黄连温胆汤联合智三针治疗脑卒中后轻度认知障碍疗效及相关机制研究

目的:观察黄连温胆汤联合智三针治疗脑卒中后轻度认知障碍的临床疗效及其对MMSE、MoCA评分的影响。方法:选取2016年6月至2018年3月青岛市中医院收治的脑卒中后轻度认知障碍患者146例,按照随机数字表法随机分为对照组和观察组,每组73例。对照组给予尼莫地平口服,观察组在对照组治疗的基础上予黄连温胆汤并配合针刺治疗。观察2组患者临床疗效、MoCA评分、MMSE评分、日常生命质量评分、IGF-1、HCY、CRP及血脂水平。结果:治疗后,2组MoCA、MMSE、MBI评分,IGF-1、HDL水平均较治疗前升高,ADL评分,HCY、CRP、TC、TG、LDL水平明显降低,观察组上述指标变化更明显,差异有统计学意义(P 0. 05)。观察组治疗后的总有效率(93. 15%)明显高于对照组(76. 71%),差异有统计学意义(P 0. 05)。结论:黄连温胆汤联合智三针治疗脑卒中轻度认知障碍可通过降低血脂水平,减轻炎性反应,降低同型半胱氨酸水平,促进神经细胞生长等作用,提高VCI患者生命质量及临床疗效。

Clinical Effects and Related Mechanism of Huanglian Wendan Decoction Combined with Zhisan Acupuncture on Mild Cognitive Impairment after Stroke

To observe the clinical efficacy of Huanglian Wendan Decoction combined with Zhisan Acupuncture on mild cognitive impairment after stroke and the influences on MMSE,MoCA score.Methods:A total of 146 patients with mild cognitive impairment after stroke treated in Qingdao Hospital of Chinese Medicine from June 2016 to March 2018 were selected and divided into the control group and the observational group according to the random number table method,with 73 cases in each group.The control group was given nimodipine,while the observational group was given Huanglian Wendan Decoction combined with Zhisan acupuncture based on the same treatment of the control group.The clinical effect,Montreal Cognitive Assessment (MoCA) score,mini-mental state examination (MMSE) score,daily life quality score,insulin-like growth factor-1 (IGF-1),homocysteine (HCY),C-reactive protein (CRP) and the level of blood lipid of 2 groups were compared.Results:After treatment,the MoCA,MMSE,modified Barthel indexes (MBI) scores,IGF-1,high density lipoprotein (HDL) levels of the 2 groups were increased,and the activities of daily living (ADL) scores,the HCY,CRP,total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL) levels of the 2 groups were significantly decreased.The above indexes of the observation group changed more obvious,the difference was statistically significant (P<0.05).The total effective rate of the observation group after treatment (93.15%) was significantly higher than that of the control group (76.71%),and the difference was statistically significant (P<0.05).Conclusion:Huanglian Wendan Decoction combined with Zhisan Acupuncture in the treatment of mild cognitive impairment after stroke can decrease the level of lipid,reduce inflammation,lower homocysteine,promote the growth of nerve cells to improve the life quality and clinical curative effect of VCI patients.