加味涤痰汤联合吡拉西坦注射液对脑卒中患者认知功能、脑血流动力学参数及日常生活能力的影响

Effects of modified Ditan decoction combined with piracetam injection on cognitive function, cerebral hemodynamics, and activities of daily living in patients with stroke

摘要:

目的 评估加味涤痰汤联合吡拉西坦注射液对脑卒中后患者认知功能、脑血流动力学参数及日常生活能力的影响。方法 选取2019年2月—2024年2月在安康市中医医院治疗的122例脑卒中患者，采用随机数字表法分为对照组（吡拉西坦注射液）和联合组（吡拉西坦注射液联合加味涤痰汤），各61例。比较两组患者的认知功能［神经行为认知状态检查表（NCSE）、蒙特利尔认知评估量表（MoCA）］、神经功能［美国国立卫生研究院卒中量表（NIHSS）］、脑血流动力学［中脑动脉（MCA）、基底动脉（BA）、平均血流速度（Vmean）］、近期预后［日常生活能力（ADL）］及不良反应。结果 联合组治疗前后NCSE、MoCA评分的差值均大于对照组（P <0.05）。联合组治疗前后NIHSS评分的差值大于对照组（P <0.05）。联合组治疗前后MCA、BA、Vmean的差值均大于对照组（P <0.05）。联合组治疗前后ADL评分的差值均大于对照组（P <0.05）。联合组与对照组患者不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 加味涤痰汤联合吡拉西坦注射液能有效改善脑卒中后患者的认知功能和脑血流动力学参数，有助于改善患者的日常生活能力，治疗安全，适合临床推广应用。

Abstract:

Objective To evaluate the effects of modified Ditan decoction combined with piracetam injection on cognitive function, cerebral hemodynamic parameters, and activities of daily living in patients with stroke.Methods A total of 122 stroke patients admitted to Ankang Traditional Chinese Medicine Hospital from February 2019 to February 2024 were included and randomly assigned to a control group (n = 61, piracetam injection alone) and a combination group (n = 61, piracetam injection plus modified Ditan decoction). The primary evaluation indicators included cognitive function, neurological function, cerebral hemodynamics, activities of daily living, and adverse reactions.Results The differences in NCSE and MoCA scores before and after treatment were greater in the combination group than in the control group (P < 0.05). The reduction in NIHSS score was greater in the combination group than in the control group (P < 0.05). The differences in MCA, BA, and Vmean before and after treatment were also greater in the combination group (P < 0.05). The improvement in ADL score was greater in the combination group than in the control group (P < 0.05). No statistically significant difference was observed in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion Modified Ditan decoction combined with piracetam injection effectively improves cognitive function and cerebral hemodynamic parameters in patients with stroke, enhances activities of daily living, and demonstrates good safety. This therapeutic strategy is suitable for clinical application and promotion.