摘要
目的观察清脑益智颗粒联合盐酸多奈哌齐治疗缺血性卒中后认知功能障碍的疗效及对患者认知功能和日常生活活动能力的影响。方法选取2022年10月—2024年11月在上海市静安区中医医院门诊就诊和脑病科住院的缺血性卒中后认知功能障碍患者102例,随机分为对照组和治疗组各51例。2组均予脑卒中基础治疗,同时对照组加用盐酸多奈哌齐片及10%清脑益智颗粒治疗,治疗组加用盐酸多奈哌齐片及清脑益智颗粒治疗,2组均连续治疗8周。比较2组治疗前、治疗4周、治疗8周后认知功能及生活能力,治疗前及治疗8周后血清同型半胱氨酸(Hcy)、叶酸、维生素B_(12)水平,统计2组中医证候疗效。结果治疗前、治疗4周后简易智力状态检查量表(MMSE)评分、蒙特利尔认知量表(MoCA)评分、Barthel指数评分组内及组间比较差异均无统计学意义(P均>0.05);2组治疗8周后MMSE评分、MoCA评分、Barthel指数评分均明显高于治疗前及治疗4周后(P均<0.05),且治疗组MMSE评分、MoCA评分、Barthel指数评分均明显高于对照组(P均<0.05)。治疗后2组血清Hcy水平均明显低于治疗前,叶酸、维生素B_(12)水平均明显高于治疗前,且治疗组Hcy水平明显低于对照组,叶酸、维生素B_(12)水平均明显高于对照组,差异均有统计学意义(P均<0.05)。治疗组总有效率明显高于对照组[91.84%(45/49)比70.83%(34/48),P<0.05]。结论清脑益智颗粒联合盐酸多奈哌齐片可改善缺血性卒中后认知功能障碍患者的认知功能及临床症状,并能调节Hcy、叶酸、维生素B_(12)水平。
Objective It is to evaluate the efficacy of granules for clearing brain and replenishing wisdom combined with donepezil hydrochloride in the treatment of cognitive impairment after ischemic stroke and its effects on patients’cognitive function and activities of daily living.Methods A total of 102 patients with cognitive impairment after ischemic stroke who visited the outpatient department or were hospitalized in the neurology department of Shanghai Jing’an District Hospital of Traditional Chinese Medicine from October 2022 to November 2024 were enrolled,and were randomly divided into control group(n=51)and treatment group(n=51).Both groups received standard stroke therapy,and the control group additionally received donepezil hydrochloride tablets and 10%granules for clearing brain and replenishing wisdom,while the treatment group received donepezil hydrochloride tablets and granules for clearing brain and replenishing wisdom.Both groups were continuously treated for 8 weeks.The cognitive function and activities of daily living before treatment and after treatment for 4 and 8 weeks,and the serum levels of homocysteine(Hcy),folate and vitamin B_(12) before treatment and after treatment for 8 weeks were compared between the two groups,the efficacies of Traditional Chinese Medicine syndrome of the two groups were assessed.Results There were no statistically significant differences in MMSE scores,MoCA scores and Barthel Index scores between before treatment and after 4 weeks of treatment in each group and between the two groups(all P>0.05).After 8 weeks of treatment,the MMSE scores,MoCA scores and Barthel Index scores in each group were significantly higher than those before treatment and after 4 weeks of treatment(all P<0.05),furthermore,the MMSE scores,MoCA scores and Barthel Index scores in the treatment group were significantly higher than those in the control group(all P<0.05).The serum levels of Hcy in both groups were significantly lower,while the levels of folate and vitamin B_(12) were significantly higher after treatment than those before treatment,and the level of Hcy was significantly lower,while the levels of folate and vitamin B_(12) were significantly higher in the treatment group than those in the control group,the differences were all statistically significant(all P<0.05).The total effective rate in the treatment group was significantly higher than that in the control group[91.84%(45/49)VS.70.83%(34/48),P<0.05].Conclusion Granules for clearing brain and replenishing wisdom combined with donepezil hydrochloride can improve cognitive function and clinical symptoms,and regulate levels of Hcy,folate,and vitamin B_(12) in patients with post-ischemic stroke cognitive impairment.
作者
李怿霞
李文娟
LI Yixia;LI Wenjuan(Shanghai Jing’an District Hospital of Traditional Chinese Medicine,Shanghai 200072,China)
出处
《现代中西医结合杂志》
2025年第15期2075-2079,2170,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
上海市卫生健康委员会中医药科研项目(2022QN035)
静安区名老中医专家传承创新工作室建设项目(徐建传承创新工作室,JA2021-MLZZ003)。
关键词
清脑益智颗粒
缺血性卒中后认知功能障碍
granules for clearing brain and replenishing wisdom
ischemic stroke
cognitive impairment
