Clinical Effect Of Zhong-Feng-Gan-Shen Decoction On Vascular Dementia And Influence Of Klotho And FGF23

Objective:Clinical observation and animal experiment were conducted to investigate the clinical effect of Zhong-Feng-Gan-Shen decoction on vascular dementia and its influence on Klotho and FGF23。Methods:1.Clinical observation: A total of 68 patients were enrolled,divided into control group and treatment group,the control group received basic Western medicine treatment and Donepezil HCL treatment,treatment group patients were added with Zhong-Feng-Gan-Shen decoction on the basis of control group,4 weeks of Montreal Cognitive Assessment(MoCA),Daily Living Ability Scale(ADL)and TCM Syndrome Differentiation Scale(SDSVD)were evaluated before and after treatment to evaluate the efficacy.Fasting venous blood was used to measure serum Klotho and FGF23 concentrations before and after treatment.2.Animal experiments:purchase 36 SPF SD rats(weight 200±20g),after1 week of adaptive feeding,10 rats were randomly selected to perform sham operation after bilateral common carotid artery exposure,and 26 rats were selected to prepare VaD model.After behavioral evaluation of the success of modeling,6 rats died of accidents and 6 rats failed in modeling were excluded.The rats were divided into model group(10 rats)and treatment group(10 rats).Treatment group to Zhong-Feng-Gan-Shen decoction lavage,model group and control group in the amount of normal saline lavage,a total of intervention treatment of 4 weeks.Observe separately:(1)Behavioral indicators: Morris Water maze experiment.(2)Laboratory indicators: the expressions of Klotho and FGF23 in serum of the rats in the experment were detected by ELISA;The amplification levels of Klotho m RNA and FGF23 m RNA in the hippocampus of the rats in the experment were detected by Real-Time PCR.Results:1.Baseline data suggested that the two groups were comparable,the clinical observation results showed that the scores of MoCA and ADL of the two groups after treatment were higher than those before treatment,the SDSVD score was lower than that before treatment,the differences were statistically significant(P<0.05).2.Morris water maze test showed that the model group and the treatment group had learning and memory dysfunction,and the treatment group had significantly improved learning and memory ability than the model group(P<0.05).Serum ELISA results suggested that the model group and the treatment group had a significant reduction in serum Klotho concentration and a significant increase in serum FGF23 concentration compared with the sham-operation group(P<0.05).The concentration of Klotho was increased and the concentration of FGF23 was decreased in the treatment group compared with the model group(P<0.05).The RT-q PCR results suggested that the expression of Klotho m RNA was decreased and the expression of FGF23 m RNA was increased in the model and treatment groups compared with the sham-operation group,Klotho m RNA expression was increased and FGF23 m RNA expression was decreased in the treatment group compared with the model group(P<0.05).Conclusions:1.Baseline data suggested that the two groups were comparable,Zhong-Feng-Gan-Shen decoction can improve cognitive function and quality of life in VaD patients.2.Zhong-Feng-Gan-Shen decoction can treat VaD by regulating the expression of Klotho and FGF23,the abnormal expression of Klotho and FGF23 may be one of the pathogenesis of VaD.