摘要
【目的】观察益智清心方治疗老年高血压合并认知功能障碍(cognitive dysfunction,CD)肾虚痰瘀证患者的疗效及其对氧化应激水平和血管内皮功能的改善作用。【方法】将72例老年高血压合并CD肾虚痰瘀证患者随机分为研究组和对照组,每组各36例。对照组给予常规西药治疗,研究组在对照组基础上给予益智清心方治疗,疗程为3个月。观察2组患者治疗前和治疗1个月、2个月、3个月后蒙特利尔认知评估量表(MoCA)评分、简易精神状态量表(MMSE)评分、血清氧化应激指标和血管内皮功能指标的变化情况,并评价2组患者的临床疗效。【结果】(1)疗效方面,治疗3个月后,研究组的总有效率为94.44%(34/36),对照组为58.33%(21/36),组间比较,研究组的疗效明显优于对照组(P<0.01)。(2)MoCA和MMSE评分方面,研究组治疗1个月、2个月、3个月后和对照组治疗3个月后的MoCA和MMSE评分均较治疗前升高(P<0.05),且研究组在治疗1个月、2个月、3个月后对MoCA和MMSE评分的升高幅度均明显优于对照组(P<0.05或P<0.01)。(3)氧化应激指标方面,研究组治疗1个月、2个月、3个月后和对照组治疗3个月后的血清丙二醛(MDA)水平均较治疗前下降(P<0.05),血清总抗氧化能力(TAOC)、超氧化物歧化酶(SOD)水平均较治疗前升高(P<0.05),且研究组在治疗1个月、2个月、3个月后对血清MDA水平的下降幅度及对血清TAOC、SOD水平的升高幅度均明显优于对照组(P<0.05或P<0.01)。(4)血管内皮功能方面,治疗1个月、2个月、3个月后,2组患者的血清一氧化氮(NO)水平均较治疗前升高(P<0.05),血清内皮素1(ET-1)水平均较治疗前下降(P<0.05),且研究组在治疗1个月、2个月、3个月后对血清NO水平的升高幅度及对血清ET-1水平的下降幅度均明显优于对照组,差异均有统计学意义(P<0.01)。【结论】益智清心方可有效改善老年高血压合并CD肾虚痰瘀证患者的认知功能,减轻氧化应激反应及血管内皮功能受损程度,疗效显著。
Objective To investigate the clinical efficacy of Yizhi Qingxin Recipe for the treatment of elderly hypertension patients complicated with cognitive dysfunction(CD)and differentiated as kidney deficiency and phlegm-stasis syndrome,and to observe its effect on oxidative stress level and vascular endothelial function of the patients.Methods Seventy-two elderly hypertension patients complicated with CD and differentiated as kidney deficiency and phlegm-stasis syndrome were randomly divided into the study group and the control group,with 36 cases in each group.The control group was treated with conventional western medicine,while the study group was treated with Yizhi Qingxin Recipe on the basis of treatment for the control group.Both groups of patients were treated for 3 months.Before treatment and after one month,2 months and 3 months of treatment,the changes in Montreal Cognitive Assessment Scale(MoCA)scores,Mini-mental State Examination(MMSE)scores,serum oxidative stress indicators and vascular endothelial function indicators in both groups were observed.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 3 months of treatment,the overall effective rate of the study group was 94.44%(34/36)and that of the control group was 58.33%(21/36).The intergroup comparison showed that the clinical efficacy of the study group was significantly superior to that of the control group(P<0.01).(2)The MoCA and MMSE scores of the study group were increased after one,2 and 3 month(s)of treatment and the scores of the control group were increased after 3 months of treatment compared with those before treatment(P<0.05).The intergroup comparison showed that the increase of MoCA and MMSE scores in the study group was significantly superior to that in the control group after one,2 and 3 month(s)of treatment(P<0.05 or P<0.01).(3)The serum level of oxidative stress indicator of malondialdehyde(MDA)in the study group after one,2 and 3 month(s)of treatment and in the control group after 3 months of treatment was decreased compared with before treatment(P<0.05),while serum total antioxidant capacity(TAOC)and superoxide dismutase(SOD)levels in both groups were increased compared with those before treatment(P<0.05).The decrease degree of serum MDA level and the increase degree of serum TAOC and SOD levels in the study group were significantly superior to those in the control group after one,2 and 3 month(s)of treatment(P<0.05 or P<0.01).(4)After one,2 and 3 month(s)of treatment,the serum nitric oxide(NO)level in both groups was higher and the serum endothelin 1(ET-1)level was lower than those before treatment(P<0.05),and the increase degree of serum NO level and the decrease degree of serum ET-1 in the study group after one,2 and 3 month(s)of treatment were significantly superior to that in the control group(P<0.01).Conclusion Yizhi Qingxin Recipe is effective on improving cognitive function and reducing oxidative stress and the damage of endothelial function in elderly hypertension patients complicated with CD of kidney deficiency and phlegm-stasis syndrome.
作者
牛翠
谢雪琼
张玉洁
张萍
NIU Cui;XIE Xue-Qiong;ZHANG Yu-Jie;ZHANG Ping(Shunyi District Hospital,Beijing 101300,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China)
出处
《广州中医药大学学报》
CAS
2023年第5期1077-1083,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
中国中医科学院科技创新工程项目(编号:C12021A01409)。
关键词
益智清心方
高血压
认知功能障碍
氧化应激
血管内皮功能
Yizhi Qingxin Recipe
hypertension
cognitive dysfunction
oxidative stress
vascular endothelial function
