脑心通胶囊合醒神开窍针法治疗血管性痴呆疗效及对血清Livin、VEGF、IL-18、IFN-γ的影响

摘要

Objective It is to observe the effect of donepezil,oxiracetam combined with Naoxintong capsule and Xing-nao Kaiqiao acupuncture on vascular dementia and levels of serum anti-apoptosis factor (Livin ),vascular endothelial growth factor (VEGF),and interleukin-18 (IL-18)and interferon-γ (IFN-γ). Methods One hundred and forty patients with vascular dementia were randomly divided into two groups. In the control group,70 patients were treated with donepezil and Oxiracetam,and 65 patients in the observation group were additionally treated with Naoxintong Capsule and Xingnao Kaiqiao acupuncture. The clinical efficacy was evaluated,the incidence of adverse reactions and the changes of MMSE scores,HDS scores,ADL scores,the levels of HCT,whole blood viscosity,FIB,Livin,VEGF,IL-18 and IFN-γ before and after treatment were observed in the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group (P ＜0.05);there was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05);the MMSE scores,HDS scores,ADL scores,Livin and VEGF lev-els were increased significantly while HCT,whole blood viscosity,FIB,IL-18 and IFN-γ levels were significantly de-creased after treatment in the two groups (P＜0.05),and the above indicators were significantly better in the observation group than those in the control group after treatment (P＜0.05). Conclusion Donepezil,oxiracetam combined with Naox-intong capsule and Xingnao Kaiqiao acupuncture can significantly improve the levels of intelligence and quality of daily life, improve the hemorheological parameters,and regulate the levels of Livin,VEGF,IL-18 and IFN-γ in the treatment of vas-cular dementia,and its safety meet clinical requirements.%目的 观察多奈哌齐、奥拉西坦联合脑心通胶囊合醒神开窍针法治疗血管性痴呆疗效及对血清抗凋亡因子(Livin)、血管内皮生长因子(VEGF)、白细胞介素 -18(IL -18)、干扰素 -γ(IFN-γ)水平的影响.方法 将140例血管性痴呆患者随机分为2组,对照组70例给予多奈哌齐 +奥拉西坦治疗,观察组65例在对照组治疗基础上加用脑心通胶囊合醒神开窍针法治疗,统计2组临床疗效和不良反应发生情况,观察治疗前后简易智能状态检查量表(MMSE)评分、长谷川简易智能评定量表(HDS)评分、日常生活能力量表(ADL)评分、血细胞比容(HCT)、全血黏度、纤维蛋白原(FIB)、Livin、VEGF、IL-18及IFN-γ水平变化情况.结果 观察组治疗总有效率显著高于对照组(P ＜0.05);2组不良反应发生率比较差异无统计学意义(P＞0.05);2组治疗后 MMSE评分、HDS评分、ADL评分、Livin及 VEGF水平均显著提高(P均 ＜0.05),HCT、全血黏度、FIB、IL-18及 IFN-γ水平均显著降低(P均 ＜0.05),且观察组治疗后以上指标均显著优于对照组(P均 ＜0.05).结论 多奈哌齐、奥拉西坦联合脑心通胶囊合醒神开窍针法治疗血管性痴呆可显著提高患者智力水平和日常生活质量,改善血液流变学指标,调节Livin、VEGF、IL-18及IFN-γ水平,且安全性符合临床要求.