A Study On Efficacy Mechanism In Vascular Dementia With Bushen-Huoxue Therapy On The Theory Of Brainderived And Yinyang

ObjectiveIn order to discover the clinical efficiency and mechanism of bushen-huoxue therapy on VaD based on the brainderived theory of TCM, two different ways of bushen-huoxue therapy to distinguish between Yin and Yang is observed:WKPBC(warming the kidney and promoting blood circulation), NKPBC(nourishing the kidney and promoting blood circulation).And the influence on cholinergic neurotransmitter system and endothelial function active substances is evaluated.Additionally,based on the analysis on the intervention effect and the difference of DIOS(differences of intelligent obstacle structural), IOCN(the imbalance of cholinergic neurotransmitter), EFCAM(the endothelial function changes of active material) between two cards of IKYANGBS(insufficiency of kidney-YANG and blood stasis) and IKYINBS (insufficiency of kidney-YANG and blood stasis),the superiority of two different treatments distinguished between Yin and Yang is inspected, and the hypothesis of "Brain theory of Yin and Yang" is putforward. Methods:This experiment divided50patients with IKYANGBS syndrome diagnostic criteria of VaD into2groups:one is WKPBC group of25cases, the other is control group1of25cases.50patients with IKYINBS syndrome diagnostic criteria of VaD were divided into NKPBC Group of25cases and control group2of25cases.Both of which were based on the principle of complete randomization, according to the proportion of1:1with random number table method. The WKPBC group was given the WKPBC treatment, NKPBC group was given the NKPBC treatment, control group1and control group2were given Oxiracetam capsule treatment. The aspects of the research include:Mini Mental State Examination(MMSE),Activity of Daily Living(ADL),Chinese medicine syndrome, central cholinergic neurotransmitter and vascular endothelial active substance,observation clinical curative effect of the WKPBC and NKPBC treatments on VaD, and discuss the biochemical mechanisms.In addition,from the aspects of the clinical characteristics, composition of intelligent obstacle, cholinergic neurotransmitter imbalance and the change of vascular endothelial active substance,compare differences between IKYANGBS syndrome and IKYINGBS syndrome in curing VaD,finding the clinical and material basis that brain could be divided into Yin and Yang brain. Results100patients were collected, including50patients with IKYANGBS syndrome, and50patients with IKYINGBS syndrome.5cases were rejected and fallen off,95cases were finally included in the statistics,47patients with IKYANGBS syndrome (including WKPBC group24cases, control group1has23cases), meanwhile48patients with IKYINGBS syndrome (including NKPBC group24cases, control group2has24cases). WKPBC and NKPBC groups, the control group1,2can be obviously improved MMSE, ADL, TCM syndrome integral (compared with before treatment, P<0.01or P<0.05), WKPBC group and NKPBC group curative effect is better than Oxiracetam capsule(comparison between groups after treatment, P<0.05or P<0.01));WKPBC group and NKPBC group can obviously improve the NIHSS (P<0.05),meanwhile the improvement of control group1and2was not significant (P>0.05). MMSE points on the project, the WKPBC group in the improvement of language, NKPBC group in the improvement of visual spatial ability to execute, were superior to Oxiracetam capsule (P<0.05or P<0.01). Four groups all can raise the Ach content, inhibit AchE activity, lower contents of ET and increase CGRP (P<0.01or P<0.05). WKPBC group improving the Ach, NKPBC group inhibiting AchE activity were superior to Oxiracetam capsule (P<0.05).Two Chinese traditional medicine group, lowering contents of ET and increasing CGRP effect were better than control group (P<0.01). IKYANGBS syndrome and IKYINBS syndrome of VaD comparison:for MMSE factor composition, IKYANGBS group has obvious language impairment(P<0.01), WKPBC group is obviously better than Oxiracetam capsule after treatment(P<0.05); NKPBC group has obvious visual spatial ability to execute damage (P<0.05),NKPBC group is obviously better than Oxiracetam capsule after treatment(P<0.01).Conclusion1.Both the prescription of WKPBC and NKPBC are secured and effective against VaD. And the superiority of treatment based on syndrome differentiation by TCM is obvious.2. The advantage of treatment on VaD by differentiation of Yin and Yang lies on the clinical effects of WKPBC and NKPBC, and the improvement of cognitive impairment factors.3.The mechanism of intervention by the prescription of WKPBC and NKPBC against VaD probably take its course on the imbalance of cholinergic neurotransmitter and vascular endothelial active substance.4.Brain also takes its difference on Yin and Yang. The Clinical manifestations, the cognitive ability to form, the imbalance of cholinergic neurotransmitter and vascular endothelial active substance through kidney-yang deficiency and blood stasis disease and kidney-yin deficiency and blood stasis disease on VaD may form as the clinical and material basis of the brain theory of Yin and Yang...