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

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

    摘要
  • 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。

     

    Abstract:
      OBJECTIVE  To retrospectively observe the distribution characteristics of syndrome pattern in Chinese medicine of vascular Parkinsonism mild cognitive impairment (VP-MCI) and to analyze the clinical efficacy of Naoluotong paste in the treatment of brain blockage caused by phlegm and collateral blockage caused by blood stasis.
      METHODS  A total of 108 cases of VP-MCI were collected and analyzed for their syndrome patterns in Chinese medicine and distribution characteristics. Among them, 75 cases of VP-MCI with brain blockage caused by phlegm and collateral blockage caused by blood stasis were divided into treatment and control groups according to the treatment of Naoluotong paste combined with donepezil and donepezil alone. The treatment course was 4 weeks. The traditional Chinese medicine (TCM) syndrome scores, Mini MentalState Examination (MMSE), Montreal Cognitive Assessment (MoCA), Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), as well as changes in blood flow velocity in the bilateral cephalic and cervical vessels were observed before and after treatment in both groups.
      RESULTS  In 108 patients with VP-MCI, 69.44% of them were identified as brain blockage caused by phlegm and collateral blockage caused by blood stasis. After treatment, the main TCM syndrome scores were significantly reduced in the treatment group (P < 0.05, P < 0.01), whose result was better than that in the control group (P < 0.05, P < 0.01). Besides, the MoCA score in the treatment group was significantly increased (P < 0.01), whose result was better than that in the control group (P < 0.05). The mean blood flow in the anterior cerebral artery (ACA) and middle cerebral artery (MCA) were significantly improved in the treatment group. The mean blood flow velocity of bilateral anterior cerebral artery (ACA) and middle cerebral artery (MCA) in the treatment group was significantly higher than that before treatment (P < 0.05), and compared with the control group(P < 0.05).
      CONCLUSION  The main syndrome pattern in Chinese medicine of VP-MCI is brain blockage caused by phlegm and collateral blockage caused by blood stasis. Naoluotong paste combined with donepezil can significantly improve cerebral blood flow and cognition level in VP-MCI patients with brain blockage caused by phlegm and collateral blockage caused by blood stasis.

     

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