补肾活血方治疗老年慢性脑供血不足临床研究

周山1，杨丽燕 1，梁昊 2

1.海口市中医医院，海南 海口 570216；2.湖南中医药大学中医学院，湖南 长沙 410208摘要：目的 观察补肾活血方对老年慢性脑供血不足（CCCI）患者临床症状、眩晕程度、认知功能的改善作用并探讨其作用机制。方法 采用随机数字表法将70例患者分为观察组和对照组各35 例。2组均予降压、降糖、调脂等基础治疗。对照组在常规治疗基础上，予盐酸氟桂利嗪胶囊，每次5 mg，每日 1次，睡前口服；观察组在常规治疗基础上，予补肾活血方，每日1剂，分2次口服。均连续治疗30 d。观察治疗前后中医症状评分、眩晕残障程度评定量表（DHI）中文版评分及蒙特利尔认知评估量表（MoCA）评分，检测基底动脉（BA）、双侧椎动脉（VA）、双侧大脑中动脉（MCA）的平均血流速度（Vm）及血浆酸性磷脂（AP）含量，评价临床疗效。结果 观察组总有效率为 94.3%（33/35），对照组为 82.9%（29/35），2 组比较差异有统计学意义（P＜

0.05）；2 组患者治疗后中医症状评分、DHI评分及血浆AP含量较治疗前下降，MoCA评分及 VA、LBA、RBA、LMCA、RMCV 的 Vm 较治疗前升高（P＜0.05）；治疗后观察组中医症状评分、DHI 评分、MoCA 评分、LVA、LMCA、RMCA的Vm及血浆AP含量改善优于对照组（P＜0.05）。结论 补肾活血方治疗老年CCCI疗效显著，可改善患者临床症状及眩晕程度，提高认知水平，其作用机制可能与提高患者脑Vm、降低血浆AP含量有关。关键词：慢性脑供血不足；老年；补肾活血方；脑血流速度

DOI：10.3969/j.issn.1005-5304.2017.10.007

中图分类号：R277.73 文献标识码：A 文章编号：1005-5304(2017)10-0027-04

Clinical Study on Bushen Huoxue Decoction for Elderly Patients with Chronic Cerebral Circulation Insufficiency

ZHOU Shan1, YANG Li-yan1, LIANG Hao2 (1. Haikou Hospital of Traditional Chinese Medicine, Haikou 570216, China; 2. Ｃollege of Ｔraditional Chinese Ｍedicine, Hunan University of Chinese Medicine, Changsha 410208, China)

Abstract: Objective To observe the effects of Bushen Huoxue Decoction on clinical symptom, vertigo degree and cognitive function for elderly patients with chronic cerebral circulation insufficiency (CCCI); To explore its possible mechanism. Methods Totally 70 cases were randomly divided into observation group and control group according to the random digits table method, with 35 cases in each group. The two groups were given Western medicine consisting of blood pressure control, glucose control and blood lipid control. Based on this, the control group was given Flunarizine Hydrochloride capsules, 5 mg once a day orally before sleeping. The observation group was given Bushen Huoxue Decoction, one dose a day and taken twice a day. The treatment lasted for 30 days. The TCM symptom score, Chinese version of dizziness handicap inventory (DHI) and Montreal cognitive assessment (MoCA) score were observed. The mean blood flow velocity (Vm) of basilar artery (BA), bilateral vertebral artery (VA), bilateral middle cerebral artery (MCA) and the content of plasma acid phospholipid (AP) were detected, and the clinical efficacy was evaluated. Results The total effective rate of the observation group was 94.3% (33/35), which was significantly higher than that of 82.9% (29/35) in the control group, with statistical significance (P<0.05); after treatment, the TCM symptom score, DHI score, and the content of plasma AP were significantly lower than those of pre-treatment in the same group (P<0.05); the MoCA score and the Vm of VA, LBA, RBA, LMCA, RMCV were significantly higher than those of pre-treatment in the same group (P<0.05); the TCM symptom score, DHI score, MoCA score, the Vm of LVA, LMCA, RMCA and the content of plasma AP in the observation group were improved better than those in the control group, with statistical significance (P<0.05). Conclusion Bushen Huoxue Decoction has an obvious therapeutic effects for elderly patients with CCCI, which can improve clinical symptom, vertigo degree and cognitive level, which possible mechanism is related to increasing the cerebral blood flow velocity and reducing the content of plasma AP.

Key words: chronic cerebral circulation insufficiency; elderly; Bushen Huoxue Decoction; cerebral blood flow velocity