Clinical Effect Of Bushen Huoxue Decoction On Mild Cognitive Impairment Of Cerebral Small Vascular Disease

Objective: To observe the clinical effect of Bushen Huoxue Decoction on mild cognitive impairment of cerebral small vessel disease,and compare the changes of cognitive function,daily living ability and TCM symptoms of patients before and after treatment,so as to objectively evaluate the clinical effect of Bushen Huoxue Decoction on this disease and promote its wide application in clinic.Methods: From July 2019 to December 2019,60 patients with mild cognitive impairment due to cerebral small vascular disease were selected from the outpatient department of Affiliated Hospital of Tianjin Institute of Traditional Chinese Medicine.and 30 patients were divided into Chinese medicine group and control group.On the premise of basic treatment such as antiplatelet aggregation,antihypertensive,hypoglycemic,lipid-lowering and spot-stabilizing,the control group was given citicoline sodium capsule orally,while the traditional Chinese medicine group was given Bushen Huoxue Decoction combined with citicoline sodium capsule.Both groups were treated for 12 weeks,Hachinski ischemic score(HIS)was assessed before treatment,Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MOCA),Verbal Fluency Test(VFT),Activity of Daily Living Scale(ADL),The Scale for the Differentiation of Syndrome of Vascular Dementia(SDSVD)were performed before and after 12 weeks treatment and one year after admission.The liver and kidney function,blood routine,urine routine,electrocardiogram and the occurrence of adverse events were recorded before and after the experiment.Results: 1.The basic data,MMSE,MOCA total scores and individual scores,VFT,ADL,SDSVD scores of the two groups before the experiment were evenly distributed,and there was no significant difference(P > 0.05).2.Cognitive function: After 12 weeks of treatment,the total scores of MMSE and MOCA in the control group and the Chinese medicine group were higher than those before treatment,and the improvement in the Chinese medicine group was more obvious,which was statistically significant compared with the control group(P < 0.05).Compared with the control group,the score of MMSE before and after treatment increased more significantly than that of the control group,and the difference was statistically significant(P < 0.05);Comparing the single score of MOCA before and after treatment,the scores of execution ability,calculation ability,abstract generalization ability and delayed recall were significantly higher than those of the control group,and the difference was statistically significant(P <0.05).Before and after treatment,there were significant differences in VFT scores between the Chinese medicine group and the control group and before treatment(P < 0.05),but there was no significant difference between the control group and before treatment(P > 0.05).One year later,compared with the control group and before treatment,the total scores of MMSE and MOCA in the traditional Chinese medicine group were still significantly different(P < 0.05),while the control group had no significant difference compared with before treatment(P > 0.05).Comparing the scores of each single item of MMSE,the scores of time orientation,delayed memory,calculation and execution ability of the Chinese medicine group and the control group were significantly different,with statistical significance(P < 0.05);Comparing the scores of each single item of MOCA,there were significant differences in the scores of execution ability,calculation ability,abstract generalization ability,and delayed recall between the Chinese medicine group and the control group,which were statistically significant(P < 0.05).There was no significant difference in VFT scores compared with those before treatment(P > 0.05),while the scores of the control group decreased significantly(P <0.05).3.Life ability: After 12 weeks of treatment,the total ADL score,BADL and IADL scores,and the scores of the Chinese medicine group were not significantly different from those of the control group and the control group.The difference was not statistically significant(P >0.05),but the difference before and after the Chinese medicine group was statistically significant(P < 0.05).One year later,the total scores of ADL in the Chinese medicine group did not change significantly compared with those before treatment,and the difference was not statistically significant(P > 0.05),while the scores of the control group decreased significantly compared with those before treatment,which was statistically significant(P <0.05).There is a statistical difference between the scores of the Chinese medicine group and the control group(P < 0.05);There was no significant difference in BADL scores between the two groups(P > 0.05),and IADL scores in the Chinese medicine group were better than those in the control group,and the difference was statistically significant(P < 0.05).4.TCM symptoms: After 12 weeks of treatment,the SDSVD scores of the control group and the traditional Chinese medicine group were lower than before treatment,and the reduction of the traditional Chinese medicine group was more obvious,which was statistically significant compared with the control group(P < 0.05),and the therapeutic effect was better than that of the control group.One year later,compared with the control group and before treatment,the difference in SDSVD scores in the traditional Chinese medicine group was still statistically significant(P < 0.05),while the difference in the control group was not statistically significant(P > 0.05).Conclusion: 1.Bushen Huoxue Decoction can improve the overall cognitive function and self-care ability of patients with cerebral small vessel disease,and improve the scores of TCM symptom scale,and the effect is better than that of the control group.2.Bushen Huoxue Decoction has a good therapeutic effect on patients with mild cognitive impairment in the early stage,and the long-term effect of Chinese medicine group is still obvious one year later.