摘要
目的:观察化瘀涤痰益智方结合认知康复训练治疗卒中后认知障碍(PSCI)的临床疗效及对肠道菌群多样性的影响。方法:选取60例符合纳入标准的PSCI患者,依据随机数字表随机分为治疗组和对照组,各30例。两组患者均给予常规对症治疗,对照组进行认知康复训练治疗,治疗组给予化瘀涤痰益智方结合认知康复训练联合治疗,共治疗12周。分别观察两组患者治疗前后MMSE评分、MoCA评分、SS-QOL评分、血清神经递质水平和肠道菌群多样性的变化情况,同时比较MMSE和MoCA疗效。结果:与治疗前比较,治疗后两组患者MMSE、MoCA和SS-QOL评分明显升高,5-HT、DA与NE的含量明显上调,OUT、Chao1与Shannon指数明显增加,Simpon指数明显降低,差异均有统计学意义(P<0.05)。与对照组比较,治疗组治疗后MMSE、MoCA和SS-QOL评分明显升高,5-HT、DA与NE的含量明显上调,OUT、Chao1与Shannon指数明显增加,Simpon指数明显降低,差异均有统计学意义(P<0.05)。治疗组MMSE疗效总有效率83.3%(25/30)高于对照组50%(15/30)(P<0.05);治疗组MoCA疗效总有效率86.7%(26/30)高于对照组60%(18/30)(P<0.05)。结论:化瘀涤痰益智方结合认知康复训练可明显改善PSCI患者的认知功能,疗效确切,其机制可能与改善肠道菌群多样性,增加神经递质水平有关。
Objective:To observe the clinical efficacy of the Huayu Ditan Yizhi Formula combined with cognitive rehabilitation training in treating post-stroke cognitive impairment(PSCI)and its effect on gut microbiota diversity.Methods:Sixty PSCI patients meeting the inclusion criteria were randomly divided into a treatment group and a control group,with 30 patients in each group.Both groups received conventional symptomatic treatment.The control group underwent cognitive rehabilitation training,while the treatment group received a combination of the Huayu Ditan Yizhi Formula and cognitive rehabilitation training for a total of 12 weeks.Changes in MMSE scores,MoCA scores,SS-QOL scores,serum neurotransmitter levels,and dropped out,leaving 94 patients who completed the clinical trial(48 in the treatment group and 46 in the control group).All enrolled patients had finished radiotherapy,chemotherapy,and targeted therapy for more than two months.The treatment group received modified Free Wanderer Powder orally,while the control group was given Herba Agrimoniae granules.Patients were re-evaluated every two weeks,and cancer-related fatigue scores and TCM symptom scores were recorded four weeks later.Immune function indicators were also compared before and after treatment between the two groups.Results:After treatment,cancer-related fatigue scores in both groups decreased significantly compared to pre-treatment levels(P<0.05),with the treatment group showing more significant improvement(P<0.05).The TCM symptom scores of liver qi stagnation and spleen deficiency in the treatment group significantly decreased post-treatment(P<0.05),and levels of CD4+,CD8+,and CD4+/CD8+improved significantly compared to pre-treatment levels(P<0.05).Conclusion:Modified free wanderer powder can improve cancer-related fatigue and enhance immune function in breast cancer patients of liver qi stagnation and spleen deficiency type.
作者
汪金宇
程为平
程光宇
WANG Jinyu;CHENG Weiping;CHENG Guangyu(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)
出处
《中医药信息》
2024年第8期47-51,57,共6页
Information on Traditional Chinese Medicine
基金
黑龙江省自然科学基金项目(LH2021H091)
黑龙江省卫生健康委科技计划项目(20220202041131)。
关键词
化瘀涤痰益智方
脑卒中
认知障碍
肠道菌群
Breast cancer
Cancer-related fatigue
Liver qi stagnation and spleen deficiency
Free wanderer powder
作者简介
第一作者:汪金宇(1989-),女,2021级中西医结合临床专业博士研究生,主要研究方向:中西医结合治疗脑病的研究;通信作者:程为平(1958-),男,教授,主任医师,博士研究生导师,主要研究方向:中西医结合治疗脑病的研究。
