[1]姜 文,胡洁玲,蒋小娟,等.通脑益智颗粒联合西药治疗血管性认知障碍肾虚痰瘀证疗效研究[J].陕西中医,2024,(11):1481-1485.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.008]
　JIANG Wen,HU Jieling,JIANG Xiaojuan,et al.Study on curative effect of Tongnao Yizhi granules combined with western medicine on syndrome of kidney deficiency and phlegm stasis of vascular cognitive impairment[J].,2024,(11):1481-1485.[doi:DOI:10.3969/j.issn.1000-7369.2024.11.008]
点击复制

通脑益智颗粒联合西药治疗血管性认知障碍肾虚痰瘀证疗效研究
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年11期
页码:
1481-1485
栏目:
临床研究
出版日期:
2024-11-05

文章信息/Info

Title:
Study on curative effect of Tongnao Yizhi granules combined with western medicine on syndrome of kidney deficiency and phlegm stasis of vascular cognitive impairment
作者:
姜 文1; 胡洁玲1; 蒋小娟 1; 常 诚2
(1.南京中医药大学南通附属医院,江苏 南通 226000; 2.南京中医药大学附属医院,江苏 南京 210004)
Author(s):
JIANG Wen; HU Jieling; JIANG Xiaojuan; CHANG Cheng
(Nantong Hospital Affiliated to Nanjing University of Chinese Medicine,Nantong 226000,China)
关键词:
血管性认知障碍;  通脑益智颗粒;  细胞焦亡;  肾虚痰瘀;  炎症反应;  核苷酸结合寡聚化结构域样受体蛋白3;  炎症小体
Keywords:
Vascular cognitive impairment;  Tongnao Yizhi granule;  Parched cell death;  Kidney deficiency and phlegm stasis;  Inflammatory reaction;  Nucleotide-binding oligomerization domain-like receptor protein 3;  Inflammasome
分类号:
R 74
DOI:
DOI:10.3969/j.issn.1000-7369.2024.11.008
文献标志码:
A
摘要:
目的:探讨通脑益智颗粒对血管性认知障碍(VCI)肾虚痰瘀证患者的临床疗效及安全性。方法:将 64 例VCI 肾虚痰瘀证患者随机分为对照组、观察组,每组 32 例。对照组采用常规治疗,观察组在此基础上加服通脑益智颗粒,疗程12周。观察患者临床疗效、中医证候积分(SDSVD)、神经心理学评分(MMSE、MoCA、ADL)、脑血流动力学指标(ACA-PI、ACA-Vm、MCA-PI、MCA-Vm)、细胞焦亡相关血清炎症因子(NLRP3、IL-1β)、不良反应发生率。结果:观察组总有效率高于对照组(P<0.05)。治疗后两组患者MMSE、 MoCA、ADL 评分升高,SDSVD评分、MCA-PI、ACA-PI、 NLRP3、IL-1β降低,且观察组变化程度大于对照组,差异有统计学意义(均P<0.05)。两组均未发现严重不良反应。结论:通脑益智颗粒联合常规治疗可安全有效地改善VCI 肾虚痰瘀证患者的认知功能,提高临床疗效,其机制可能是抑制细胞焦亡介导的炎症反应及对脑血流动力学有所改善。
Abstract:
Objective:To observe clinical efficacy and safety of Tongnao Yizhi granules in treatment of patients with vascular cognitive impairment(VCI)of kidney deficiency and phlegm stasis type.Methods:64 cases of VCI with kidney deficiency and phlegm stasis syndrome were randomly divided into control group and observation group,32 cases in each group.The control group were treated with conventional therapy,and the observation group additionally treated with Tongnao Yizhi granules on the basis of it,for 12 weeks.Clinical efficacy,TCM syndrome score(SDSVD),neuropsychological score(MMSE,MoCA,ADL),cerebral hemodynamic parameters(ACA-PI,ACA-Vm,MCA-PI,MCA-Vm),pyropsis-related serum inflammatory factors(NLRP3,IL-1)and incidence of adverse reactions were observed.Results:The total effective rate of the observation group was higher than that in the control group(P<0.05).After treatment,MMSE,MoCA and ADL scores increased,SDSVD score,MCA-PI,ACA-PI,NLRP3 and IL-1β decreased in the two groups,and the degree of change in the observation group was higher than that in the control group,difference statistically significant(all P<0.05).No serious adverse effects were found in either group.Conclusion:Tongnao Yizhi granule combined with conventional therapy can safely and effectively improve cognitive function and clinical efficacy in patients with VCI of kidney deficiency and phlegm stasis type,which may be related to inhibiting inflammation mediated by apoptosis and improving cerebral hemodynamics.

