补肾活血汤加减治疗血管性痴呆的临床研究

[目的]观察中药复方补肾活血汤（由熟地、山茱萸、淮山、龟板、何首乌、枸杞、巴戟天、肉苁蓉、石菖蒲、远志、水蛭、蒲黄、紫河车、太子参、陈皮等组成）治疗血管性痴呆（VD）的临床疗效.[方法]采用随机数字表法将80例VD患者随机分为2组,治疗组（40例）采用补肾活血汤结合辨证加减治疗,对照组（40例）采用西药都可喜和尼莫地平治疗,观察2组的临床疗效,以简易智能状态检查量表（MMSE）评定VD患者的智力障碍程度,以日常生活能力量表（ADL）评定VD患者的生活能力,并检测治疗前后患者的血液流变学指标的变化.[结果]治疗组的临床总有效率为80.0%,对照组为57.5%,2组比较,治疗组疗效优于对照组（P＜0.01）.治疗后2组的MMSE及ADL评分均较治疗前改善（P＜0.01）,且治疗组在MMSE及ADL评分改善方面优于对照组（P＜0.05）;治疗后治疗组的全血高切粘度、全血低切粘度、血浆粘度、红细胞比容等血液流变学指标均较治疗前有明显的改善（P＜0.01）,其改善作用优于对照组（P＜0.05或P＜0.01）.[结论]补肾活血汤辨证加减治疗能改善VD患者的学习、记忆能力和提高患者的生活能力,这可能与其改善VD患者的血液流变学指标有关.

Clinical Observation on Modified Bushen Huoxie Decoction for the Treatment of Vascular Dementia

[ Objective ] To observe the therapeutic effect of Bushen Huoxie Decoction (mainly composed of Radix Rehmanniae Preparata, Fructus Corni, Rhizoma Dioscoreae, Carapax et Plastrum Testudinis, Radix Polygoni Multiflori, Fructus Lycii, Radix Morindae Officinalis, Herba Cistanches, Rhizoma Acori Tatarinowii, Radix Polygalae, etc. ) for the treatment of vascular dementia (VD) . [Methods] Eighty cases of VD were randomized into two groups by using random number table: group A ( n = 40) was treated with modified Bushen Huoxie Decoction and group B (n = 40) with duxil and nimodipine. After a 3-month treatment, the therapeutic effect of the two groups was evaluated, and mini-mental state examination (MMSE), activities of daily life (ADL) and blood rheology before and after treatment were observed. [Results] The total therapeutic effective rate was 80.0% in group A and 57.5% in group B, the difference being significant ( P < 0.01). MMSE and ADL scoring was much improved in group A as compared with group B ( P < 0.05); blood rheology parameters such as whole blood high-shear viscosity (WBHSV), whole blood low-shear viscosity (WBLSV), plasma viscosity (PV), hematocrit (HCT) were much improved after treatment as compared with those before treatment, and the effect was better in group A than that in groups B (P < 0.05 or P< 0.01). [Conclusion] Modified Bushen Huoxie Decoction can improve the learning, memory and ADL, and this may be related to the improvement of blood rheology in patients with VD.