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脑络通浸膏治疗血管性帕金森综合征轻度认知障碍的回顾性研究

王欣彤 朱清 梁森 邓颖 吴文涛

王欣彤, 朱清, 梁森, 邓颖, 吴文涛. 脑络通浸膏治疗血管性帕金森综合征轻度认知障碍的回顾性研究[J]. 南京中医药大学学报, 2023, 39(1): 16-20. doi: 10.14148/j.issn.1672-0482.2023.0016
引用本文: 王欣彤, 朱清, 梁森, 邓颖, 吴文涛. 脑络通浸膏治疗血管性帕金森综合征轻度认知障碍的回顾性研究[J]. 南京中医药大学学报, 2023, 39(1): 16-20. doi: 10.14148/j.issn.1672-0482.2023.0016
WANG Xin-tong, ZHU Qing, LIANG Sen, DENG Ying, WU Wen-tao. Retrospective Study on the Treatment of Vascular Parkinsonism Mild Cognitive Impairment with Naoluotong Paste[J]. Journal of Nanjing University of traditional Chinese Medicine, 2023, 39(1): 16-20. doi: 10.14148/j.issn.1672-0482.2023.0016
Citation: WANG Xin-tong, ZHU Qing, LIANG Sen, DENG Ying, WU Wen-tao. Retrospective Study on the Treatment of Vascular Parkinsonism Mild Cognitive Impairment with Naoluotong Paste[J]. Journal of Nanjing University of traditional Chinese Medicine, 2023, 39(1): 16-20. doi: 10.14148/j.issn.1672-0482.2023.0016

脑络通浸膏治疗血管性帕金森综合征轻度认知障碍的回顾性研究

doi: 10.14148/j.issn.1672-0482.2023.0016
基金项目: 

全国名老中医药专家传承工作室建设项目 国中医药人教函〔2018〕134号

江苏省名老中医药专家传承工作建设项目 苏中医科教〔2016〕6号

详细信息
    作者简介:

    王欣彤,女,硕士研究生,E-mail: 15850520209@163.com

    通讯作者:

    吴文涛,男,主任医师,主要从事脑血管病和帕金森病研究,E-mail: 2982905696@qq.com

  • 中图分类号: R277.7

Retrospective Study on the Treatment of Vascular Parkinsonism Mild Cognitive Impairment with Naoluotong Paste

  • 摘要:   目的  回顾性观察血管性帕金森综合征轻度认知障碍(Vascular Parkinsonism mild cognitive impairment, VP-MCI)的中医证型分布特点及分析脑络通浸膏治疗该病的痰浊阻窍证和瘀血阻络证的临床疗效。  方法  收集确诊的108例VP-MCI病例, 分析其中医证型及分布特点。纳入符合痰浊阻窍证和瘀血阻络证的75例VP-MCI的病例按脑络通浸膏联合多奈哌齐治疗和多奈哌齐单药治疗分为治疗组和对照组, 疗程为4周。观察2组治疗前后中医证候评分及简易精神状态量表(Mini mental state examination, MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)和统一帕金森病评分量表(Movement disorder society unified Parkinson's disease rating scale, MDS-UPDRS)评分情况; 双侧头颈部血管血流速度的变化情况。  结果  108例VP-MCI患者中医辨证为痰浊阻窍证和瘀血阻络证者占69.44%。治疗后, 治疗组主要中医证候积分明显减少(P < 0.05,P < 0.01), 优于对照组(P < 0.05,P < 0.01); 治疗组MoCA评分明显提高(P < 0.01), 优于对照组(P < 0.05);治疗组双侧大脑前动脉(ACA)和大脑中动脉(MCA)的平均血流速度较治疗前明显提高(P < 0.05), 优于对照组(P < 0.05)。  结论  VP-MCI的主要中医证型为痰浊阻窍证和瘀血阻络证。脑络通浸膏联合多奈哌齐可明显改善痰浊阻窍证和瘀血阻络证VP-MCI患者的脑血流和认知水平。

