| Objective: ToinvestigatethetherapeuticefficiencyoftreatingVascularDementia(VD)by FUZHI Capsule through clinical observe,and reveal it's action mechanism by detectingacetylcholinesterase(AchE),Cholineacetyltransferase(CHAT)inhippocampusandmerleukin-6(IL-6),tumornecrosisfactor-É‘(TNF-É‘)inserumwithVDrat.Methods: In the clinical study we adopt DSM-IV,MMSE,BBS,ADL and TCMsyndrome differentiation standard and choose 80 cases who take part in this study freely andconforming with the observation criteria 80 cases are randomly divided into two groups. Thetreating method adopt simple-blinded randomize-controlled.40 cases in treated group takeFUZHI4capsuleseachtimethreetimesadayorally.40cases incontrol grouptakeDonepezil1tabletseachtimeepisodeandthestatesoftongueandpulsearerecordedeverymonthBeforetreatmentandaftertreatmentcomplexionlips, bodytype, pathologicsymptomarerecordedmeanwhilesafetyparametersareobserved.Takingmedicinecontinues12weeksandfollow-upisonetimeeverymonthBeforetakingmedicineandaftertakingmedicineMMSE,BBS,ADL,TCM on statistical analysis, especially observe MMSE,TCM episode and electroencephalogram. In the first experimental study we replicated VD rats by Pulsinelli 4-vo blockingwayandrandomlyclassifiedintotwogroupssuchas FUZHICapsulegroup,modleandgroupand sham operation group. Then examineAAR rate , hippocampal AchEactivityand CHATcontent and the content of IL-6, TNF-É‘in serum in three times(3d,7d and 4w). In thesecondexperimentalstudywereplicatedVDratsbyblockingbilateralcommoncarotidarteriespermanentlyandrandomlyclassifiedintosixgroups,namely,modelgroup, FUZHICapsulelow dose group, FUZHI Capsule middle dose group, FUZHI Capsule high dose group,Donepezil group, and sham operation group. The lasted for one month. Morris water mazewas used totest the learningand memoryabilities of these rats before and after makingmodeland after treatment. Such factors have been detected as the hippocampal AchE activity andCHATcontentandthecontentofIL-6, TNF-É‘inserumaftertreatment.Results: In evaluation of the therapeutic efficiency and safety analysis, 80 cases hadfinishedthe clinical test accordingtoplan, there is no case hadbeen dropped off. There wasstatisticallydifference according to MMSE,BBS,ADL, TCM episode in before and aftertreatment's assessing (P<0.01).There is no statistically difference for MMSE after treatmentbetweenthetreatedgroupandthecontrolgroup(P>0.05),whilethereisstatisticallydifferencefor BBS (P<0.05),ADL (P<0.01) and TCM episode (P<0.01) between two groups. In thetreatedgroupthetotaleffectiverateofMMSE,BBS,ADL,TCMepisodereached95.0%.Inthecontrolgroupthetotaleffectiverateoftheseindexesdifferentlyreached75.0%, 80.0%,67.5%, 72.5%. To analyze the results of therapy of two groups, there was statisticallydifference on BBS, ADL and TCM episode's effect, while there was no statisticallydifference on MMSE's effect. This informed that the treated groups effectiveness in behavior ability and TCM episode advantage over the control group's effectiveness in behavior abilitythrough statistical analysis. In first experimental study ,the learning and memoryabilities ofmodel rats were obviously decreased while it was raised by FUZH in three times. Thehippocampus AchE activity were raised while CHAT positive expression were descended in3d,and the content of IL-6(3d), TNF-É‘(7d) in serum were obviously raised compared.Aftertreatmentof FUZHIfor3d,thehippocampalCHATcontentdecreased(P<0.01).ThenFUZHI increased the content of hippocampal AchE in 7d.FUZHI obviouslydecreased thecontent of TNF-É‘in serum (3d,7d and ww) and decreased IL-6 (just 3d). In secondexperimental study ,by comparison with operated group (P<0.01) the learning and memoryabilities of model rats were obviously impaired. The hippocampus AchE activity were raisedwhile CHAT positive expression were descended ,and the content of IL-6, TNF-É‘inserum were obviously raised compared with sham operation group. After treatment of eachdosage FUZHI for one month, by comparison with model group the learning and memoryabilitiesofVDratsobviouslyimproved,Donepezilgroupincreasedtoo(P>0.05).FUZHIhighdose and Donepezil group decreased the hippocampal AchE activity (P>0.05). FUZHI highdose and middle dose can increased the hippocampal CHAT content, and there was relationbetweendoseandefect.EachdosageofFUZHIobviouslydecreasedthecontentofTNF-É‘inserum (P<0.01).FUZHI high dose and Donepezil group decreased IL-6 (P<0.01). Donepezilgroupdidn'thavesucheffect(P>0.05).ConcIusion:FUZHICapsuleandDonepezilbothcanimprovethecognitiveabilityofVDpaitent.However FUZHI Capsule's effectiveness in behavior ability and TCM episode werebetter than Donepezil in treating VD. Experiment has confirmed that FUZHI Capsule coulddecreasetheAchEactivityinhippocampus andincreasethepositiveexpressionofCHAT.Anddecrease the content of IL-6 and TNF-É‘in VD rats'serum. This informed that FUZHICapsule maybe lighten the injury of inflammation and increase the low level of hippocampalcocholinergicnerveafterinfraction.
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