| Objective: To observe the clinical efficacy and safety of the traditional medicine "tonifying kidney and activating blood" for the early treatment of mild cognitive impairment of cerebral small vessel disease(MCI-CSVD),and to provide a new treatment for patients with mild cognitive impairment of cerebral small vessel disease,and a new strategy for prevention of progression to vascular dementia.Methods: This was a prospective case-control study in patients with confirmed diagnosis of CSVD.The patients were selected from the departments of neurology and nephrology of Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital between October 2018 and October 2019.The general demographic information,education level and basic diseases of the patients were collected.The syndromes of traditional Chinese medicine(TCM)were classified.The patients who met the criteria were divided into treatment group and control group according to the random number table.Thirty five cases in the control group accepted the health guide,including the second-level prevention of stroke,dietary guidance and exercise guidance.The patients in treatment group were treated with "tonifying kidney and activating blood circulation" characteristic Chinese medicine for 12 weeks as a course of treatment.Neuropsychological scales were used to assess the levels of whole cognitive and different cognitive domains before and after treatment,including the Montreal Cognitive Assessment(Mo CA),Rey Auditory Vocabulary Learning Scale(RAVLT),Wired Test(Trail Making Test,TMT),Digital Breadth Test(the digit span test,DST),Speech Fluency Test(verbal fluency test,VFT),and Activity of daily living(ADL).The results were analyzed by using SPSS 23.0 statistical software.Results: In this study,a total of 70 patients with MCI-CSVD were included,4 cases were removed,66 cases were actually observed,the rate of loss was 5.71%,and the sample loss rate was in accordance with the plan.1.general comparative analysis: Age,sex,length of education,TCM syndrome score,pre-treatment Montreal cognitive assessment(Mo CA),hearing vocabulary learning scale(RAVLT),line test(TMT),digital breadth test(DST),speech fluency test(VFT)assessment baseline comparison between the two groups showed no statistically significant difference(P >0.05),indicating that the two groups of patients were comparable.2.Comparison of TCM syndrome score and comprehensive efficacy: the difference between the two groups was statistically significant(P<0.05).The difference in efficacy index was statistically significant(P<0.05),and the efficacy of the treatment group was significantly higher than that of the control group.Comparison of comprehensive efficacy: the total effective rate of the treatment group(90.91%)was significantly higher than that of the control group(69.69%),and the difference was statistically significant(P<0.05).3.Comparison of Montreal cognitive assessment(Mo CA)scores: the difference was statistically significant in the treatment group(P<0.05)and in the control group(P<0.05).The difference between the two groups was statistically significant(P<0.05).4.Comparison of ADL scores: the difference was not statistically significant in the treatment group(P>0.05),while the difference was not statistically significant in the control group(P>0.05).The difference between the two groups was not statistically significant(P>0.05).5.Comparison of TMT scores: the difference was statistically significant in the tmt-b treatment group(P<0.05),but not in the control group(P>0.05),and the difference was statistically significant in the two groups(P<0.05).The difference in TMT b-tmt A treatment group was statistically significant(P<0.05),while that in the control group was not(P>0.05).The difference in scores between the two groups was statistically significant(P<0.05).6.Comparison of scores of auditory vocabulary learning scale(RAVLT delayed memory): the difference was statistically significant in the treatment group(P <0.05),but not in the control group(P>0.05).The difference between the two groups was statistically significant(P<0.05).7.Comparison of DST scores: the difference was statistically significant in the treatment group(P<0.05),and in the control group(P<0.05).The difference between the two groups was statistically significant(P<0.05).8.Comparison of speech fluency test(VFT)scores: the difference was statistically significant in the treatment group(P <0.05),while the difference was not statistically significant in the control group(P>0.05).The difference between the two groups was statistically significant(P<0.05).Conclusion:1.The general data of the two groups were not statistically significant and comparable.2.After treatment the curative effect and TCM symptom integral index,Montreal cognitive assessment(Mo CA)score,attachment test(TMT)score,hearing vocabulary learning scale(RAVLT delayed memory)score,digit span test(DST),verbal fluency test(VFT)score comparison,difference have statistical significance,small hints kidney and activating blood to improve brain vascular disease in patients with mild cognitive dysfunction syndromes,the overall cognitive domain and execution,attention,delay free recall,the respect such as information integration ability is superior to the traditional integrated intervention therapy.3.The difference in the comprehensive efficacy between the two groups was statistically significant,suggesting that the overall recovery rate of patients with mild cognitive impairment of cerebrovascular disease by tonifying kidney and activating blood circulation was higher than that of traditional comprehensive intervention alone.This study was further verified that the rational use of traditional Chinese medical methods to improve the cognitive function of patients with cognitive impairmen were effective.It was one of the most important treatment methods available at present.Starting with the early mild cognitive impairment,it was in line with the theory of "treating diseases without disease and preventing disease" in the traditional medicine.It improved the cognitive function of patients effectively,improved the quality of life of patients. |
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