Bushengyiqihuoxue Treatment Of Vascular Dementia Clinical Observations And Experimental Research

Introduction: With the prolonging of people's life, the incidence rate of vascular dementia (VaD) rises obviously. It has become a common but difficultly cured disease in the process of mankind aging. But both traditional Chinese medicine (TCM) and western medicine are short of ideal therapeutic efficacy. therefore, it is very significance for the research of treating VaD. In this paper, under the guidline of TCM theory, The methods of the invigorating kidney, benefiting vital energy and promoting blood flow were used to treat VaD by the clinical observation and experimental studies.1 Clinical researchObjective: To observe further clinical curative effect of the invigorating kidney, benefiting vital energy and promoting blood flow treatment to mild VaD, and probe the mechanism.Methods: In this study, block random, double-bland and contrast clinical research methods were applied. 70 cases of VaD were divided randomly into two groups including 50 cases in trial group and 20 cases in control group. The patients of trial group were given the Shenxiong invigorating the kidney capsule (5 tablets, tid), while those in control group were given Piracetam (5 tablets, bid). All patients of the two groups were treated for 2 months, and one third cases were follow-up surveyed 1 month. The cognitive ability, the neurological impairment, the activities of daily living, TCM symptom of VaD, the quality of life, EEG, the neurotransmitter in brain and security index were measured respectively before treatment and later.Results: The clinical effect to patients showed that total effective rate of the cognitive ability, the activities of daily living and TCM symptom of VaD was 74.46% , 80.85% and 85.11% respectively, while the curative effect of trial group was higher than that of control group in TCM symptom of VaD (P<0.05). The results of general evaluated by fuzzy mathematics showed the effective rate of trial group was higher than that of control group .The total scores of MMSE and the scores of each field after treatment increased more than those before treatment except for express ability in trial group; The scores of trial group about total cognitive ability and calculation ability increased more than those of control group (P< 0.05).Comparing with those before treatment, the Scores of ADL and IADL were higher in trial group, and after treatment, the scores of PSMS in trial group increased more than those of control group (P<0.05). The scores of TCM symptom after treatment in trial group than that of before treatment; the scores of trial group about TCM symptom after treatment were lower than those of control group (P<0.05). Comparing with those before treatment, the Scores of neurologic impairment after treatment were lower in VaD patients. The results measured by WHOQOL-SF36 indicated: the total scores and the scores of each field both trial group after treatment increased more than those before treatment; the scores of trial group about total body, PF field , RP field and VT field increased more than those of control group (P<0.05). Ach,DA and NE after treatment improved more than before treatment, Ach and NE of trial group improved more than those of control group (P<0.05). EEG after treatment improved more than before treatment (P<0.01) in trial groups. Security test showed that the Shenxiong invigorating the kidney capsule was safe for patients.Conclusion: The results showed that the clinical curative effect of Shenxiong tonifying the kidney is better than Piracetam. Its some mechanism is that it can improve brain neurotransmitter of VaD sufferer.2 Experimental studyObjective: To probe the action mechanism of the invigorating kidney, benefiting vital energy and promoting blood flow therapeutic method.Methods: In experimental study, bEnd.3 CMEC strain making hypoxia and recovering oxygen cell model was applied. The cell was random distributed 7 groups, which was joined prepared normal rat serum or contain drug serum (Shenxiong invigorating kidney or Piracetam), except normal control. After the cell incubated 24 hours, washed the cell using PBS and then joined new culture solution and above-mentioned contain drug serum. Then the cell was laid up in home-made hypoxia bag and recover oxygen 1 hour after wanting oxygen 7 hour. In the end, the supernatant was obtained and tested content of NO, ET and VEGF.Results: The CMEC cell of model group excreted NO less than the cell of normal group, and excreted ET more than it, so NO/ET shrink(P<0.01). Both Shenxiong invigorating the kidney and Piracetam promoted conspicuously the cell excreting NO and decreased ET, so that NO/ET rose. Action of A, B and C groups in Shenxiong invigorating kidney groups was better than Piracetam(P<0.01 or 0.05).VEGF of model group cell was less than normal control group(P<0.01). Compare with model group, Shenxiong tonifying the kidney and Piracetam promoted in evidence that the cell released VEGF(P<0.01), but action of Shenxiong tonifying the kidney was more obvious than Piracetam(P<0.01).Conclusion: Shenxiong tonifying the kidney can obviously promote CMEC to excrete NO and VEGF, and decrease ET, so that NO/ET rise. So Shenxiong tonifying the kidney can improve brain vascular function and protect nerve function.