通心络胶囊对血管性认知功能障碍患者血管内皮功能和氧化应激的影响

摘要

Objective To investigate the effect of Tongxinluo capsules on vascular endothelial function and oxidative stress in patients with vascular cognitive impairment.Methods A total of 92 cases were enrolled in the Department of Geriatric of Shaanxi Medical Hospital of CAPF from January 2014 to January 2016.All patients were randomly divided into control group (n =45) treated with Donepezil (5 mg once a day) and observation group (n =47) treated with Donepezil (5 mg once a day) and Tongxinluo capsules (3 capsules three times a day) for 24 weeks.The serum of total cholesterol (TC),triglyceride(TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),superoxide dismutase (SOD),malondialdehyde(MDA),endothelin 1 (ET-1) and nitric oxide (NO) were measured in the morning and compared in the two groups before and after treatment.Evaluation of clinical curative effect was performed with Mini mental state examination (MMSE) and Activity of daily living scale (ADL).Results:After treatment for 24 weeks,the MMSE score was increased (t =2.212,P =0.027) while the ADL score was decreased (t =-2.040,P =0.028) in two groups.Compared with the control group,the level of TC,TG,LDL-C,MDA and ET-1 were significantly lower after treatment (t =-3.057,t =-3.000,t =-3.324,t =-2.217,t =-2.212,P ＜ 0.05) while HDL-C,SOD and NO were significantly higher in observation group (t =2.642,t =2.294,t =2.348,both P ＜ 0.05).Conclusion It demonstrated that the Tongxinluo capsules combining Donepezil could effectively reduce the level of oxidative stress,improve vascular endothelial function and enhance the living quality in patients with vascular cognitive impairment.%目的 探讨通心络胶囊对血管性认知功能障碍患者血管内皮功能和氧化应激的影响.方法 选择2014年1月-2016年1月在武警陕西总队医院接受治疗的92例血管性认知功能障碍患者,随机数字表法分为对照组(n=45)和治疗组(n=47).对照组口服盐酸多奈哌齐5 mg,1次/d;治疗组口服盐酸多奈哌齐5 mg,1次/d,通心络胶囊3粒,3次/d,连续治疗6个月.分别在治疗前后测定患者血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平、超氧化物歧化酶(SOD)、丙二醛(MDA)和内皮素(ET)-1、一氧化氮(NO)水平,比较2组治疗前后上述指标差异.采用简易精神状态量表(MMSE)及日常生活能力量表(ADL)比较2组患者治疗前后变化.结果 与治疗前比较,2组患者治疗6个月后,MMSE和ADL评分均改善,且治疗组优于对照组(t=2.212、-2.040,P＜0.05);治疗组治疗后TC、TG、LDL-C、HDL-C水平均改善,且治疗组优于对照组(t=-3.057、-3.000、-3.324、2.642,P＜0.01);治疗组治疗后ET-1、NO、SOD、MDA均改善,且改善程度优于对照组(t=-2.212、2.348、2.294、-2.217,P＜0.05).结论 通心络胶囊联合盐酸多奈哌齐能有效降低血管性认知功能障碍患者的氧化应激水平,改善血管内皮功能,提高患者的生活质量.