参考文献/References:

[1] 中国医师协会神经内科分会认知障碍专业委员会,《中国血管性认知障碍诊治指南》编写组.2019年中国血管性认知障碍诊治指南[J].中华医学杂志,2019,99(35):2737-2744.
[2] FLIER W M,SKOOG I,SCHNEIDER J A,et al.Vascular cognitive impairment[J].Nature Reviews Disease Primers,2018,15(2):18003.
[3] 王亚妮,李维婷,袁成代,等.丁苯酞联合胞磷胆碱钠片治疗非痴呆性血管性认知障碍临床疗效及与同型半胱氨酸、甲状腺激素水平相关性研究[J].陕西医学杂志,2022,51(10):1285-1289.
[4] 国家卫生健康委办公厅.血管性认知障碍的诊疗规范(2020年版)[J].全科医学临床与教育,2021,19(3):197-199.
[5] 郝静,白龙跃,牛志学,等.益气补肾活血化痰方联合常规治疗对肾虚血瘀、痰浊阻滞型血管性痴呆认知功能障碍患者的临床疗效[J].中成药,2022,44(3):789-793.
[6] 孙海洋,孙景波,程骁,等.基于“填精补髓、清脑通络法”探讨血管性认知障碍中医证治规律[J].陕西中医,2023,44(8):1098-1101.
[7] SHA S,TAN J,MIAO Y,et al.The role of autophagy in hypoxia-induced neuroinflammation[J].DNA and Cell Biology,2021,40(6):733-739.
[8] TIAN Z,JI X,LIU J.Neuroinflammation in vascular cognitive impairment and dementia:Current evidence advancesand prospects[J].International J of Molecular Sciences,2022,23(11):6224.
[9] 李艳娇,李双阳,王饶琼,等.细胞焦亡与血管性认知障碍的相关性及中医药研究进展[J].中药药理与临床,2023,39(9):112-117.
[10] 田金洲,韩明向,涂晋文,等.血管性痴呆的诊断、辨证及疗效判定标准[J].北京中医药大学学报,2000,23(5):16-24.
[11] 田金州,韩明向,涂晋文,等.血管性痴呆诊断、辨证及疗效评定标准(研究用)[J].中国老年学杂志,2002,22(5):329-331.
[12] PAN Y,CAI W,HUANG J,et al.Pyroptosis in development inflammation and disease[J].Front Immunol,2022,16(9):991044.
[13] GALLUZZI L,VITALE I,AARONSON S A,et al.Molecular mechanisms of cell death:Recommendations of the nomenclature committee on cell death 2018[J].Cell Death and Differentiation,2018,25(3):486-541.
[14] DING J,WANG K,LIU W,et al.Pore-forming activity and structural autoinhibition of the gasdermin family[J].Nature,2016,535(7610):111-116.
[15] 王曦,王晓冬,邱颐.细胞焦亡及炎症小体与认知功能障碍相关疾病关系的研究进展[J].神经疾病与精神卫生,2023,23(1):60-66.
[16] POH L,SIM W L,JO D G,et al.The role of inflammasomes in vascular cognitive impairment[J].Molecular Neurodegeneration,2022,17(9):44.
[17] 柏华,杨波,余德军,等.核苷酸结合寡聚化结构域样受体蛋白3在阿尔茨海默病和血管性痴呆患者中的表达及相关因素研究[J].中国康复理论与实践,2016,22(3):306-309.
[18] 刘硕.瑞舒伐他汀对老年血管性痴呆患者氧化应激及血清IL-6、IL-1β、TNF-α水平的影响[J].中国实用医药,2022,17(4):165-167.
[19] XU T T,LI H,DAI Z,et al.Spermidine and spermine delay brain aging by inducing autophagy in SAMP8 mice[J].Aging,2020,12(7):6401-6414.
[20] AFTABIZADEH M,TATAREKNM,ANDREETTO E,et al.Blocking inflammasome activation caused by β-Amyloid peptide and islet amyloid polypeptide through an IAPP mimic[J].ACS Chemical Neuroscience,2019,10(8):3703-3717.
[21] 向岁.痰瘀同治法治疗血管性痴呆的临床观察和实验研究[D].武汉:湖北中医药大学,2022.
[22] EULATE R G,GONI I,GALIANO A,et al.Reduced cerebral blood flow in mild cognitive impairment assessed using phase-contrast MRI[J].J of Alzheimer's Disease,2017,58(2):585-595.
[23] WANG F,CAO Y,MA L,et al.Dysfunction of cerebrovascular endothelial cells:Prelude to vascular dementia[J].Frontiers in Aging Neuroscience,2018,18(11):376.
[24] ZOTIN M C,SVEIKATA L,VISWANATHAN A,et al.Cerebral small vessel disease and vascular cognitive impairment:From diagnosis to management[J].Current Opinion in Neurology,2021,34(2):246-257.
[25] 陈玉辉,王音,徐蕾,等.应用经颅多普勒超声评价神经血管耦合功能的研究进展[J].中国脑血管病杂志,2018,15(12):662-665.
[26] 王宇,段艳丽,刘淑杰,等.血管性认知功能障碍患者血流动力学水平与认知功能的相关性研究[J].国际精神病学杂志,2021,48(3):500-506.
[27] 唐嫄.益肾填精法治疗慢性脑供血不足的临床研究[D].北京:北京中医药大学,2013.
[28] 朱云鹤,吴云虎,方向.通窍活血汤治疗瘀血内阻型血管性认知障碍的临床观察[J].中国实验方剂学杂志,2019,25(2):139-143.

