补肾祛瘀中西医结合治疗脑小血管病患者血压变异性、蒙特利尔认知评估及动脉硬化指数的临床研究
Clinical Study on Blood Pressure Variability, Montreal Cognitive Assessment and Arteriosclerosis Index in Patients with Cerebral Small Vessel Disease Treated with Integrated Traditional Chinese and Western Medicine by Invigorating Kidney and Removing Blood Stasis.
作者信息
Wang Tianzhan, Liang Fang, Wang Yuxin, Huo Qingping, Wang Bing
机构信息
Department of Traditional Chinese Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
出版信息
Evid Based Complement Alternat Med. 2022 Oct 13;2022:5661303. doi: 10.1155/2022/5661303. eCollection 2022.
OBJECTIVE
To explore the clinical improvement in blood pressure variability, Montreal Cognitive Assessment, and angiosclerosis index in patients with cerebral small vessel disease treated with integrated traditional Chinese and Western medicine.
METHODS
A randomized controlled study of patients with cerebral small vessel disease who were treated in our hospital from November 1, 2018, to January 31, 2022. The enrolled patients were randomized into 2 groups according to the random numbers: an observation group treated with integrated traditional Chinese and Western medicine and a control group treated with Western medicine only. Blood pressure variability, Montreal Cognitive Assessment (MoCA), and angiosclerosis index were compared between the two groups.
RESULTS
There were 71 qualified cases in the observation group and 58 qualified cases in the control group. Before treatment, the indicators between the two groups were comparable ( > 0.05). After treatment, the mean values of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly decreased ( < 0.05); the decrease of 24hSBP-coefficient of variation (CV), daytime SBP (dSBP)-CV, 24hSBP-standard deviation (SD), and dSBP-SD in the observation group was significantly better than that in the control group; the MoCA scores of the observation group were significantly higher than those of the control group (( < 0.05); the ABI and PWV were significantly different between the two groups ( < 0.05); TC, TG, HDL-C, and LDL-C in observation group decreased after treatment, and HDL-C increased significantly ( < 0.05).
CONCLUSION
Integrative traditional Chinese and Western medicine treatment can further reduce the blood pressure variability, especially systolic blood pressure; improve the MoCA score and cognitive function, increase the ankle-brachial index, reduce pulse wave velocity and the degree of arteriosclerosis; and improve lipid metabolism a comprehensive intervention role.
目的
探讨中西医结合治疗对脑小血管病患者血压变异性、蒙特利尔认知评估及血管硬化指数的临床改善情况。
方法
对2018年11月1日至2022年1月31日在我院接受治疗的脑小血管病患者进行随机对照研究。将入选患者按随机数字分为2组：中西医结合治疗的观察组和仅接受西医治疗的对照组。比较两组的血压变异性、蒙特利尔认知评估（MoCA）及血管硬化指数。
结果
观察组有71例合格病例，对照组有58例合格病例。治疗前，两组指标具有可比性（>0.05）。治疗后，收缩压（SBP）和舒张压（DBP）的平均值显著降低（<0.05）；观察组24小时收缩压变异系数（CV）、日间收缩压（dSBP）-CV、24小时收缩压标准差（SD）及dSBP-SD的降低情况明显优于对照组；观察组的MoCA评分显著高于对照组（<0.05）；两组的踝臂指数（ABI）和脉搏波速度（PWV）有显著差异（<0.05）；观察组治疗后总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）及低密度脂蛋白胆固醇（LDL-C）降低，HDL-C显著升高（<0.05）。
结论
中西医结合治疗可进一步降低血压变异性，尤其是收缩压；改善MoCA评分及认知功能，增加踝臂指数，降低脉搏波速度及动脉硬化程度；并对脂质代谢起到综合干预作用。
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