Clinical Observation Of Quyu Tongqiao Decoction In Treating Cognitive Impairment After Stroke With Phlegm And Blood Stasis Blocking

Objective:To observe the clinical efficacy of Quyu Tongqiao Decoction in the treatment of post-stroke cognitive impairment due to phlegm and blood stasis obstructing collaterals.Methods:From March 2020 to January 2021,patients with phlegm-stasis-collateral-blocking post-stroke cognitive impairment in the encephalopathy department and inpatient department of Nanjing University of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine were selected,and 60 cases were included.60 patients were divided into test group and control group.Both groups received basic treatment.The test group was added with Quyu Tongqiao Decoction,50ml each time,twice a day,warm after meals;the control group was added donepezil,5mg each time,once a day,orally before bed.Each group took the medicine for 8 weeks.The two groups were evaluated by MMSE,MOCA,ADL,TCM Syndrome Scoreboard before and after treatment,and Hs-CRP and Hcy values were measured before and after treatment.Results:A total of 60 patients were enrolled in this trial,one case fell off due to diarrhea in the experimental group,one case fell off due to non-cooperation in the control group,and a total of 58 patients in the two groups completed the study.(1)Comparison of baseline data:There was no statistical difference between the two groups in age,gender,education level,smoking,drinking,hypertension,diabetes,atrial fibrillation,and hyperlipidemia(P>0.05).The above baseline data suggested two Group patients are comparable;(2)Comparison of evaluation indicators before treatment:Hcy,hs-CRP levels,MMSE,MoCA,ADL scale scores,and TCM syndrome scores were compared between the two groups before treatment,indicating that there was no statistical difference between the two groups(P>0.05),the two groups are comparable.(3)Comparison of evaluation indicators after treatment:①MMSE and MOCA scale scores:the two groups of patients after treatment MMSE,MOCA scale scores were significantly different from before treatment(P<0.01),the scores of the two groups were significantly increased;the amount of MMSE between the groups Significant difference in table scores(P<0.01),suggesting that the experimental group improved cognition more significantly,but there was no statistical difference in the MOCA scale scores between the groups;the efficacy evaluation was performed on the MMSE and MOCA scale scores of the two groups of patients,and it was found that both groups were There was no statistical difference(P>0.05).②ADL scale score:The ADL scale scores of the two groups of patients after treatment were significantly different from those before treatment(P<0.01),and the scores of the two groups were significantly reduced;but there was no statistical difference between the groups(P>0.05).③Traditional Chinese Medicine Syndrome Score:After treatment,compared with before treatment,the test group has a significant difference(P<0.01),and the TCM syndrome score is significantly reduced,but there is no statistical difference in the control group(P>0.05);comparison between the two groups The difference is significant(P<0.01);the efficacy evaluation of the two groups of patients indicates that the difference is significant(P<0.01),and the experimental group can significantly improve the TCM syndromes..HCY and Hs-CRP levels:After treatment,compared with before treatment,the test group HCY and Hs-CRP levels decreased significantly(P<0.01),and the control group could reduce HCY levels with statistical differences(P<0.05).The control group significantly reduced the level of Hs-CRP,the difference was significant(P<0.01).Both groups had the effect of reducing the levels of HCY and Hs-CRP;however,there was no statistical difference between the groups(P>0.05).There is little difference in reducing HCY and Hs-CRP levels.⑤Stroke location:In patients with cognitive impairment after stroke,the anterior circulation infarcted side is mostly concentrated on the left side,followed by both sides,and finally on the right side.Conclusion:Quyu Tongqiao Decoction can treat post-stroke cognitive impairment with phlegm and blood stasis obstructing collaterals.It is significantly better than donepezil in improving TCM syndromes,but it has the same effect in improving cognitive scale scores and living ability scores.Quyu Tongqiao Decoction can improve the cognition and living ability of PSCI patients with phlegm and blood stasis obstructing collaterals,significantly reduce TCM syndromes,and reduce HCY and Hs-CRP levels.