| Objective:To explore the clinical efficacy,safety and serum inflammatory factor level of Tongqiao Huoxue decoction（Tongqiao Huoxue decoction）combined with Tiedu Tiaoshen needling method in patients with VaD.Furthermore,to observe the behavioral changes and the changes of serum inflammatory factors in vascular dementia rats treated with Tongqiao Huoxue decoction combined with promoting and regulating the mind-regulating acupuncture method,and to reveal that blood stasis blocking orifice is the core pathogenesis of VaD.The theory of"brain-kidney-du"axis was proved to be the pathophysiological basis of the occurrence and treatment of VaD.Methods:（1）Clinical study:According to the randomized double blind method,120 VaD patients were randomly divided into three groups:Huperzine A group（n=30）,Chinese medicine group（n=30）,acupuncture group（n=30）and acupuncture group（n=30）.Each group was given basic treatment(aspirin tablets（0.1 g,Q d）and Atto vastatin calcium tablets（10 mg,Q d）orally for each VaD patient.VaD patients with hypertension and diabetes need to be treated with basic hypotension and routine hypoglycemic therapy.Among them,Huperzine A group is treated with Huperzine A,traditional Chinese medicine group is treated with Tongqiao Huoxue decoction,acupuncture group is treated by acupuncture and moxibustion group,and traditional Chinese medicine is used.Acupuncture group was treated with Tongqiao Huoxue decoction（Tongqiao Huoxue decoction）.The course of treatment was 1 month.Before and after treatment,the clinical symptom score scale,MMSE scale,HDS scale,ADL scale and SDSD scale were used to test and observe the clinical symptoms,adverse reactions and serum inflammatory factor TNF-αin each group of VaD patients,and the clinical symptoms,side effects and serum inflammatory factors TNF-αin VaD patients were observed.Changes of IL-1βand IL-6 levels.Then the collected data are collected and analyzed by SPSS22.0 statistical analysis software.（2）Animal experiment:The animal model of VaD was established according to Olsson method[1].Morris water maze test（location navigation test and space exploration test）was used to evaluate the behavior of VaD model rats to confirm whether the model was successful or not.Healthy SD rats in normal group were randomly divided into four groups:model group,low-dose,middle-dose and high-dose Tongqiao Huoxue decoction（Tongqiao Huoxue decoction）group.The model rats were randomly divided into four groups:the model group,the middle-dose group and the high-dose group.The normal group and the model group were given the same volume of distilled water（1.44mL/100g·d）once a day,and the low dose group of Tongqiao Huoxue decoction was given 0.18mL/100g·d daily.The middle dose group of Tongqiao Huoxue decoction was given 0.36mL/100g·d traditional Chinese medicine once a day,and the high dose group of Tongqiao Huoxue decoction was given 0.72mL/100g·d traditional Chinese medicine once a day.After the treatment of Tongqiao Huoxue decoction,the VaD model rats in low dose,middle dose and high dose groups were treated with Tiedu Tiaoshen Acupuncture method for one month and observed.At the end of a course of treatment,the serum inflammatory factor level and behavioral evaluation results of normal group,model group,Tongqiao Huoxue decoction low dose,middle dose and high dose groups were compared and analyzed,and the conclusion was drawn.Results:（1）Clinical study:In the course of the study,one patient in the Chinese medicine group was excluded from the other treatment by taking other treatment VaD,during the course of treatment.The patients in the acupuncture group withdrew from the study because of their own factors.One case was excluded and 118 cases were included and completed.They were 30cases in the Huperzine A group,29 cases in the Chinese medicine group,29cases in the acupuncture group and 30 cases in the acupuncture and moxibustion group with traditional Chinese medicine.After one month of intervention,it was found that the scores of clinical symptom score,MMSE,HDS and ADL in Huperzine A group,traditional Chinese medicine group,acupuncture group and traditional Chinese medicine acupuncture group were significantly higher than those before treatment.The difference was statistically significant（P<0.05）.The levels of serum inflammatory factors TNF-α,IL-1β,IL-6 and the scores of SDSD scale were significantly lower than those before treatment（P<0.05）.Compared with Huperzine A group,the scores of all scales and the levels of serum inflammatory factors TNF-α,IL-1βand IL-6 were not significantly changed in Chinese medicine group and acupuncture group after treatment,and there was no significant difference between the two groups（P>0.05）.Compared with traditional Chinese medicine acupuncture group,the scores of various scales and serum inflammatory factors TNF-α,IL in Huperzine A group,Chinese medicine group and acupuncture group after treatment were measured.The levels of-1βand IL-6 were significantly different（P<0.05）.There were no side effects and adverse events in the four groups.（2）Animal experimental study:Five groups of rats behavior test results showed that the model group VaD model rats Morris water maze test results were the worst,Tongqiao Huoxue decoction low-dose,middle-dose and high-dose groups of VaD model rats Morris water maze test level gradually improved with the increase of dose.Compared with normal SD rats,the levels of serum inflammatory factors TNF-α,IL-1βand IL-6 in the VaD model rats in the model group were higher than those in the normal group（P<0.05）.Compared with the VaD model rats in the model group,the VaD model rats in the Tongqiao Huoxue decoction groups were treated with low,middle and high doses of Tongqiao Huoxue decoction.The levels of serum inflammatory factors TNF-α,IL-1βand IL-6 were all decreased（P<0.05）.Compared with the low dose group,the levels of serum inflammatory factors TNF-α,IL-1βand IL-6 in the middle dose group and the high dose group of VaD model rats were lower than those of the low dose group and the high dose group（P<0.05）,and that of Tongqiao Huoxue decoction group was lower than that of the low dose group（P<0.05）.Compared with the middle dose group,the levels of serum inflammatory factors TNF-α,IL-1βand IL-6 in the high dose group of VaD model rats were lower than those in the middle dose group（P<0.05）.Conclusion:Tongqiao Huoxue decoction combined with promoting governor and regulating mind was effective in the treatment of vascular dementia,improved the learning,cognitive and memory function of the patients,increased the scores of MMSE,HDS,ADL scales,and decreased the symptoms of traditional Chinese medicine（TCM）.It can regulate the level of serum inflammatory factors;The disturbance of serum inflammatory factor level also existed in vascular dementia rats.Tongqiao Huoxue decoction combined with Tiedu Tiaoshen needling method could also regulate the level of serum inflammatory factor,and the effect of high-dose treatment was better.The results of clinical observation and animal experiment indicate that serum inflammatory factors may be one of the pathogenesis of VaD.Vad occurs.The levels of serum inflammatory factors such as TNF-α,IL-1βand IL-6 were highly expressed at the time of development.After intervention with Tongqiao Huoxue decoction combined with Tiedu Tiaoshen Acupuncture,the serum inflammatory factors TNF-α,IL-1βin the body were observed.The levels of IL-6 were significantly lower than those before,and the symptoms of VaD were improved significantly.This also proves that through intervention down-regulate the level of serum inflammatory factors can improve the symptoms of VaD.The decrease of serum inflammatory factor level may be related to regulating"brain-kidney-du channel"axis,playing its role of tonifying the kidney and regulating the regulation of blood circulation and dredging collaterals.It is also proved that blood stasis blocking orifice is the nuclear heart disease of VaD in traditional Chinese medicine.Machine,"tonifying the kidney to clear the governor,promoting blood circulation to clear collaterals"is the basic traditional Chinese medicine treatment for the prevention and treatment of VaD. |
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