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.
Abstract
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 gut microbiota diversity were observed before and after treatment in both groups.MMSE and MoCA efficacy were also compared.Results:Compared to before treatment,the MMSE,MoCA,and SS-QOL scores of both groups significantly increased after treatment,while the levels of 5-HT,DA,and NE were significantly upregulated.The OUT,Chao1,and Shannon indices significantly increased,and the Simpson index significantly decreased,with statistically significant differences(P＜0.05).Compared to the control group,the treatment group showed significant improvements in MMSE,MoCA,and SS-QOL scores,with significant upregulation in 5-HT,DA,and NE levels.The OUT,Chao1,and Shannon indices significantly increased,and the Simpson index significantly decreased,with statistically significant differences(P＜0.05).The overall effective rate of MMSE efficacy in the treatment group was 83.3%(25/30),higher than the control group's 50%(15/30)(P＜0.05).The overall effective rate of MoCA efficacy in the treatment group was 86.7%(26/30),higher than the control group's 60%(18/30)(P＜0.05).Conclusion:The Huayu Ditan Yizhi Formula combined with cognitive rehabilitation training can significantly improve cognitive function in PSCI patients,with a confirmed therapeutic effect.The mechanism may be related to improving gut microbiota diversity and increasing neurotransmitter levels.
基金项目
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)
维普
万方数据