischemia/reperfusion injury by attenuating endoplasmic reticulum stress induced apoptosis[J].Neurosci Lett,2013,546:57-62.
[3]Yu Q,Li X H,Jiang W,et al.Combined Effects of donepezil and Behavioral Training on Learning-Memory Ability and Event-Related Potential P300 in Rats with Mid/Advanced Cerebral Infarction[J].Chin Med J(Engl),2018,131(18):2172-2178.
[4]中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志,2011,44(2):142-147.
[5]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志,2015,48(4):258-273.
[6]中国中西医结合学会急救医学专业委员会.中国急性缺血性脑卒中中西医急诊诊治专家共识[J].中华危重病急救医学,2018,30(3):193(3):193-197.
[7]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):146-153.
[8]Niwa F,Kondo M,Sakurada K,et al.Regional Cerebral Blood Flow in123I-IMP Single-photon Emission Computed Tomography and the Wechsler Memory Scale-revised in Nondemented Elderly Subjects with Subjective Cognitive Impairment[J].Intern Med,2016,55(24):3571-3578.
[9]国家中医药管理局脑病急症科研协作组.中风病中医诊断疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[10]Yu T S,Kim A,Kernie S G.Donepezil rescues spatial learning and memory deficits following traumatic brain injury independent of its effects on neurogenesis[J].Plos One,2015,10(2):e0118793.
[11]郭忠伟,陈杏丽.美金刚联合多奈哌齐治疗中重度阿尔茨海默病的研究[J].中华全科医学,2014,12(5):755-757.
[12]潘燕.益肾活血中药+多奈哌齐治疗脑梗死后记忆功能障碍疗效及对脑电位、氧化应激指标的影响[J].现代中西医结合杂志,2018,27(1):39-42.
[13]Kruk-Slomka M,Boguszewska-Czubara A,Slomka T,et al.Correlations between the Memory-Related Behavior and the Level of Oxidative Stress Biomarkers in the Mice Brain,Provoked by an Acute Administration of CB Receptor Ligands[J].Neural Plast,2015,2016:9815092.
[14]Li X L,Fan N X,Meng H Z,et al.Specific neuroprotective effects of manual stimulation of real acupoints versus non-acupoints in rats after middle cerebral artery occlusion[J].Afr J Tradit Complement Altern Med,2013,10(4):186-195.
[15]薛月芹.探讨益肾活血方联合电针穴位刺激对脑梗死后记忆功能障碍临床疗效及氧化应激指标的影响[J].中国医药科学,2018,8(13):39-43.
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