Effects of butylphthalein capsules combined with acupuncture on cognitive function and cerebral hemody-namic status in patients with vascular dementia after ischemic stroke
Objective To explore the application effect of butylphthalide capsules combined with acupuncture in patients with vascular dementia after ischemic stroke and its influence on cerebral hemodynamics and cognitive function.Methods Patients with vascular dementia after ischemic stroke in Hangzhou Hospital of Traditional Chinese Medicine were selected from March 2021 to December 2023 as the subjects of this study.Ac-cording to different treatment methods,they were divided into a control group(n=52,routine treatment+acupunc-ture treatment)and a combined group(n=48,butylphthalide capsule on the basis of control group).The clinical ef-ficacy,hemodynamic status[middle cerebral artery blood flow velocity(Vm),resistance index(RI),pulsatility index(PI)],serum-related indicators[serum calcitonin gene-related peptide(CGRP),endothelin(ET),hypoxia-inducible factor-1α(HIF-1α)],Montreal Cognitive Assessment(MoCA)scores,Activity of Daily Living(ADL)scores,and ad-verse reactions of the two groups were observed and compared between two groups.Results The total effective rate of treatment in combined group was 95.8％,which was higher than 82.7％in control group(x2=4.403,P=0.036).After treatment,the MMSE and MoCA scores of both groups increased.The MMSE and MoCA scores of the combined group were(29.0±1.0)and(25.9±1.0),respectively,which were higher than those of the control group[(27.7±1.1)and(23.1±1.2),respectively](t=5.950,12.442,P＜0.001).After treatment,the serum-related in-dicators of both groups changed.The CGRP in the combined group was(31±6)ng/L,which was higher than(29±6)ng/L in the control group(t=2.266,P=0.026).The ET and HIF-1α in the combined group were(69±7)pg/ml and(254±45)pg/ml,respectively,which were lower than(73±7)pg/ml and(288±52)pg/ml in the control group,re-spectively(t=3.413,3.479,P=0.001,0.001).After treatment,the hemodynamic status of the both groups de-creased.The Vm,RI,and PI in the combined group were[(19.8±1.6)cm/s,(1.59±0.19),and(0.71±0.21)],respec-tively,which were all lower than those in the control group[(19.2±1.3)cm/s,RI(1.74±0.23),PI(0.78±0.11)](t=2.121,3.539,2.111,t=0.036,0.001,0.037).After treatment,the average ADL scale scores of the both groups de-creased,with the combined group scoring(27±6),which was lower than the(31±5)of the control group(t=4.283,P＜0.001).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(y2=2.211,P=0.137).Conclusion Butylphthalide capsule combined with acupuncture has a significant effect on patients with vascular dementia after ischemic stroke.It can improve cerebral ischemia and nerve injury,regulate hemodynamic parameters,and enhance the cognitive level and daily living ability.It is safe,reliable,and has application value.
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