Clinical Observation Of Tongqiao Huoxue Decoction In The Treatment Of Cognitive Impairment Of Cerebral Small Vessel Disease (Blood Stasis Blocking Collaterals)

Objective:To observe the clinical efficacy and evaluate the efficacy and safety of Tongqiao Huoxue Decoction in the treatment of cerebral small-vessel disease cognitive Impairment(CSVCI)caused by blood stasis blocking collaterals,with a view to improving the cognitive Impairment caused by cerebral small-vessel disease using the dialectical theory of Chinese medicine and providing individualized Chinese medicine treatment plans for clinical practice.Methods:To reduce risk factors,all sixty individuals with CSVCI were given routine basic therapy,and then randomly assigned to either a control group(N=30)or a treatment group(N=30).The control group received a single 5mg tablet of donepezil hydrochloride per night,while the treatment group received Tongqiao Huoxue Decoction following the same protocol.Both groups underwent a 12-week treatment course,during which their MMSE,MOCA,VFT,CDT,DST,ADL,SDSVD,Hcy,hs-CRP,and LDL-C scores were assessed before and after treatment to observe the therapeutic effects.After collecting the data,the statistical software SPSS23.0 was utilized to compare the differences before and after treatment,and to comprehensively evaluate the feasibility and safety of using Tongqiao Huoxue Decoction to treat CSVCI.Result:1.Clinical efficacy analysis:(1)Cognitive function: following the 12-week treatment,both groups showed improvement in their MMSE,MOCA,DST,VFT,and CDT scores(P<0.05),with the Tongqiao Huoxue Decoction group demonstrating a superior therapeutic effect compared to the control group(P<0.05).(2)ADL scores: after 12 weeks of treatment,both groups showed improvements in ADL scores compared to before treatment(P<0.05).Tongqiao Huoxue Decoction did not have a better healing effect than the control group(P>0.05).(3)TCM syndrome scores: the SDSVD scores of both groups of patients decreased after12 weeks of treatment compared to before treatment(P < 0.05),and the curative effect of Tongqiao Huoxue Decoction was better than that of the control group(P < 0.05).(4)Clinical efficacy determination:after treatment,the total effective rate of cognitive function of MOCA in Tongqiao Huoxue Decoction group was 90.00%,and that of control group was 66.67%.The two groups showed a statistically significant difference in the efficacy of cognitive function(P< 0.05).After treatment,the Tongqiao Huoxue Decoction group showed a total effective rate of 83.33% for TCM syndrome,while the control group had a rate of 40.00%,the difference between the two groups was significant(P< 0.05).2.Laboratory indicators:Hcy,hs-CRP,LDL-C: after 12 weeks of treatment,the levels of Hcy,hs-CRP,LDL-C in Tongqiao Huoxue Decoction group were lower than those before treatment(P< 0.05),after 12 weeks of treatment,significant differences(P< 0.05)were observed in the levels of hs-CRP and LDL-C in the control group,which were lower than the levels before treatment.The level of Hcy was lower than that before treatment,but there was no significant difference(P> 0.05),the level of reduction of all three biochemical indexes in the Tongqiao Huoxue Decoction group was better than that in the control group(P<0.05).Conclusion:1.The efficacy of Tongqiao Huoxue Decoction is significantly better than that of oral donepezil alone in improving the cognitive ability and TCM efficacy scores of CSVCI patients caused by blood stasis blocking collaterals.It also can notably enhance the daily living ability of CSVCI patients caused by blood stasis blocking collaterals.However,the efficacy of the two ways is comparable.2.Tongqiao Huoxue Decoction can decrease the levels of Hcy,hs-CRP and LDL-C in serum of patients with CSVCI caused by blood stasis blocking collaterals,which indicates that Tongqiao Huoxue Decoction can improve the chronic inflammatory state and vascular endothelial function of patients with CSVCI.