| Objective:To observe the clinical effect of QianyangYuyin prescription in the treatment of hypertensive cerebral small vascular disease,to provide a new way of treatment for hypertensive CSVD and to improve the life quality of patient.Methods:Using random,parallel and controlled methods,The 70 cases of hypertensive cerebral micro vascular disease were divided into experimental group and control group,35 cases each,The experimental group was given Qianyang Yuyin granule(Number:Z20100007)+basic treatment(control blood pressure and blood pressure variability,anti-platelet aggregation,lipid lowering,etc);The control group was only given basic treatment.Both groups were treated continuously for 24 weeks,Week 0,week 24,The cognitive function(MMSE scale,MoCA scale),motor function(Tinetti balance and gait scale),serum endothelial injury markers(CRP,serum uric acid,proteinuria,serum homocysteine),imaging(total nuclear magnetic load)and TCM syndrome score were evaluated.To observe and compare the improvement of the two groups before and after treatment.Week 0,12,24,Conduct security checks.Results(1)Before treatment,baseline data on sex,age,duration of hypertension and level of education in the two groups were not statistically significant and comparable.(2)Improvement of cognitive function:MMSE results:the effective rate in the experimental group was 66.67%;The control rate was 45.45%,MoCA results:the total effective rate of the test group was 57.58,The total effective rate in the control group was 39.39%,There was a statistical difference between the two groups,After treatment,the scores were tested,And statistically significant,The results showed that the improvement of test group was better than that of control group;MoCA single integral,The patient’s score was significantly reduced in three items:visual space and executive ability,attention and computational power,and delayed recall ability,After treatment,both groups had higher scores,Statistically significant,And the average score of each item in the test group improved better than that in the control group,The"visual space and executive ability" item is statistically significant.(3)Improvement of motor function:the effective rate of the test group was 63.64%,and the effective rate of the control group was 48.48%.After examination,there were statistical differences between the two groups.In terms of single item,the "balance" and "gait" of the two groups decreased and improved after treatment,among which there was statistical difference between the two groups after treatment,which proved that the improvement of "gait" in the test group was better than that in the test group.(4)Improvement of serum endothelial lesion markers:C reactive protein,serum uric acid:compared with before treatment,the values of the two groups decreased after intervention,among which there was statistical difference in the test group,but there was no statistical difference in the control group.Blood homocysteine:compared with before treatment,the value of the test group decreased and the difference was statistically significant.Compared with the control group before treatment,the value increased and the difference was statistically significant.The control group should strengthen the control of this index.Proteinuria:after treatment,the positive level of proteinuria in both groups decreased significantly.The results of the two groups were statistically significant,indicating that the test group was better than the control group.(5)Imaging improvement:The total nuclear magnetic load of the two groups was 1.92±0.883 before treatment,2.00±0.866 after treatment,2.03±0.984 before treatment and 2.12±0.992 after treatment.The total load of the two groups increased after treatment and before treatment.The increase trend of the test group was less than that of the control group,but there was no statistical significance.(6)TCM syndrome integration:the effective rate of the test group was 72.73%,and the effective rate of the control group was 36.36%,which was statistically significant compared with before treatment.After treatment,the two groups had statistical significance in hemiplegia,limb numbness,mouth and eye skew,memory decline,dizziness,walking instability compared with before treatment.The control group had statistical significance compared with before treatment.Compared with the two groups after treatment,the difference between limb numbness and walking instability in the experimental group and the control group was statistically significant,indicating that the improvement of limb numbness and walking instability was better than that in the control group.(7)Analysis of adverse reaction events:Three safety indexes(blood and urine routine,liver and kidney function,12-lead electrocardiogram)were not abnormal.During the period of taking medicine,one case of the control group had nausea,improved after drug treatment,and no nausea and other discomfort occurred.Conclusion1.The pathogenesis of hypertensive cerebral small vascular disease is summarized as:yin deficiency and yang hyperactivity,stasis blocking brain collaterals.2.Qianyang Yuyin prescription can improve the dizziness,hemiplegia,tongue strong speech,memory loss,waist and knee weakness,local tingling and other clinical symptoms of hypertensive cerebral microvascular disease.3.latent yang yuyin prescription can improve cognitive function,motor function,down-regulation of C reactive protein,serum uric acid,proteinuria,blood homocysteine levels in patients with hypertensive cerebral microvascular disease,and slow down the development trend of imaging.the mechanism may be related to improving vascular endothelial function,lowering blood pressure,improving blood pressure variability,etc.There was no obvious damage of liver and kidney function in the treatment of hypertensive cerebral microvascular disease 4.Qianyang Yuyin prescription,and the safety grade was Ⅱ grade. |
