Clinical Observation And Experimental Study Of Yizhi Tongmai Fang In Treating Vascular Dementia

Objective: To observe the clinical efficacy of Yizhi Tongmai Recipe in treating mild and moderate vascular dementia with deficiency of kidney essence and deficiency of phlegm and blood stasis;objective to study the effect of Yizhi Tongmai Recipe on learning and memory of Morris water maze in rats with vascular dementia.Method:(1)clinical study: the vascular dementia patients were randomly divided into the control group and the treatment group from June 2016 to June 2017 in the Department of traditional Chinese medicine of the affiliated Provincial Hospital of Shandong University,the outpatient of the neurology department and the ward.The control group was treated with conventional western medicine.On this basis,the treatment group was treated with Yizhi Tongmai Recipe,and the clinical efficacy indexes(MMSE,ADL,SDSVD,total effective efficiency)and the changes of safety indexes were observed before and after the treatment.(2)experimental research:60 Wistar rats were randomly divided into sham operation group,model group,NLRP3 interference group,empty vector group,Yizhitongmai granule group and nimodipine group;the permanent bilateral carotid artery ligation(bilateral common carotid artery occlusion,BCCAO)to establish VD animal model;hippocampus by stereotactic injection of recombinant lentivirus(si-NLRP3),to observe the effectiveness of exogenous gene mediated transgene expression in the brain tissue;using the water maze behavioral tests were performed on rat spatial orientation ability of learning and memory,Result:(1)clinical observation: compared with the control group,the total effective rate of MMSE score,ADL score,SDSVD score and clinical efficacy in the twelfth week treatment group were improved,with the increase of MMSE score and the decrease of ADL and SDSVD score(P<0.05).No adverse reaction occurred during the treatment.(2)Experimental study:(1)navigation experiment: on the fifth day,the escape latency of the model group was significantly longer than that in the sham group(P < 0.01),and the escape latency was significantly prolonged(P < 0.01).Compared with the model group,the escape latency was no difference(P > 0.05),and the escape latency was shortened in the siNLRP3 group.P < 0.05),the escape latency of Yizhi Tongmai group was significantly reduced(P < 0.01).(2)Space exploration test: compared with the sham group,the time of the model group in the target quadrant was significantly shortened and the number of crossing platforms decreased significantly(P < 0.05).Compared with the model group,the difference of the no-load group was not significant(P > 0.05).The stay time of the target group in the siNLRP3 group and the Yizi Tong Mai group was significantly longer than that in the model group.Number increased significantly(P < 0.05),and the improvement in Yizhi Tongmai group was the most significant(P < 0.01).Nimodipine intervention group showed no significant difference(P > 0.05).Conclusion:1,Yizhi Tongmai Recipe Combined with standardized western medicine has significant clinical effect,it can significantly improve the cognitive impairment,self-care ability,TCM syndrome symptoms and total efficiency of the patients with kidney essence deficiency and phlegm stagnation type vascular dementia.It is better than using standardized western medicine alone,and it is safe and reliable.2.The learning and memory ability of model group decreased.Yizhi Tongmai granule and nimodipine could improve the learning and memory function of vascular dementia rats,and the effect of Yizhi Tongmai granule was obviously improved.It is suggested that Yizhi Tongmai Recipe has certain protective effect on brain tissue.