Clinical And Mechanism Research Of Xingshen Jiannao Decoction On Treating Vascular Cognitive Impairment No Dementia With Hyperhomocysteinemia

Objective:To explore the therapeutic effect and mechanism of Xingshen Jiannao Decoction in the treatment of VCIND with HHcy through clinical observations and animal experiments.Methods: 1.Sixty patients were randomly divided into two groups.The control group was given symptomatic treatment,and the treatment group was treated with Xingshen Jiannao Decoction for 8 weeks.Record the scores of MMSE,MoCA,CDR,ADL,TCM syndrome and Plasma Hcy before treatment,4w and8 w after treatment to evaluate the curative effect.2.Sixty SD rats were randomly divided into three groups with 20 rats in each group.The blank group was fed with ordinary feed,the model group and traditional Chinese medicine group were fed with 3% methionine feed.The HHcy model was preliminarily established with 12.94umol/L as the standard,and the VCIND model was screened by Morris water maze.After successful model building,the traditional Chinese medicine group was given Xingshen Jiannao Decoction by gavage,the blank group and model group were given the same amount of distilled water by gavage.After 14 d of intervention,the following observations were made:(1)Behavioral indicators: water maze experiment.(2)Biochemical indicators:NO,SOD,MDA,Hcy.Results:PartⅠClinical study: A total of 60 cases were included,and baseline data were comparable.1.Cognitive function:The scores of MMSE,MoCA and CDR in the treatment group were improved(P<0.05),and the effect of improving cognitive function was better than that of the control group(P<0.05).2.ADL: The ADL scores of the two groups were improved(P<0.05),and there was a statistical difference between the two groups after 8w of treatment(P<0.05).3.Hcy: Plasma Hcy decreased in both groups(P<0.05).After 4w and 8w of treatment,there was a difference between the two groups(P<0.05).4.TCM syndromes:(1)TCM syndrome total scores:TCM syndrome scores of the treatment group decreased significantly(P<0.05),after 8w,the effect was better than the control group(P<0.05);(2)TCM symptom scores:After 8w of treatment,the treatment group is better than the control group in terms of sluggish thinking,forgetfulness,language disorder,temperament changes,waist and knee weakness,dizziness and tinnitus,heavy limbs,dark lip nails,and two stools(P<0.05).Part Ⅱ Animal experiment: Excluding the rats whose Hcy is not up to the standard and having mental,limb,and vision defects,and finally included: 7 rats in the blank group,12 rats in the model group,and 11 rats in the traditional Chinese medicine group.1.Animal behavior:(1)Results of positioning and navigation experiment:During the 5d training,the escape latency of rats gradually shortened.Except for the fourth day,the model group was higher than the blank group and traditional Chinese medicine group.The average 5d incubation period of the model group was significantly higher than that of the traditional Chinese medicine group(P<0.05).(2)Space exploration experiment results:in terms of target quadrant frequency and target quadrant time:the model group is different from the blank group and the traditional Chinese medicine group(P<0.05);there is no significant difference between the traditional Chinese medicine group and the blank group(P>0.05).2.Biochemical indicators:(1)Hcy: After treatment,the Hcy of the traditional Chinese medicine group decreased significantly(P<0.05),which was more significant than the model group(P<0.05)(2)Blood SOD,MDA,NO:(1)SOD,MDA:There are differences between the model group with the blank and traditional Chinese medicine group(P<0.05),and there is no significant difference between the blank group and the traditional Chinese medicine group(P>0.05);(2)NO:There is a statistical difference between the model group and the traditional Chinese medicine group(P<0.05).Conclusion: Xingshen Jiannao Decoction can improve the cognitive function and daily living ability of patients with VCIND,and its mechanism is related to reducing the damage of HHcy to blood vessels and reducing the damage of blood vessels and neurons caused by oxidative stress.