| Objective: To observe the symptom changes in patients with vasc ular dementia by yam balls, provide the basis for the diagnosis and treatment of vascular dementia. To observe the expression of neurotrophic factors and behavior changes in rat with vascul ar dementia, exploring mechanisms that yam pills might had in r oles of vascular dementia.Methods: The first past has 120 cases of patients, met the diag nostic criteria for vascular dementia, were randomly divided in to Chinese medicine group of 60 cases and western medicine grou p of 60 patients.Keeping the basis treatment for cerebrovascula r disease and its risk factors. Yam pills, 9 grams each time, t hree times a day,were gave to CM group; Donepezil hydrochloride(5mg / piece)was gave to WM group every night. After 8 weeks of treatment, relevant scores were observed before and after the treatment, including scores of MMSE,ADL,NPI and adverse reactio ns. The second part established an animal model of vascular dementia through cutting the bilateral carotid artery.Selecting f rom adult Wistar rats, the control group, sham, vascular demen tia group were randomized,20 rats in each group. After eight we eks of drug intervention, the rats were tested through the wate r maze learning and memory testing; PCR assay the expression of neurotrophic factor BDNF in hippocampus.Results: 1 MMSE score: Chinese group and the control group show ed an upward trend in MMSE score(p <0.01). There is no signifi cant difference(p> 0.05) in scores before and after treatment. MMSE score was significantly increased(p <0.01) after the fir st 12 weeks of treatment. No significant difference(P> 0.05) e xisted between the two groups after 12 weeks of treatment.2 NPI score: scores in TCM group and in the control group were decre ased. No significant difference(p> 0.05) existed between the t wo groups before the treatment. After 12 weeks of treatment,c ompared with scores before treatment, scores of CM group after and before had significant differences(p <0.01), and the contr ol group statistically significant differences(p <0.05).3 ADL score: score medicine group and the control group showed a dec reasing trend. No significant difference(p> 0.05) existed betw een the two groups before the treatment. After 12 weeks of trea tment,compared with scores before treatment, the scores of the two groups had significant differences(p <0.01),but between t he two groups had no significant difference(p > 0.05). 4 Score s of TCM symptoms: Among the test group of 60 cases, 35 cases w ere markedly effective and 17 cases effective. The total effective rate was 86.67% in the control group, 7 cases were markedly effective and 20 cases effective. The total efficiency is 45%. The total effective rate between the two groups was significan tly different(p <0.01).5 Navigation test: After 4d training, e scaping latency for each group were shorter than the sham opera tion group, model group was significantly longer(P <0.05), the Medicines and model group were significantly shorter(P <0.05).6 Space exploration test: the number of going through platforms was reduced than the sham group, and the swimming speed decrea sed(P <0.05); Compared with the model group, the number of goi ng through the platform in TCM group was increased,and swimming speed was increased, the difference between the two groups wa s statistically significant(P <0.05).7 Compared with the sham group, the BDNF levels in hippocampal of model group rat were s ignificantly lower(P <0.05); Compared with the model group, h BDNF levels in ippocampus of rats treated yam pill increased(P <0.05).Conclusions: Modified yam pills can effectively improve TCM sym ptoms scores,intelligent and activities of daily living. NPI sc ores decreased after treatment, suggesting that yam pills effec tively improved the behavior and psychotic symptoms in patients with vascular dementia.Modified yam pills can effectively impr ove ability of learning and memory, and increase hippocampal br ain-derived neurotrophic factor levels in the process of modifi ed yam pills treating VD,which may exert influence through the releasing of BDNF. |
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