摘要
目的:探讨脑髓康干预皮层下小血管病所致轻度血管性认知障碍潜在的神经机制。方法:将患者随机分为治疗组和对照组各20例。治疗组服用脑髓康胶囊,对照组服用尼莫地平片,周期均为6个月。分别比较蒙特利尔认知评估积分总有效率及血管性痴呆的中医辨证量表(SDSVD)总有效率,采集静息态功能磁共振数据并计算治疗有效与无效之间比率低频振荡振幅(fALFF)的组间差异。结果:治疗6个月后,治疗组20例和对照组17例完成全部研究,两组MoCa积分总有效率(80.00%vs76.48%)差异无统计学意义,但中医证候积分总有效率治疗组为90.00%,对照组为58.82%,明显优于对照组。与无效患者相比,治疗组有效患者表现为右侧额上回激活显著增加,对照组有效患者表现为右侧额中回激活显著增加。结论:右侧额叶自发性神经活动增高是认知功能改善的有效预测靶标,额中回和额上回可能是区别中西药在改善中医证候积分上疗效差异的潜在原因。
Objective: To investigate the potential neural mechanism of Naosuikang on the treatment of mild vascular cognitive impairment caused by subcortical cerebral small vessel disease. Methods:Patients were randomly divided into Naosuikang treatment group(n = 20) and positive control group(n = 20). Patients in the positive group were given nimodipine tablets. The intervention course was 6 months. The Montreal cognitive evaluation score and the total score of Syndrome Differentiation Scale of Vascular Dementia(SDSVD) were collected before and after the treatment. The resting-state functional magnetic resonance imaging(fMRI) data were collected and the frational Amplitude of Low Frequency Fluctuations(fALFF) between effective and ineffective treatment was calculated. Results: After 6 months of treatment, 20 cases in Naosuikang group and 17 cases in the positive control group had completed the whole study. No significant difference was observed in total effective rate of MoCa score between the two groups(80.00% vs 76.48%). But the total effective rate of SDSVD in Naosuikang gourp was significant higher than that in positive control group(90.00% vs 58.82%). Compared to ineffective patients, the activation of right superior frontal gyrus was significantly increased in Naosuikang group, and the activation of the right middle frontal gyrus was significantly increased in the positive control group. Conclusion: The increase of spontaneous nerve activity in the right frontal lobe is an effective predictor of cognitive function improvement. The difference between middle frontal gyrus and superior frontal gyrus may be the potential reasons for the difference of SDSVD improvements between Chinese medicine and western medicine.
作者
王建军
郑浩涛
周流畅
孔繁鑫
刘璇
秦秀德
蔡浩斌
林松俊
虢周科
Wang Jianjun;Zheng Haotao;Zhou Liuchang;Kong Fanxin;Liu Xuan;Qin Xiude;Cai Haobin;Lin Songjun;Guo Zhouke(the Fourth Clinical College,Guangzhou University of Chinese Medicine,Shenzhen 518033;Shenzhen Hospital of Chinese Medicine,Shenzhen 518033)
出处
《中药药理与临床》
CAS
CSCD
北大核心
2019年第3期152-156,共5页
Pharmacology and Clinics of Chinese Materia Medica
基金
国家自然科学基金青年科学基金项目(81804004)
深圳市科创委学科布局(JCYJ20160428174825490),深圳市科创委自由探索项目(JCYJ20170307154620600)
中国博士后科学基金面上项目(2018M643207)
广东省中医药管理局建设专项(20182122)
广东省中医药局建设专项(201707060738)
深圳市卫生系统科研项目(SZBC2018005)
关键词
血管性认知障碍
功能磁共振
比率低频振荡振幅
脑髓康
额叶
vascular cognitive impairment
functional magnetic resonance imaging
fALFF
Naosuikang
frontal lobe