     

  • 图  1  108例VP-MCI患者中医证型构成及分布

    Figure  1.  TCM syndrome type composition and distribution of 108 VP-MCI patients

    表  1  2组患者治疗前后中医证候积分比较(x±s)

    Table  1.   Comparison of the TCM syndrome scores before and after treatment between the 2 groups(x±s)

    组别 时间 遗忘 少语 头昏 口多黏涎 体胖 疼痛 舌紫暗
    治疗组 治疗前 3.75±0.69 1.24±0.39 1.71±0.44 1.44±0.42 3.53±0.77 3.85±0.75 3.98±0.82
    治疗后 2.43±0.55**## 1.20±0.33 1.13±0.37*# 1.21±0.33*# 3.29±0.85 2.34±0.83*# 2.41±0.76*#
    对照组 治疗前 4.11±0.43 1.35±0.52 1.87±0.29 1.58±0.37 4.01±0.92 3.75±0.71 3.22±0.87
    治疗后 3.62±0.58 1.56±0.41 1.65±0.48 1.52±0.31 3.14±0.51 3.31±0.68 3.87±0.73
    注: 组内比较, *P < 0.05, **P < 0.01; 组间比较, #P < 0.05, ##P < 0.01。
    下载: 导出CSV

    表  2  2组患者治疗前后MMSE、MoCA、MDS-UPDRS评分比较(x±s)

    Table  2.   Comparison of MMSE, MoCA, and MDS-UPDRS scores before and after treatment in 2 groups(x±s)

    组别 时间 MMSE MoCA MDS-UPDRS
    观察组 治疗前 21.31±2.34 21.35±2.40 44.16±7.12
    治疗后 23.61±2.02 26.32±1.14**# 33.25±5.34
    对照组 治疗前 21.52±2.33 21.71±2.27 45.32±8.27
    治疗后 22.27±1.30 22.58±2.32 35.20±7.09
    注: 组内比较, **P < 0.01; 组间比较, #P < 0.05。
    下载: 导出CSV

    表  3  2组患者治疗前后双侧ICA、ACA、MCA的Vp和Vm比较(x±s, cm·s-1)

    Table  3.   Comparison of Vp and Vm of bilateral ICA, ACA, and MCA before and after treatment in 2 groups(x±s, cm·s-1)

    组别 时间 部位 ICA ACA MCA
    Vp Vm Vp Vm Vp Vm
    观察组 治疗前 右侧 72.31±6.12 35.16±7.27 61.66±7.22 45.80±8.29 94.38±8.09 56.12±8.04
    左侧 67.22±7.30 41.35±7.43 58.39±9.32 43.22±6.66 96.57±8.29 61.34±6.77
    治疗后 右侧 81.42±6.21 49.52±9.01 75.54±6.75 68.25±5.87*# 102.77±10.02 79.53±9.06*#
    左侧 76.37±7.42 46.25±6.15 67.33±5.88 65.13±7.27*# 96.62±8.13 87.61±7.72*#
    对照组 治疗前 右侧 68.28±9.45 37.72±5.99 59.32±7.74 40.44±6.95 98.36±6.84 53.74±6.99
    左侧 70.55±5.07 33.69±8.31 64.62±8.50 39.76±7.33 113.65±9.29 58.81±7.07
    治疗后 右侧 78.21±6.32 44.52±7.09 71.75±7.71 51.16±5.88 121.72±7.66 52.89±6.98
    左侧 81.40±5.49 39.73±8.76 73.31±7.53 45.08±8.90 116.93±8.37 60.35±8.31
    注: 组内比较, *P < 0.05; 组间比较, #P < 0.05。
    下载: 导出CSV
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  • 收稿日期:  2022-10-25
  • 网络出版日期:  2023-01-18
  • 发布日期:  2023-01-10

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