Clinical Observation On The Treatment Of Vascular Cognitive Impairment With No Dementia With Modified Buyang Huanwu Decoction

Objective:To observe the clinical effect of modified Buyang Huaiwu Decoction in treating Vascular Cognitive Impairment of None Dementia(VCIND)with Qi deficiency and blood stasis syndrome,and to explore the etiology and pathogenesis of the disease from the perspective of traditional Chinese medicine,so as to provide new ideas and clinical basis for the treatment of Vascular Cognitive Impairment(VCI).Methods:60 cases of VCIND with Qi deficiency and blood stasis syndrome were divided into two groups randomly.One is the control group(30 cases),which was only given nimodipine.Another is treatment group(30 cases),which was given modified Buyang Huanwu Decoction with nimodipine.The course of treatment was 12 weeks.MoCA,ADL and the TCM syndrome score were evaluated before and after treatment for 4 weeks,8 weeks and 12 weeks.The effectiveness of modified Buyang Huanwu Decoction in the treatment of VCIND was observed through statistical analysis and comparison of these data.Results:1.Western medicine scale analysis:(1)Intra group control:the total score of MoCA in the control group and the treatment group increased significantly after 4 weeks of treatment(all P<0.05).At the end of 12 weeks,the scores of sub item of MoCA in the control group were significantly improved only in visuospatial executive ability,orientation and delayed recall(all P<0.05).While the scores of visuospatial executive ability,attention,language,abstraction,delayed recall and orientation in the treatment group were significantly improved compared with those before treatment(all P<0.05).The ADL score of the control group was significantly improved 8 weeks after treatment(P<0.05),while the treatment group was significantly improved 4 weeks after treatment(P<0.05).(2)Inter group control:at the end of 12 weeks of treatment,the total score of MoCA and ADL score of the treatment group were better than those of the control group(P<0.05,P<0.05).MOCA sub items showed that there were significant differences in visuospatial and executive ability,attention and delayed recall between the two groups,and the treatment group was better than the control group(all P<0.05).2.TCM syndrome analysis:compared with before treatment,the TCM syndrome scores of the two groups decreased significantly 4 weeks after treatment(all P<0.05).After 8 and 12 weeks of treatment,the improvement in the treatment group was better than that in the control group(P<0.05,P<0.05).At the end of 12 weeks after treatment,the scores of qi deficiency syndrome and blood stasis syndrome in the two groups were significantly improved compared with those before treatment(all P<0.05).Compared with the control group,the score of blood stasis syndrome in the treatment group was significantly lower than that in the control group at the end of 12 weeks after treatment(P<0.05),while the score of qi deficiency syndrome in the treatment group was significantly lower than that in the control group 4 weeks after treatment(all P<0.05).3.At the end of 12 weeks,the effective rate of ADL,cognition and TCM syndrome score of the treatment group was significantly better than that of the control group(all P<0.05).4.There were no serious adverse reactions in the two groups.Conclusion:1.Modified Buyang Huanwu Decoction Combined with nimodipine and nimodipine alone showed significant effect in improving cognition,improving quality of life and reducing TCM syndrome score,and the TCM combined group was better than the western medicine control group.2.Modified Buyang Huanwu Decoction Combined with nimodipine showed better advantages in improving the visual spatial executive ability,recall ability and attention.3.Modified Buyang Huanwu Decoction Combined with nimodipine in the early treatment of visual spatial executive ability,recall ability and attention showed significant improvement,which may be related to the early improvement of TCM Qi deficiency syndrome.