ABSTRACT
Objective: To observe the clinical efficacy of Peiyuan Tongnao capsule combined with "Zhisanzhen" for post-stroke dementia (PSD) and investigate its mechanism.Method: Ninety-eight eligible patients were randomly divided into control group (49 cases) and observation group (49 cases) by random number table.Both groups received donepezil tablet,10 mg/time,qd,and nimodipine tablet,30 mg/time,qd.Patients in control group additionally took "Zhisanzhen" ,qd,5 times/week.Based on the treatment in control group,patients in observation group additionally took Peiyuan Tongnao capsule,3 capsules/time,tid.The treatment course was 12 weeks.Before and at the 4th,8th and 12th week after treatment,mini-mental state examination (MMSE),montreal cognitive assessment (MoCA),activity of daily living scale (ADL),neuropsychiatric inventory (NPI) and symptoms of traditional Chinese medicine (TCM) were evaluated.Before and after treatment,levels of serum hyperhomocysteinemia (Hcy),hepatocyte growth factor (HGF),oxidized low density lipoprotein (Ox-LDL) and acetylcholinesterase (AchE) were detected.Result: The total clinical effective rate was 93.88% in observation group,better than 77.55% in control group (χ2=5.333,PFcontrol=3.947,Fobservation=5.833,PFcontrol=3.876,Fobservation=6.011,Pth and 12th after treatment,scores of MMSE in the observation group were all higher than those in control group (Pth week after treatment,score of MoCA in observation group was higher than that in control group (PPPPPConclusion: Peiyuan Tongnao capsule combined with "Zhisanzhen" can improve cognitive and behavioral abilities,improve clinical efficacy,ameliorate abnormal mental behavior,relieve clinical symptoms,and regulate levels of Hcy,Ox-LDL,AchE and HGF in the treatment of post-stroke dementia.
ABSTRACT
VCI represents a spectrum of cognitive impairments associated with stroke, vascular brain injury, or subclinical disease ranging from the least to most severe manifestations. Few studies are available on the prevalence of post-stroke VCI and none have been conducted in Brazil. Objective: To determine the prevalence rates of VCI and associated risk factors in a sample of ischemic stroke patients. Methods: We evaluated 172 patients with ischemic stroke for cognitive impairment one year after ictus. Results: Patients comprised 81 women (47.1%) and had a mean age of 67.77 (7.86) years, schooling of 3.52 (2.99) years, and MMSE score of 24.94 (3.59) points. After cognitive evaluation, 4.6% were diagnosed as CIND(cognitive impairment no dementia) and 12.2% had a diagnosis of dementia (probable vascular dementia in 20 patients and one subject with cerebrovascular disease and Alzheimers disease). Conclusion: The prevalence of dementia was lower than previous reports but our sample had a lower age than others, while a 12 month-period of follow-up prevented interference from associated neurodegenerative disorders.
CCV representa um espectro de comprometimento cognitivo associado ao AVC, lesão cerebral vascular ou doença subclínica que vai desde as manifestações menos graves às mais graves. Há poucos estudos sobre a prevalência de CCV pós AVC e nenhum no Brasil. Objetivo: Determinar a prevalência de VCI em uma amostra de pacientes com AVC isquêmico e fatores de risco associados. Métodos: Foram avaliados 172 pacientes com AVC isquêmico após um ano do ictus, em relação ao comprometimento cognitivo. Resultados: Os pacientes foram compostos por 81 mulheres (47,1%) e tinham idade média de 67,77 (7,86) anos, a escolaridade de 3,52 (2,99) anos, a pontuação do MEEM de 24,94 (3,59)pontos. Após a avaliação cognitiva, 4,6% foram diagnosticados como CCSD (comprometimento cognitivo sem demência) e 12,2% tiveram diagnóstico de demência (demência vascular provável em 20 pacientes e um com doença cerebrovascular e doença de Alzheimer). Conclusão: A prevalência de demência na nossa população está entre as mais baixas, porém,nossos pacientes são mais jovens e foram acompanhados por um período de 12 meses, o que evita a contaminação por doenças neurodegenerativas associadas.