Clinical Study On Treatment Of Post-stroke Cognitive Impairment By Tongnao Decoction

[Background]Stroke is one of the main causes of death of Chinese people at present.The disease not only affects people's exercise ability but also has a great influence on the cognitive competence.As a common manifestation of stroke,cognitive impairment has a serious impact on patients' life ability and the quality of life.Therefore,early screening and intervention for post-stroke cognitive impairment(PSCI)is very important.This study was conducted to analyze the risk factors of Post-stroke cognitive impairment and from the point of view of TCM syndrome differentiation,investigate the effect of Chinese medicine intervention on patients with post-stroke cognitive impairment,observe the clinical efficacy.Experiment I Analysis of risk factors for Post-stroke Cognitive Impairment[Objective]To investigate the risk factors of post-stroke cognitive impairment.[Methods]100 patients with acute cerebral infarction within 1 weeks of onset were included in the study.They were divided into normal group(n=44)and abnormal group(n=56)according to the MMSE score.We compare the differences between the two groups in general data,cerebral infarction related indexes,imaging changes and blood examination indexes and analyze the risk factors of post-stroke cognitive impairment.[Results]56.0%of the 100 patients had cognitive impairment.There were no statistically significant diffidences(P>0.05)between the two groups in gender,education,smoking history,drinking history,hypertension,diabetes,coronary heart disease,imaging changes,blood homocysteine,blood uric acid,blood lipid level.But there were significant differences in age,BMI index,NIHSS score(P<0.05).Therefore age is independent risk factor of post-stroke cognitive impairment.[Conclusion]The incidence of post-stroke cognitive impairmen is correlated with age,BMI index and NIHSS score,and age is an independent risk factor for PSCI.Experiment II Observation of the Clinical Effect of Tongnao Decoction on Post-stroke Dognitive Impairment Patients with Symptom of Phlegm and Blood Stasis[Objective]To explore the clinical efficacy of Tongnao Decoction in,the treatment of post-stroke cognitive impairment patients with symptom of phlegm and blood stasis.[Methods]80 post-stroke cognitive impairment patients with symptom of phlegm and blood stasis were included in the study.They were randomly divided into experimental group and control group.The control group was treated with conventional cerebral infarction plus donepezil,and the experimental group was added with Tong Nao decoction on the basis of the control group,for a course of three months.The observational time point for the treatment were the fourteenth day and the ninetieth day and the observed data was patients' NIHSS,MRS,BI index,MMSE and TCM symptom score.[Results]After treatment,two groups of NIHSS,MRS,BI index,MMSE and TCM syndrome integral were significantly improved compared with those before treatment(P<0.01).After 14 days' treatment,there was no significant difference between the two groups(P>0.05).After 3 months' treatment,the above therapeutic indexes of the experimental group were significantly improved than those of the control group(P<0.05).[Conclusion]Tongnao decoction combined with donepezil in the treatment of phlegm and blood stasis type PSCI patients is better than donepezil alone.Tongnao decoction can improve the exercise ability,living ability,cognitive function and TCM symptoms of PSCI patients.