Clinical Observation And Mechanism Study Of Yuan Zhi Decoction In The Treatment Of Vascular Dementia

Research purposes:Vascular Dementia(VD)is a kind of dementia syndrome secondary to cerebrovascular disease.lt is a common and frequently occurring disease in the field of neurology.To this day,although there are some clinical studies on the treatment of VD,there is still a lack of accepted and effective treatment of VD.At present,traditional Chinese medicine is playing a more and more important role in the treatment of vascular dementia.My director Professor Jiang Yajun combined the classic theory of traditional Chinese medicine with his many years of clinical experience on this disease,proposed the point of view that VD is caused by deficiency of kidney essence and obstructing collaterals of phlegm and blood stasis.And composed the prescription of Yuan Zhi Decoction.The clinical application has achieved good curative effect.In this subject,the clinical curative effect of Yuan Zhi Decoction was observed.And the mechanism of Tenuifolin(the monarch drug of Yuan Zhi Decoction)were studied from the animal model.Research methods:(1)clinical study:40 patients with vascular dementia were collected.The cases were randomly divided into the treatment group(conventional western medicine plus Yuan Zhi Decoction)and the control group(only conventional Western Medicine).The two groups were treated for 8 weeks.The effects of two groups of patients on MMSE score,ADL score and TCM syndrome score were observed before and after the treatment.(2)mechanism research:We chose 48 10-week-old male B6 mice.The average body weight of the mice was(25±2)g.And the 48 male B6 mice were randomly divided into four groups.They were VD model group,sham operation group(Sham),Tenuifolin treatment(Ten)group,Donepezil positive control group.The mouse model of VD was subjected for continuously repeated three times ischemia-reperfusion through the ligation of bilateral common carotid artery of both sides(2VO).Behaviourological methods(Morris water-maze tests)were investigated to test the learning and memory ability of the mice.The expression of ChAT protein in the cholinergic circuits of mice was detected by immunohistochemical analysis and Western blot.Research result:1.clinical study:The MMSE score in both group was higher than that in the former(P<0.01).And after the treatment,the treatment group compared with the control group,P>0.05,indicating that the curative effect of the treatment group and the control group is similar,there is no obvious difference.The ADL score in both group was lower than that in the former(P<0.01).And after the treatment,the treatment group compared with the control group,P>0.05,indicating that the curative effect of the treatment group and the control group is similar,there is no obvious difference.The score of TCM syndrome in the treatment group was lower than that in the former(P<0.01),and the decrease was better than that in the control group(P<0.01).Before and after the treatment,there was no significant difference in safety indicators between the two groups(P>0.05).2.mechanism research:The Morris water-maze tests results showed that the incubation period of the Ten treatment group and the Donepezil positive control group was significantly shorter than that of the VD model group(P<0.01).The number of times across the platform of the Ten treatment group and the Donepezil positive control group was more than that of the VD model group(P<0.01).The Immunohistochemical analysis confirmed the effects of 2VO method.Tenuifolin can reduce the injury degree of mouse VD cholinergic neurons(P<0.05).Western Blot results showed that Tenuifolin can increase the expression level of ChAT protein VD mouse cholinergic neural circuits.Analysis conclusion:Yuan Zhi Decoction can improve the symptoms of vascular dementia patients.It can improve the MMSE score and reduce the score of ADL and TCM syndrome of vascular dementia patients.And it has no significant side effects.The main active component of Polygala(the monarch drug of Yuan Zhi Decoction)-Tenuifolin can improve the ability of learning and memory of mice with vascular dementia by regulating expression level of ChAT protein in cholinergic circuits.