【摘要】 目的 观察芪参还五胶囊联合吡拉西坦胶囊治疗血管性痴呆痰瘀互结型的疗效及对患者认知功能、日常生活能力和氧化应激指标的影响。方法 将94例血管性痴呆痰瘀互结型患者按照随机数字表法分为2组，对照组47例予吡拉西坦胶囊治疗，治疗组47例在对照组治疗基础上加芪参还五胶囊治疗，2组均治疗12周。比较2组疗效；比较2组治疗前后中医证候评分、简易精神状态检查表(MMSE)评分、日常生活能力量表(ADL)评分；比较2组治疗前后超氧化物歧化酶(SOD)、丙二醛(MDA)、中枢神经特异蛋白(S100β)、神经元特异性烯醇化酶(NSE)水平变化；观察2组不良反应发生情况。结果 治疗组总有效率85.11%(40/47),对照组总有效率65.96%(31/47),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候评分较本组治疗前降低(P<0.05),MMSE评分、ADL评分均较本组治疗前升高(P<0.05);治疗后治疗组中医证候评分低于对照组(P<0.05),MMSE评分、ADL评分均高于对照组(P<0.05)。2组治疗后SOD水平较本组治疗前升高(P<0.05),MDA水平较本组治疗前降低(P<0.05);治疗后治疗组SOD水平高于对照组(P<0.05),MDA水平低于对照组(P<0.05)。2组治疗后S100β、NSE水平均较本组治疗前降低(P<0.05),治疗后治疗组S100β、NSE水平均低于对照组(P<0.05)。治疗组不良反应发生率6.38%(3/47),对照组不良反应发生率4.26%(2/47),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 芪参还五胶囊联合吡拉西坦胶囊治疗血管性痴呆痰瘀互结型，可有效提高患者临床疗效，改善患者认知功能和日常生活能力，其作用机制可能与改善氧化应激反应、降低脑损伤指标有关。更多还原

【Abstract】 Objective To investigate the effect of Qishen Huanwu Capsules combined with conventional Western medicine in treating cognitive function, ability of daily living(ADL) and oxidative stress indicators in patients with vascular dementia(VaD) of phlegm and blood stasis. Methods The patients(n=94) with VaD(phlegm and blood stasis) were randomized 1:1 to receive piracetam capsule(the control group) or Qishen Huanwu Capsule + piracetam capsule(the treatment group) for 12 weeks. The clinical efficacy, traditional Chinese medicine(TCM) syndrome score, Mini-Mental State Examination(MMSE) score, ADL score, superoxide dismutase(SOD) and malondialdehyde(MDA) before and after treatment in the two groups were included as comparators. Central nervous system specific protein(S100β) and neuron-specific enolase(NSE) levels were evaluated. The occurrence of adverse reactions was recorded. Results The total effective rate in the treatment group was higher than in the control group(85.11% [40/47] vs 65.96% [31/47]; [P<0.05], respectively). After treatment, TCM syndrome scores in the two groups were lower than before treatment(P<0.05), and MMSE score and ADL score were higher than before treatment(P<0.05), the treatment group was superior to the control group for these indexes(all P<0.05). SOD level in the two groups increased(P<0.05), and the MDA level decreased(P<0.05); the treatment group was superior to the control group for SOD and MDA(both P<0.05). S100β and NSE in the two groups were lower than those before treatment(P<0.05), which in the treatment group were lower than those in the control group after treatment(P<0.05). There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(6.38% [3/47] vs 4.26%(2/47); [P>0.05], respectively). Conclusion For VaD patients(phlegm and blood stasis type), Qishen Huanwu Capsule combined with conventional Western medicine can effectively improve the clinical efficacy, cognitive function and ADL. Its mechanism may be related to improving oxidative stress response and reducing brain injury indexes.更多还原