相似文献/References:

[1]郭粉娥,李世英,郝乃猛.藏红花素调控Nrf2/HO-1通路改善血管性认知障碍大鼠学习记忆能力实验研究[J].陕西中医,2022,(11):1516.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.006]
　GUO Fen'e,LI Shiying,HAO Naimeng.Research of Crocin improved learning and memory ability in vascular cognitive impairment rats by regulating Nrf2/HO-1 pathway[J].,2022,(11):1516.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.006]
[2]张琼文,沙 磊,张美珠,等.针灸治疗血管性认知障碍研究进展[J].陕西中医,2023,(7):990.[doi:DOI:10.3969/j.issn.1000-7369.2023.07.039]
　ZHANG Qiongwen,SHA Lei,ZHANG Meizhu,et al.Research progress of acupuncture and moxibustion in treating vascular cognitive impairment[J].,2023,(11):990.[doi:DOI:10.3969/j.issn.1000-7369.2023.07.039]
[3]孙海洋,孙景波,程 骁,等.基于“填精补髓、清脑通络法”探讨血管性认知障碍中医证治规律[J].陕西中医,2023,(8):1098.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.023]
　SUN Haiyang,SUN Jingbo,CHENG Xiao,et al.Discusses the TCM syndrome and treatment law of vascular cognitive impairment based on the method of “Tianjing Busui Qingnao Tongluo”[J].,2023,(11):1098.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.023]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(82201586); 江苏省中医临床医学创新中心项目(K2021j17-5); 江苏省南通市社会民生科学研究基金资助项目(MS22022048); 江苏省南通市中医联盟项目(TZYK202102)
更新日期/Last Update: 2024-11-11