复方苁蓉益智胶囊联合奥拉西坦治疗轻中度血管性痴呆的临床研究

目的 探讨还原型谷胱甘肽片对酒精性脂肪肝（AFLD）斑马鱼模型的保肝功效。方法 选取黑色素等位基因突变型（albino）品系斑马鱼，分别水溶给予还原型谷胱甘肽片500、1 000、2 000、4 000、8 000 μmol/L，同时设置对照组和模型组，除对照组外，利用2%无水乙醇诱导斑马鱼32 h建立AFLD模型，观察记录斑马鱼的死亡情况及表型，确定还原型谷胱甘肽片的最大耐受浓度（MTC）。黑色素等位基因突变型（albino）品系斑马鱼分别给予还原型谷胱甘肽片500、1 000、2 000 μmol/L和阳性对照药RU-21 100 μg/mL，同时设置对照组和模型组，除对照组外建立AFLD模型，采用油红O染色观察斑马鱼肝脏脂肪染色强度（S），计算还原型谷胱甘肽片的保肝功效；H&E染色观察斑马鱼肝脏病理学改变；实时荧光定量PCR（qRT-PCR）检测白细胞介素（IL）-6、高迁移率族蛋白1b（HMGB-1b）和肿瘤坏死因子（TNF）-α mRNA表达。结果 还原型谷胱甘肽片对AFLD模型斑马鱼的MTC为2 000 μmol/L。与对照组比较，模型组S显著增加（P<0.001）；与模型组比较，还原型谷胱甘肽片1 000、2 000 μmol/L组和RU-21组S显著降低（P<0.01、0.001）；还原型谷胱甘肽片500、1 000、2 000 μmol/L和RU-21 100 μg/mL组保肝功效分别为14%、32%、71%和48%。还原型谷胱甘肽片2 000 μmol/L组肝细胞结构正常，脂肪空泡较模型组减少。与对照组比较，模型组IL-6、HMGB-1b和TNF-α mRNA表达显著增加（P<0.05、0.01）；与模型组比较，还原型谷胱甘肽片500、1 000、2 000 μmol/L组IL-6、HMGB-1b和TNF-α mRNA表达显著降低（P<0.01、0.001）。结论 还原型谷胱甘肽片对AFLD具有明显的保肝作用，其机制与下调IL-6、HMGB-1b和TNF-α表达有关。

Clinical study on Compound Congrong Yizhi Capsules combined with oxiracetam in treatment of mild to moderate vascular dementia

Objective To investigate the clinical effect of Compound Congrong Yizhi Capsules combined with oxiracetam in treatment of mild to moderate vascular dementia. Methods Patients (120 cases) with mild to moderate vascular dementia in Tianjin Xiqing Hospital from January 2018 to January 2020 were divided into control and treatment groups based on parity order, and each group had 30 cases. Patients in the control group were iv administered with Oxiracetam Injection, 4 g added into normal saline 500 mL, once daily. Patients in the treatment group were po administered with Compound Congrong Yizhi Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, the MMSE, ADL, and NIHSS scores, and the levels of serum BDNF, Hcy, and IGF-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was higher than that in the control group (91.67% vs 76.67%, P < 0.05). After treatment, the MMSE score in two groups were significantly increased, while the scores of ADL and NIHSS were significantly decreased (P < 0.05), and the scores of the treatment group were significantly better than that of the control group (P < 0.05). After treatment, BDNF and IGF-1 in two groups were significantly increased, while Hcy were significantly decreased (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Compound Congrong Yizhi Capsules combined with oxiracetam is safe and effective on treatment of mild to moderate vascular dementia, can improve patients'' cognitive function, self-care ability, and promote the improvement of symptoms.