| Objective:By observing the clinical effect of the modified zuoguiyin combined with donepezil hydrochloride in the treatment of patients with kidney-essence deficiency post-stroke cognitive impairment with hyperhomocysteinemia caused by renal insufficiency.To explore the theoretical basis of modified zuoguiyin in the treatment of poststroke cognitive impairment and hyperhomocysteinemia,and to provide an objective basis for its promotion.Methods:In this study,a randomized controlled study method was adopted to include 60 subjects meeting the standard,which were randomly assigned to the treatment group of traditional Chinese and western medicine and the treatment group of western medicine,with 30 cases in each group.Both groups were treated with antithrombotic,lipid-regulating,antihypertensive,hypoglycemic,myocardial blood supply improvement,functional rehabilitation and other treatments according to the 2016 edition of Guidelines and consensus on the diagnosis and treatment of cerebrovascular diseases in China.Patients were also instructed to improve their lifestyle during treatment,such as quitting smoking,drinking less coffee,eating less food with high methionine,avoiding excessive exercise,and eating more fruits and vegetables.On this basis,the Chinese and western medicine treatment group was treated with donepezil hydrochloride 5mg qd combined with zuoguiyin plus or minus prescription.Western medicine group was treated with donepezil hydrochloride 5mg qd for 3 months.Before and after treatment,subjects in the two groups were given MMSE and MoCA scale to evaluate their cognitive level and plasma homocysteine level,and the relevant results were recorded in detail.Statistical software was used for statistical analysis.The effects of the two treatment regimens on the cognitive function of the subjects were evaluated by comparing the effects before and after treatment in the MMSE scale and MoCA scale and the effects between groups.By comparing homocysteine levels before and after treatment in both groups,the effects of two treatment regimens on homocysteine of the subjects were evaluated.At the same time,the effects of the modified zuoguiyin in the treatment of kidney-essence deficiency post-stroke cognitive impairment with the TCM score.Results:1.Cognitive function: The scores of MMSE and MoCA scales assessed before and after the treatment of Chinese and western medicine treatment group and western medicine treatment groupe were compared between the two groups.The results indicated that the MMSE and MoCA scales of the two groups after 3 months of intervention were higher than those before treatment,and the difference was statistically significant(P<0.05).Compared the curative effect before and after treatment in the two groups,the results indicated that the effective rate of the Chinese and western medicine treatment group was higher than that of the western medicine treatment group,which was statistically significant(P<0.05).2.Plasma homocysteine: The plasma homocysteine of the Chinese and western medicine treatment group and the western medicine treatment group were compared before and after the treatment.The results indicated that the plasma homocysteine in the Chinese and western medicine treatment group was significantly lower than that in the western medicine treatment group after 3 months of treatment,and the difference was statistically significant(P< 0.05).Comparison between the two groups at 1,2 and 3 months after treatment indicated that there was no significant difference in plasma homocysteine between the two groups at 1 month after treatment(P>0.05).After treatment for 2 and 3 months,there were statistically significant differences in plasma homocysteine between the two groups(P<0.05).3.The TCM score: The TCM scores of the Chinese and western medicine treatment group and the western medicine treatment group were compared before and after the western medicine treatment.After treatment,the TCM score of the Chinese and western medicine treatment group was significantly lower than that of the western medicine treatment group,and the difference was statistically significant(P<0.05).Conclusion:The effects of modified Zuogui Yin and donepezil hydrochloride on cognitive function in patients with kidney-essence deficiency PSCI with renal deficiency were better than those of donepezil hydrochloride alone;The treatment of modified Zuogui Yin and donepezil hydrochloride can reduce the plasma homocysteine level in patients with kidney-essence deficiency Hyperhomocysteinemia,and it also can improve TCM symptoms and signs in patients. |
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