| Objective:To observe the curative efficacy of Xingshen Jiannao Decoction on patients with VCIND and sleep disorders,to explore the effects of Xingshen Jiannao Decoction on learning and memory ability and synaptic plasticity of VCIND rats,discuss the correlation between synaptic plasticity and sleep disorders.Methods:1.90 patients were randomly divided into control group(symptomatic treatment),treatment group(Xingshen Jiannao Decoction),45 patients each.During the treatment period,the two groups were evaluated by MMSE,Montreal Cognitive Assessment(Mo CA),Clinical Dementia Rating Scale(CDR),ADL and Pittsburgh Sleep Quality Scale(PSQI)on their cognitive function,daily living ability,sleep and TCM symptoms before and after treatment.All data were analyzed by SPSS17.0.1.A total of 60 SPF male SD rats were randomly divided into blank group(normal diet),model group(high methionine diet)and TCM group(high methionine diet) with 20 rats each.After the VCIND model was successfully established,three groups of rats were given intragastric intervention,the TCM group was given Xingshen Jiannao formula intragastric administration,the other rats were given normal saline intragastric administration.After 14 days,learning and memory ability,hippocampal neurons,synaptic protein SYN1 and PSD95 were detected by Morris water maze,paraffin section staining and Western blotting.Results:Part I Clinical Study:1.Baseline Comparison:The control group and the treatment group were statistically consistent in many aspects(sex ratio,ethnic ratio,age composition,risk factors,pre-treatment scale scores).2.MOCA score:Intergroup comparison:MOCA score of the treatment group was always higher than that of the control group during the treatment period(P<0.05);Intra-group comparison: Although the treatment methods were different in the two groups,the MOCA score after treatment was higher than that at the time of inclusion(P<0.05).3.MMSE score:Intergroup comparison:After 8 weeks,the MMSE score of control group was significantly lower than that of treatment group(P<0.05).Intra-group comparison: MMSE scores of the two groups after treatment were significantly higher than those before treatment(P<0.05).4.ADL score:There was no significant difference between and within the two groups(P>0.05).5.CDR score:Intergroup comparison:no statistically significant difference was showing in CDR score between the two groups after treatment(P>0.05);Intra-group comparison:the score of the control group showed no significant change after 8 weeks(P>0.05),while the CDR score of the treatment group decreased after treatment compared with before treatment,the difference was statistically significant(P<0.05).6.PSQI score:Intergroup comparison:According to the statistical data,the sleep quality of the treatment group was higher than that of the control group(P<0.05).Intra-group comparison:Symptomatic treatment did not change the scores of the control group(P<0.05).while Xingshen Jiannao decoction could significantly reduce the PSQI score in the treatment group(P<0.05).7.TCM syndrome score:Intergroup comparison:the total scores and individual scores of TCM syndrome in the treatment group were lower than those in the control group after treatment,and the differences were statistically significant(P<0.05).Intra-group comparison:there was no significant difference in the total score of the control group compared with that before treatment(P>0.05).The single item score of staying symptoms decreased,which was statistically significant compared with that before treatment(P<0.05).The total score and individual score of the treatment group were significantly lower after treatment than before treatment,from a statistical point of view,the difference was significant(P<0.05).Part II Experimental Study:1.After feeding the high methionine diet for 3months,the blood homocysteine of the rats was generally higher than12.95umol/L.Through the water maze,the rats with 20% higher than the average escape latency of the blank group were selected as the VCIND model.The final number was: 12 rats in the model group,and 11 rats in the TCM group,7 rats in the blank group.Compared with the model group,the spatial exploration ability of rats in the TCM group was significantly improved in the water maze test after intervention,including the number of entering the fourth quadrant,the time of entering the fourth quadrant and the time of head touching the platform(P<0.05).Meanwhile,the escape latency of the first day in the model group was statistically significant(P<0.05).2.Hippocampal neurons were observed by HE staining:The neurons in the blank group were regular in morphology,uniform in staining,closely linear in arrangement and small in cell space.In the model group,the arrangement of neurons was scattered and loose,the cell space was enlarged,some of them showed vacuolar changes,and the nuclei were hyperchromatic.Compared with the model group,the arrangement of neurons in the TCM group was scattered and the cell space was slightly smaller,which could maintain the basic linear arrangement,and the cell layer was more than that in the model group.3.Western blotting showed that the contents of PSD-95 and SYN1 in rats were arranged as follows:blank group>TCM group>model group.Compared with the TCM group and the blank group,the expression level of PSD-95 in the model group were both statistically significant(P<0.05).Conclusion:It was concluded that Xingshen Jiannao Decoction can improve cognitive function,sleeping function in patients with VCIND associated with sleep disorders significantly.The relevant mechanism may be related to improving the hippocampus neuron ischemic anoxia,reducing apoptosis of hippocampus neurons,improving the expression of synaptic protein,regulating synaptic plasticity,enhancing the neurotransmitter passing on. |
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