| Objective:To observe the effects on cognitive function, carotid atherosclerosis plaque and cerebral blood flow when treating the patients of chronic cerebral circulation insufficiency (CCCI) by Jiannao granules, and to prove the clinical efficacy of the granules further.Methods:60 outpatients and inpatients of CCCI were randomly divided into treatment group and control group, and 30 patients were in each. For each group of the patients we collected detail history and recorded the results of patients'general data. The 30 patients of CCCI in the control group were treated with foundation treatment:Aspirin 100mg once a day, Nimodipine 30mg three times a day and Atorvastatin calcium 0.01g once every night. And the treatment group was also treated with Jiannao granules(composed with Huangqi 15g, Zhishouwu 10g, Shudihuang 10g, Shengpuhuang lOg, Danggui 10g, Chuanxiong 10g, Qianghuo 12g), one dose per day separately half portion warmly taken in morning and at night. Two groups of patients with hypertension, hyperlipidaemia, diabetes, coronary heart disease or other basic diseases were treated correspondingly. Two months were a course of treatment, and one course of treatment was observed. Before and after treatment, all cases of the two groups were detected with the patients'electrocardiogram, hepatic function, renal function, and the three main routine examinations, tested by Montreal cognitive assessment table volume (MoCA) and mini-mental state examination (MMSE) scale, and simultaneously examined with transcranial Doppler (TCD) and carotid arteries color ultrasound examination. Then we would compare the results of cognitive function by two test methods, and the variation of carotid arteries intima-media thickness(IMT), area and numbers of carotid atherosclerotic plaques and cerebral blood flow as well before and after treatment of the two groups. At last the data would be analyzed by statistical methods to get results and conclusions.Results:(1) In the cognitive function testing, the research results showed that cognitive function of two groups of CCCI patients after treatment was significantly increased more than before treatment (P<0.05).After treatment, MoCA score of treatment group was higher than control group, and there was significant difference also (P<0.05). And the results also confirmed CCCI patients had a wide range of cognitive impairment (about 56.67%-86.67%). Meanwhile, the research conducted 120 times testaltogether, which MMSE detected 63 cases of cognitive impairment, while MoCA detected 96 cases. The cognitive impairment detection rate of MoCA scales was 80% higher than 52.5% of MMSE scales in all cases of CCCI patients. The detection rate of two test methods comparisons showed significant difference (P<0.01). (2) In the cerebral blood flow improvement aspects, TCD results showed that in the patients of blood flow increasing, in both goups cerebral blood flow were decreased, and there was significant difference before and after treatment (P<0.05). And treatment group decreased more than control group, and there was significant difference between two groups (P<0.05). While in the patients of blood flow decreasing, in treatment group cerebral blood flow was improved after treatment, and there was significant difference before and after treatment (P<0.05). In control group blood flow, there was little change before and after treatment (P>0.05). And treatment group improved more than control group, there was significant difference between two groups (P<0.05). In treatment group cerebral, pulsatility index of middle cerebral arteries and basilar arteries were dereased, and there was significant difference before and after treatment (P<0.05). Pulsatility index of basilar arteries were decreased more than control group, and there was significant difference between two groups (P<0.05).That suggest the treatment group had better curative effect than the control group. (3) For the curative effect of carotid atherosclerosis, statistical results suggest that in treatment group of CCCI patients, IMT and area of carotid atherosclerotic plaques of carotid artery were reduced after treatment, and there was significant difference before and after treatment (P<0.05). In control group, area of carotid atherosclerotic plaques reduced, and had significant difference before and after treatment (P<0.05). But in both groups the number of plaques before and after treatment showed no significant difference (P>0.05).Compared between the two groups, area of carotid atherosclerotic plaques were reduced after treatment. The treatment group reduced more than control group, and there was significant difference with control group (P<0.05).Conclusion:As a chronic latent ischemic cerebrovascular disease, CCCI patients at early stage had varying degrees of cognitive impairment. As a mild cognitive impairment (MCI) screening scale, MoCA scale had higher detection sensitivity of cognitive impairment than MMSE scale. It could be found the missing part of the MMSE scale. Jiannao granules combined with western medicine(Aspirin, Nimodipine and Atorvastatin calcium), combining traditional Chinese and western medicine treatment, from different stages, multiple ways, multi-target to early intervene, had the functions of adjusting lipoprotein, antioxidant, scanvenging oxygen free radicals, anti-platelet aggregation, protecting vascular endothelium, improving cognitive function, promoting the regression of atherosclerotic plaques, expanding cerebrovascular, improving cerebral blood flow. |
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