| Object:To evaluate the clinical efficacy and the functional magnetic resonance imaging(fmri)of Bingchangsan sniffing intervening elderly aMCI patients with phlegm stasis obstruction and anosmia.To contrast the changes of fmri in hippocampus of different olfactions.Based on this,to explain the possible mechanism of the intervention of elderly aMCI patients by the intervention of sniffing Bingchangsan.The innovation on this study is developing a new route of smelling fragrant chinese herbal prescription for promoting the treatment of aMCI in the elderly.Methods:60 cases of elderly aMCI patients with sputum stasis obstruction and anosmia were selected and randomly divided into three groups,with 20 cases in each group.In the experimental group 1,the patients were treated with inhalation of Bingchangsan combined with oral aniracetam;In the experimental group 2,patients were treated with inhalation of compound menthol combined with oral aniracetam;In the control group,patients were treated with oral aniracetam.The total duration of observation was 12 weeks.The clinical efficacy of Bingchangsan was evaluated by comparing the TCM syndrome efficacy score,MMSE,MoCA,WMS,DSR and olfaction score of patients before and after treatment,and the possible mechanism of Bingchangsan for the treatment of aMCI was discussed by comparing the different effects of sniffing Bingchangsan or compound menthol on resting and tasking functional magnetic resonance in hippocampal.Results:1.Comparison of clinical efficacy evaluation of TCM syndromes in three groups showed that the total effective rate of experimental group 1 was significantly higher than that of experimental group 2 and control group,with a significant difference(P<0.01).There was no significant statistical difference in the total effective rate between the experimental group 2 and the control group(P>0.05).2.The scores of MMSE,MoCA,WMS and DSR in the three groups were improved after treatment compared with those before treatment.Among them,the scores of test group 1 before and after treatment showed a significant difference(P<0.01).Among them,the scores of test group 1 before and after treatment showed a significant difference(P<0.01).4.The olfactory score of test group 1 after treatment was significantly higher than that before treatment(P<0.01),and there was no significant statistical difference between test group 2 and control group before and after treatment(P>0.05).5.Task fMRI showed that NAA/Cr value in the hippocampus of the bingzhisan olfaction group after the first olfaction was higher than that before olfaction(P<0.05),and was significantly higher than that of the experimental group 2(P<0.05).There was no significant statistical difference in NAA/Cr values in the hippocampus before and after olfaction in the experimental group(P>0.05).6.In the experimental group 1,after 3 months of treatment,the value of NAA/Cr in the hippocampus was significantly increased by fMRI compared with that before treatment(P<0.01),and there was no significant statistical difference in the NAA/Cr value in the hippocampus before and after treatment between the experimental group 2 and the control group(P>0.05).Conclusion:Bingchangsan sniffing combined with anilacetam orally can significantly improve the cognitive function,especially the episodic memory ability of elderly aMCI patients with phlegm-stasis obstruction and anosmia,and the efficacy is significantly better than compound menthol sniffing combined with anilacetam orally and anilacetam orally alone.Bingchangsan can improve the olfactory function of elderly aMCI patients with phlegm stasis obstruction and anosmia.The mechanism of Bingchangsan intervention in aMCI may be related to the regulation of functional activity of neurons in the hippocampus. |
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