ABSTRACT
Objective:To observe the effect of modified Dihuangyin on vascular dementia due to kidney empty phlegm and blood stasis syndrome，and its effect on phosphoinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway ［PI3K，microtuble-associated protein 1 light chain 3（LC3）Ⅱ/LC3Ⅰ，Akt，phosphorylatedprotein kinase B（p-Akt）］ in peripheral blood. Method:Totally 100 cases were randomly divided into control group （50 cases） and observation group （50 cases），and were given donepezil，modified Dihuangyin combined with donepezil for 30 d，respectively. The main efficacy indicators ［mini-mental state examination （MMSE），clinical dementia rating （CDR），activity of daily living scale （ADL），traditional Chinese medcine（TCM） syndrome］ were compared in two groups. The cerebral blood flow dynamics ［middle cerebral artery （MCA），basilar artery （BA），anterior cerebral artery （ACA），posterior cerebral artery （PCA）］ speed，serum inflammatory factors ［tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>），interleukin-6 （IL-6），transforming growth factor-<italic>β</italic> （TGF-<italic>β</italic>），C-reactive protein （CRP）］，oxidative stress indicators ［malondialdehyde （MDA），superoxide dismutase （SOD），glutathione peroxidase （GSH-Px） ，homocysteine （Hcy）］，peripheral blood PI3K/Akt signaling pathway （PI3K，LC3Ⅱ/LC3Ⅰ，Akt，p-Akt） were tested. The efficacy and adverse reactions of the two groups were compared. Result:The total effective rate was 95.9% in observation group was higher than that 72.3% in control group （<italic>χ</italic><sup>2</sup>=5.673，<italic>P</italic><0.05）. Compared with the control group after treatment，the MMSE，ADL，SOD，GSH-Px，TGF-<italic>β</italic>，PI3K，Akt and p-Akt in the observation group were increased （<italic>P</italic><0.05），CDR，MCA，BA，ACA and PCA were increased （<italic>P</italic><0.05），and the TCM syndromes，MDA，Hcy，TNF-<italic>α</italic>，IL-6，CRP，LC3Ⅱ/LC3Ⅰ were decreased （<italic>P</italic><0.05）. There was no significant difference incidence of adverse reactions between two groups. Conclusion:Modified Dihuangyin can significantly improve the clinical symptoms of patients with vascular dementia due to kidney empty phlegm and blood stasis syndrome，and the mechanism of action may be related to PI3K/Akt signaling pathway in peripheral blood.