Clinical Observation On The Effect Of Naotong Mixture With Transcranial Magnetic Stimulation In The Treatment Of Cerebral Small Vessel Cognitive Impairment(Qi-deficiency And Phlegm-blocking Type)

Objective: The study aims to observe the clinical efficacy and safety of Naotong Mixture combined with transcranial magnetic stimulation in patients with cerebral small vessel cognitive impairment(Qi-deficiency and phlegmblocking type).The purpose is to provide a new treatment method and idea for clinical treatment of cerebral small vessel cognitive impairment.Methods: A total of 99 patients who met the inclusion criteria were randomly and single-blind divided into control group,Naotong Mixture group and combined treatment group,with 33 patients in each group.The control group was treated with conventional medical treatment plus citicoline sodium tablets,the Naotong Mixture group was treated with Naotong Mixture on the basis of the control group,and the combined treatment group was treated with Naotong Mixture and transcranial magnetic stimulation on the basis of the control group.Before treatment,4 weeks and 8 weeks after treatment,the patients were scored with Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(Mo CA),Activities of Daily Living(ADL)and Traditional Chinese Medicine(TCM)syndrome score quantification table,and the serological parameters homocysteine(Hcy),low-density lipoprotein cholesterol(LDL-C)and high-sensitivity C-reactive protein(hs-CRP)were detected.SPSS 27.0 was used for statistical analysis of the data.The changes of the scores of the three groups were observed.Results: 1.A total of 92 cases completed the study,including 32 cases in the control group,30 cases in the Naotong Mixture group and 30 cases in the combined treatment group.2.TCM syndrome score: After 4 and 8 weeks of treatment,the TCM syndrome score of the combined treatment group was lower than that of the control group and that of the Naotong Mixture group,and the TCM syndrome score of the Naotong Mixture group was lower than that of the control group,the Naotong Mixture group and the combined treatment group had statistical differences compared with the control group(P<0.05),and the Naotong Mixture group had no statistical differences compared with the combined treatment group(P>0.05).3.Mo CA score: After4 and 8 weeks of treatment,the Mo CA score of all groups was higher than that before treatment.The score of combined treatment group was higher than that of control group and Naotong Mixture group,and the score of Naotong Mixture group was higher than that of control group,the score of the three groups at 4 weeks of treatment was not statistically different(P>0.05),the score of the Naotong Mixture group and the combined treatment group at 8 weeks of treatment was statistically different from that of the control group(P<0.05),and the score of the Naotong Mixture group was not statistically different from that of the combined treatment group(P>0.05).4.MMSE score: After 4 and 8 weeks of treatment,MMSE scores of all groups were higher than before treatment.The score of combined treatment group was higher than that of control group and Naotong Mixture group,and the score of Naotong Mixture group was higher than that of control group.There was no statistical difference in the scores of the three groups at 4 weeks of treatment(P>0.05),and there was statistical difference in the scores of the three groups at 8 weeks of treatment(P<0.05).5.ADL score: After 4 and 8 weeks of treatment,the ADL scores of each group were lower than those before treatment.The ADL score of combined treatment group was lower than that of control group and Naotong Mixture group,and the ADL score of Naotong Mixture group was lower than that of control group.and there was no statistically significant difference in the scores of the three groups at 4 weeks of treatment(P>0.05),and there was a statistically significant difference in the scores of the three groups at 8 weeks of treatment(P<0.05).6.Serological indicators: After4 and 8 weeks of treatment,the levels of Hcy,LDL-C and hs-CRP in each group were lower than those before treatment.The levels of Hcy,LDL-C and hs-CRP in combined treatment group were lower than those in control group and Naotong Mixture group,and the levels of Naotong Mixture group were lower than those in control group.the Naotong Mixture group and the combined treatment group had statistical differences compared with the control group(P<0.05),and there was no statistical difference between the Naotong Mixture group and the combined treatment group(P>0.05).6.Efficacy evaluation: in terms of cognitive efficacy,the effective rate was 37.50% in the control group,63.33% in the Naotong Mixture group,and72.41% in the combined treatment group.In terms of TCM syndrome,the effective rate was 25.00% in the control group,63.33% in the Naotong Mixture group,and 75.86% in the combined treatment group.Conclusion: Naotong Mixture combined with transcranial magnetic stimulation has good efficacy and safety in the treatment of patients with cerebral small vessel cognitive impairment of Qi-deficiency and phlegmblocking type.It can significantly relieve the clinical discomfort symptoms of patients,improve the cognitive function and improve the ability of daily living of patients,as well as reduce the levels of Hcy,LDL-C,hs-CRP and other indicators,which is feasible.It is worthy of clinical promotion.