Studying On The Mechanism Of Huayu Tongluo Decoction On Cognitive Impairment Caused Small Cerebral Vascular Diseases Based On ASL-MRI

ObjectiveTo investigate the mechanism of Huayu Tongluo Decoction in improving cognitive impairment caused small cerebral vascular diseases by using arteiral spin labeling(ASL).In this study,patients with cognitive impairment caused by small cerebral vascular diseases were were divided into Huayu Tongluo Decoction group and control group according to the standard criteria and excluded criteria,and at the same time healthy group were set up.The mental state examination scale(MMSE)and the Montreal Cognitive Scale(MoCA)were used to observe the changes of cognitive function between Huayu Tongluo Decoction group and control group before and after treatment.The changes of CBF were analyzed by ASL-MRI before and after treatment.From the perspective of cerebral blood flow To explore the mechanism of Huayu Tongluo Decoction in improving the cognitive impairment caused by small blood vessel disease.Methods40 patients with cognitive impairment caused by small cerebral vascular diseases were randomly divided into two groups:20 cases of Huayu Tongluo Decoction group and 20 cases of control group,and 20 healthy subjects were set up.The control group was treated with conventional basic medicine and rehabilitation treatment.Huayu Tongluo Decoction group was treated with Huayu Tongluo Decoction,3 time/day and 33ml/time for 12 weeks,and conventional basic medicine and rehabilitation treatment.The cognitive function and cerebrovascular CBF were observed and evaluated before treatment.The changes of cognitive function were observed before and after treatment for 12 weeks after treatment.The changes of cognitive function and cerebral blood flow were observed before and after treatment in the control group and Huayu Tongluo Decoction group.Compared with the health group.SPSS20.0 statistical software was used for statistical analysis.Results(1)MMSE,MoCA scale score:There was no significant difference in the cognitive function between the treatment group and the control group(P>0.05)before treatment.After 12 weeks of treatment,the scores of MMSE and MoCA in the control group and Huayu Tongluo Decoction group were improved(P<0.05).The scores of MMSE and MoCA in Huayu Tongluo Decoction group were significantly higher than those in control group(P<0.05).(2)Cerebral blood flow CBF value:There was no significant difference in cerebral blood flow between the control group and Huayu Tongluo Decoction groupbefore treatment(P>0.05).There was significant difference among frontal lobe,the basal ganglia and the semi-oval center between patient and healthy group(P<0.05).There was no significant difference in temporal lobe between patient and healthy group.After 12 weeks of treatment,the CBF of cerebral blood flow in the frontal lobe,basal ganglia and semi-oval centers of the control group and Huayu Tongluo mixture group was improved(P<0.05),and the temporal lobe had no obvious change.(P<0.05).And the CBF of cerebral blood flow in the brain area of Huayu Tongluo mixture group is more obvious than that in the control group(P<0.05).(3)Three groups correlation of MMSE and MoCA scale score and cerebral blood flow CBF value before treatment:There was a positive correlation between the CBF values and the MMSE scale and the MoCA scale of the left frontal lobe,the basal ganglia and the semi-oval centers in the three groups before treatment.The correlation analysis showed that the left temporal There was no correlation between CBF and MMSE scale and MoCA scale.(4)The diffence correlation between MMSE scale and MoCA scale score and CBF before and after treatment:The correlation coefficient between the difference of the MMSE scale and and MoCA scale and the CBF in the left frontal lobe,basal ganglia and semi-oval centers.And the correlation analysis the difference between the CBF values of the left temporal lobe cerebral blood flow and the absence of the MMSE scale and the MoCA scale after treatment were no correlation.(5)Safety assessment:During treatment,1 case of Huayu Tongluo Decoction showed nausea and vomiting.In the control group,1 case had symptoms of dry mouth and constipation.Symptoms disappeared after symptomatic treatment.2 groups of patients after treatment and follow-up after the end of blood,urine,routine,liver and kidney function and ECG were no obvious abnormalities.ConclusionHuayu Tongluo Decoction group and control group can effectively improve the cognitive function of patients with Cerebral small blood vessel disease,the improvement of the former is better than the latter.At the same time,the use of ASL-MRI test to value of changes of cerebral blood flow before and after treatment,The improvement of blood flow in the group was better than that in the control group.The study showed that the cognitive function of cerebral small blood vessel disease changes may be associated with changes in cerebral blood flow,and Huayu Tongluo Decoction can improve the cognitive function of patients with cerebral small blood vessel disease may be related to increased cerebral blood flow CBF value.However,due to the study time and sample size constraints,need to further expand the sample number and time to be confirmed.