| 1 ObjectivesThe application of Huangpu Tongqiao Capsule intervention in patients with vascular cognitive impairment non-dementia(VCIND)kidney demyelination,phlegm and blood stasis cross card in patients with clinical efficacy,evaluation of the method of invigorating Qi and kidney,removing stasis and resolving phlegm in clinical VCIND feasibility and effectiveness,and observe the changes of serum hs-CRP and plasma Hcy before and after intervention,explore the possible mechanism of action and enrich TCM treatment of VCIND ideas and methods.2 MethodsIn this study,we collected 80 cases of VCIND patients with renal dysfunction,phlegm,blood stasis and cross-sclerosis in accordance with the diagnostic criteria.The patients were assigned randomly according to the ratio of 1:1.The treatment group and the control group were 40 cases each.The two groups of patients with general information(age,educational level,gender,etc.)compared with no statistically significant difference.Control group was given oral Donepezil(5mg×7 tablets),each5 mg,1 times a day,warm water before bedtime delivery.The treatment group to Huangpu Tongqiao Capsule(0.4g×50 tablets),4 capsules/time,3 times/day,in the fasting warm water delivery.During the treatment,two groups of patients underwent basic medical treatment of neurology but could not take medications or psychotropic drugs with relevant or antagonistic effects,and Chinese and western medicines with mental side effects.The two groups were treated for 8 weeks.The clinical efficacy,MoCA score,special cognitive domain score(directional force,attention,memory,language ability,executive function,visual space function),ADL score,TCM syndrome score,serum hs-CRP,plasma Hcy level changes.3 Results(1)Efficacy evaluation of two groups:1 The total clinical efficacy: The total effective rate of Huangpu Tongqiao Capsule group was 69.4%,slightly lower than Donepezil group 70.3%,but the difference between the two groups was not statistically significant(P= 0.939>0.05),suggesting that Huangpu Tongqiao Capsule and Donepezil intervention VCIND card is a kidney subtraction,phlegm and blood stasis in patients with similar clinical efficacy.2 TCM syndrome efficacy: The total effective rate of Huangpu Tongqiao Capsulel group was 83.3%,which was significantly higher than that of Donepezi group40.5%,and the difference between the two groups was statistically significant(P<0.01),suggesting that in improving the efficacy of TCM syndromes,Huangpu Tongqiao capsule was significantly better than Donepezil.(2)Efficacy indicators assessment of two groups:1 Comprehensive cognitive assessment: Two groups of patients before treatment,compared to 8 weeks after treatment,MoCA score was both increased and the difference analyzed by statistics between the two groups was statistically significant(P<0.01).The treatment group compared with the control group,the change of MoCA score between the two groups after 8 weeks of treatment was not statistically significant(P=0.633 > 0.05).The results showed that both Huangpu Tongqiao Capsule and Donepezil could improve cognitive function in patients within 8 weeks and the curative effect is quite similar.2 Specific cognitive domain assessment: Huangpu Tongqiao capsule in patients with VCIND perform function,visual space,attention and language ability has improved(P<0.05),and Donepezil VCIND patients with memory,orientation,visual space and executive function(P<0.05);and in terms of executive function and visual space,Huangpu Tongqiao Capsule was superior to Donepezil in the treatment group(P<0.05).3 The ability of daily life: Two groups of patients before treatment,compared to8 weeks after treatment,the ADL scores both decreased and the difference analyzed bystatistics between the two groups was statistically significant(P<0.01).The treatment group compared with the control group,the change of ADL score between the two groups after 8 weeks of treatment was not statistically significant(P=0.396 > 0.05),indicating that both Huangpu Tongqiao capsule and Donepezil can improve the daily living ability of patients in the group at 8 weeks,and the curative effect is quite similar.4 Comparison of serum hs-CRP,plasma Hcy levels between the two groups: Two groups of patients before treatment,compared to 8 weeks after treatment,the levels of serum hs-CRP and plasma Hcy both decreased and the difference analyzed by statistics between the two groups was statistically significant(P < 0.01).The treatment group compared with the control group,there was no significant difference in serum hs-CRP and plasma Hcy levels between the two groups after 8 weeks of treatment(P>0.05),indicating that both Huangpu Tongqiao Capsule and Donepezil reduced the level of serum hs-CRP and plasma Hcy.5 TCM Syndrome Points: The treatment group of patients before treatment,compared to 8 weeks after treatment,the scores of the TCM syndromes in the treatment group significantly decreased and the difference was statistically significant(P <0.01).Compared with the control group before and after treatment,TCM syndrome scores did not change significantly,and the difference was not statistically significant(P> 0.05).The treatment group compared with the control group,the change of TCM syndrome score between the two groups after treatment for 8 weeks was statistically significant(P < 0.01),indicating that Huangpu Tongqiao Capsule was significantly superior in improving the TCM syndrome score In Donepezil.(3)Security assessment of two groups:During treatment and follow-up,there was no adverse reaction in both groups taking the drug.There was no significant difference in the safety indexes of blood,urine,stool routine,coagulation routine,liver and kidney function between the two groups before treatment and after 8 weeks of treatment(P>0.05).Huangpu Tongqiao Capsules and Donepezil on the VCIND card is a kidney deficiency,phlegm and blood stasis inpatients with various safety indicators without adverse effects.4 ConclusionBoth Huangpu Tongqiao Capsule and Donepezil can effectively improve the cognitive function and daily life ability of vascular cognitive impairment non-dementia(VCIND)in patients with deficiency of kidney and phlegm and blood stasis,its mechanism may be related to the reduction of serum hs-CRP,plasma Hcy levels;Huangpu Tongqiao capsule improve VCIND patients with executive function,visual space,attention and language ability more obvious,and Donepezil in VCIND patients to improve memory,orientation Strength,visual space and executive function. |
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