益气祛痰通络法辨治血管性痴呆疗效及对HCY炎症因子和氧化应激水平的影响

摘要

目的 观察益气祛痰通络法辨治血管性痴呆(VD)临床疗效及对HCY、炎症因子和氧化应激水平的影响.方法 采用平行、随机、对照试验方案,选择符合血管性痴呆(气虚痰瘀证)诊断标准患者60例,随机分为观察组和对照组各30例.对照组予多奈哌齐治疗,观察组予益气祛痰通络法(补阳还五汤合二陈汤化裁)联合多奈哌齐治疗,疗程8周.分别记录两组患者治疗前、后MMSE、ADL、NPI、中医证候积分;检测血浆Hcy、hs-CRP、TNF-α、IL-6、MDA、SOD含量;并记录相关安全性指标(三大常规、肝肾功能等)及不良反应.结果 临床疗效比较:总有效率观察组80%,对照组60%,观察组优于对照组(P0.05).治疗后两组患者血浆hs-CRP、TNF-α、IL-6水平均较治疗前显著降低(P0.05). The plasma levels of hs-CRP,TNF-α,IL-6 were significantly lower than before in both groups(P<0.05),meanwhile,the levels of hs-CRP and IL-6 in the treatment group were decreased significantly compared to the control group(P<0.05). In addition,the plasma levels of Hcy and MDA in the two groups were significantly lower than those before treatments(P<0.05),and the levels of SOD were significantly higher than those before treatment (P<0.05),which was better in treatment group(P<0.05). Conclusions The effect of tonifying Qi,eliminating phlegm and dredging collaterals combined with Donepezil on VD(syndrome of Qi deficiency and phlegm stasis)is remarkable.It is effective in improving patients’ cognitive abilities, mental capacities,TCM clinical symptoms,and daily living abilities.The mechanism of action may be related to the reduction of plasma Hcy level,the inhibition of inflammatory responses and anti-Oxidative stress reactions in VD patients.