通心络胶囊佐治腔隙性脑梗死伴血管性认知功能障碍患者的疗效及对细胞因子、血液流变学的影响

摘要

目的：观察通心络胶囊对腔隙性脑梗死（LI）合并血管性认知功能障碍（血管性痴呆，VD）患者的疗效及其对细胞因子、血液流变学的影响。方法选择2012年6月—2014年6月吉林大学附属吉林医院脑血管诊治中心住院的 LI 合并 VD 患者80例为研究对象，采用随机数字表法分成2组，每组40例。对照组给予常规治疗，治疗组另加服通心络胶囊，2组疗程均为3个月；观察临床疗效、MMSE 及 ADL 评分、细胞因子、血液流变学的改变及不良反应。结果治疗3个月后，治疗组总有效率为87．5％（37／40），明显高于对照组的72．5％（29／40），差异有统计学意义（ P ＜0．05）。与治疗前比较，治疗后2组患者 MMSE、ADL 评分均显著改善（ P ＜0．05），且治疗组改善优于对照组（ P ＜0．05）；治疗后2组 PRA、ALd、AngⅡ、ET－1水平均下降（ P ＜0．05），且治疗组低于对照组（ P ＜0．05）；治疗后，2组全血黏度、还原黏度、红细胞聚集指数较治疗前均有改善（ P ＜0．05），且治疗组还原高切／低切、红细胞聚集指数较对照组明显好转（ P ＜0．01）；治疗组在服药1周内出现胃痛3例、恶心2例，对照组出现恶心、胃部不适3例，2组不良事件发生率比较差异无统计学意义（ P ＞0．05）。结论通心络胶囊既可改善 LI 合并 VD 患者的认知功能，亦可改善患者细胞因子、血液流变学状态，值得临床推广应用。%Objective To observe the effects of Tongxinluo capsule on lacunar infarction (LI) combined with dys-function of vascular cognitive (vascular dementia, VD) patients with curative effect and of cytokines , blood rheology influ-ence.Methods 60 cases of LI patients with VD were randomly divided into 2 groups, 30 cases in each group.The 2 groups were given clinical conventional treatment , the treatment group plus Tongxinluo ,2 groups were treated for 4 months; the ob-servation of cytokines and the changes of blood rheology .Results After 4 months of treatment, the total effective rate in the treatment group was 87.5%, significantly higher than that in the control group of 72.5% ( P <0.05).Compared with before treatment, after treatment 2 groups of patients with MMSE and ADL scores were improved ( P <0.05), and the treatment group was better than the control group ( P <0.05); after treatment, PRA, ALd, Ang II, ET-1 levels of the 2 groups were decreased ( P <0.05), and the treatment group lower than the control group ( P <0.05); after treatment, 2 groups of blood viscosity, reduced viscosity, erythrocyte aggregation index was improved compared with that before treatment ( P <0.05), the treatment group and the reduction of high /low cut, erythrocyte aggregation index were significantly better than control group ( P <0.01); the treatment group in the treatment of 1 the week of stomach in 2 cases, 3 cases of nausea, the control group of nausea, stomach discomfort in 3 cases, the incidence of adverse events was not statistically significant difference be -tween the 2 groups ( P >0.05).Conclusion Tongxinluo capsule can improve cognitive function in patients with LI and VD, but also improve cytokines, blood rheology, it is worthy of clinical application .