复方菖蒲益智汤治疗中风后轻度认知功能障碍的临床研究

目的 观察复方菖蒲益智汤治疗中风后轻度认知障碍（VCIND）患者的临床疗效。方法 128例中风后轻度认知障碍患者随机分为治疗组和对照组各64例。治疗组口服复方菖蒲益智汤，每日1剂，分早晚2次温服。对照组口服尼莫地平片，每次30mg，每日3次。2组治疗周期均为3月。分别于治疗前后对中医证候、认知能力、日常生活能力进行评价，同时检测血清同型半胱氨酸（Hcy）和乙酰胆碱酯酶（AchE）水平，并对安全性指标和不良反应进行监测。结果 与对照组比较，治疗组中医证候疗效与积分明显改善，简易精神状态检查量表（MMSE）评分及日常生活能力评分（ADL）明显升高，ADAS-cog量表评分降低，血清Hcy和AchE水平下降，差异具有统计学意义（P＜0.05）。2组治疗前后实验室指标未见明显异常，治疗期间未见患者出现不良反应。结论 复方菖蒲益智汤能明显改善中风后轻度认知障碍患者的中医证候、认知功能和日常生活能力，降低血清Hcy和AchE水平，临床疗效显著。 

Clinical Research on Compound Puchang Yizhi Decoction in Treating Mild Cognitive Impairment After Stroke

OBJECTIVE To observe the clinical therapeutic effects of the formula capable of resolving turbidity， removing toxin， activating blood circulation and dredging collectrals in improving patients with vascular cognitive impairment of none dementia(VCIND) after stroke. MEHTODS 128 cases with VCIND after stroke were randomly divided into treatment group and control group， with 64 cases in each group. Patients in the treatment group were given compound Changpu Yizhi Decociton warmly both early in the morning and late in the afternoon， one bag per day. While those in the control group were treated with nimodipine， 30mg at a time， three times per day. Both groups received three-month treatment. TCM syndromes， cognitive ability， activity of daily living before and after treatment were evaluated and the levels of homocysteine and acetylcholinesterase were tested to detect the safety index and side effects. RESULTS There experienced an evident improvement of the treatment group in TCM syndrome curative effects and scores， together with obvious increases in the scores of mini-mental state examination(MMSE) and Activity of Daily Living (ADL)， decreased scores in ADAS-cog and declined levels in homocysteine and acetylcholinesterase when compared to the control group. The difference was statistically significant(P<0.05). Neither evident abnormalities nor side effects were detected before and after treatment in the test. CONCLUSION Compound Changpu Yizhi Decoction can efficiently improve the TCM syndromes， cognitive function and daily living activity and reduce the levels of homocysteine and acetylcholinesterase of patients with VCIND after stroke.