SUBSCRIBE
Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (11): 1240-1246.doi: 10.3736/jcim20121107

• Original Clinical Research • Previous Articles     Next Articles

Effects of Chinese medicine for promoting blood circulation and removing blood stasis in treating patients with mild to moderate vascular dementia: a randomized, double-blind and parallel-controlled trial

Ming-qing Wei1, Jin-zhou Tian1(), Jing Shi1, Fu-yun Ma1, Ying-chun Miao1, Yong-yan Wang2   

  1. 1. Department of Encephalopathy, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
    2. Institute of Basic Research for Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
  • Received:2012-04-25 Accepted:2012-07-02 Online:2012-11-20 Published:2018-11-15

RichHTML

2

PDF (PC)

65

Like

Background: Vascular dementia (VaD) is the second common subtype of dementia after Alzheimer’s disease. However, there is still a lack of medication that demonstrates clinically relevant symptomatic improvement. Static blood obstructing the brain is the main Chinese medicine syndrome of VaD.

Objective: To evaluate the effects of Chinese medicine for promoting blood circulation and removing blood stasis in patients with mild to moderate VaD.

Design, setting, participants and interventions: In this 12-week randomized, double-blind, parallel-controlled trial, a total of 48 patients with mild to moderate VaD were enrolled between March 2009 and December 2010. All the patients entered a two-week placebo run-in period followed by a 12-week treatment with Chinese medicine for promoting blood circulation and removing blood stasis (n=24) or placebo (n=24), respectively. The placebo tablets have the identical taste and appearance as the Chinese medicine tablets.

Main outcome measures: The primary outcome measure was the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog); the secondary outcome measures included the Activities of Daily Living (ADL) and the Mini-Mental State Examination (MMSE).


Results: The Chinese medicine group showed a slight deterioration of 0.25 points and the placebo group showed a deterioration of 2.35 points from baseline by the ADAS-cog, and there was a significant difference between the two groups (P=0.027). The ADL and the MMSE showed no significant difference from baseline in both groups. Adverse events were rare in both groups.

Conclusion: The Chinese medicine for promoting blood circulation and removing blood stasis may improve cognition and it is safe and well tolerated.

Key words: dementia,vascular, drugs,Chinese herbal, blood-activating stasis-removing agents, randomized controlled trial

Figure 1

Flow diagram of the study population"

"

Index Placebo (n=23) Chinese medicine (n=24) P value
Age (year) 62.5±8.5 66.9±7.0 0.088
Gender (male/female) 16/8 16/8 1.00
Education (year) 8.6±1.0 8.1±1.4 0.160
Race (Han/others) 22/2 23/1 0.50
Height (cm) 167.5±8.3 165.1±6.5 0.282
Weight (kg) 66.3±11.6 66.7±10.7 0.868
HIS score 11.08±2.19 11.13±1.83 0.975
MMSE score 22.96±2.71 22.92±2.24 0.766
HAMD score 4.79±4.23 4.96±4.34 0.983
ADAS-cog score 12.50±8.30 11.53±2.88 0.252
ADL score 20.67±9.26 19.40±6.87 0.502
SDSVD score 12.67±4.66 13.08±3.16 0.324

"

Group n ADAS-cog ADL MMSE
Placebo 23 2.35±4.79 0.26±2.90 0.58±0.02
Chinese medicine 24 0.25±3.80* 1.04±3.51 0.38±1.50

Figure 2

ADAS-cog score at baseline and follow-up ADAS-cog: Alzheimer’s Disease Assessment Scale-cognitive subscale."

[1] Dubois MF, Hebert R . The incidence of vascular dementia in Canada: a comparison with Europe and East Asia. Neuroepidemiology. 2001; 20(3):179-187.
doi: 10.1159/000054785 pmid: 11490164
[2] Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, Copeland JR, Dartigues JF, Jagger C, Martinez-Lage J, Soininen H, Hofman A . Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology. 2000; 54(11 Suppl 5) : S4-S9.
[3] Dong MJ, Peng B, Lin XT, Zhao J, Zhou YR, Wang RH . The prevalence of dementia in the People’s Republic of China: a systematic analysis of 1980-2004 studies. Age Ageing. 2007; 36(6):619-624.
doi: 10.1093/ageing/afm128
[4] Broich K . Outcome measures in clinical trials on medicinal products for the treatment of dementia: a European regulatory perspective. Int Psychogeriatr. 2007 ; 19(3) : 509-524.
doi: 10.1017/S1041610207005273
[5] Tian J, Shi J, Zhang X, Wang Y . Herbal therapy: a new pathway for the treatment of Alzheimer 5 s disease . Alzheimers Res Ther. 2010; 2(5) : 30.
doi: 10.1186/alzrt54 pmid: 21067555
[6] Shi J, Wei MQ, Ma FY, Mao YC, Tian JZ. Characteristic of syndrome of Chinese medicine in vascular cognitive impairment patients. Zhong Yi Za Zhi. 2012 ; 53(6):503-506. Chinese with abstract in English.
时晶, 魏明清, 马福云, 苗迎春, 田金洲 . 血管性认知损害的中医证候特征.中医杂志. 2012; 53(6):503-506.
[7] Guo ZS. Effects of Chinese medicine for promoting blood circulation and removing blood stasis in treating patients with vascular dementia. Yi Yao Lun Tan Za Zhi. 2009; 30(22):99-100. Chinese.
郭志生 . 活血化瘀法治疗血管性痴呆疗效观察.医药论坛杂志. 2009; 30(22):99-100.
[8] He Z, Pan ZH , Lu WH. Neuroprotective effects of tanshinone II A on vascular dementia in rats. Zhongguo Zhong Yao Za Zhi. 2010; 35(14): 883-886. Chinese with abstract in English.
何治, 潘志红, 鲁文红 .丹参酮nA对血管性痴呆大鼠的神经保护作用机制 .中国中药杂志. 2010; 35(14): 883 _886 .
[9] Guo CJ, Wu JX , Li RX. Effects of Panax notoginseng saponins on the concentrations of neurotransmitters in brain of Alzheimer 5 s disease model mouse. Zhongguo Lin Chuang Yao Xue Za Zhi. 2004; 13(3): 150-152. Chinese with abstract in English.
郭长杰, 伍杰雄, 李若馨 . 三七总皂苷对痴呆模型大鼠大脑皮质内神经递质含量的影响.中国临床药学杂志. 2004; 13(3) : 150-152.
[10] American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 4th ed, text revised. Washington DC: American Psychiatric Association. 2000.
doi: 10.1016/S0033-3182(88)72438-X
[11] Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A, Moody DM , O’Brien MD, Yamaguchi T, Graf man J, Drayer BP, Bennett DA, Fisher M, Ogata J, Kokmen E, Bermejo F, Wolf PA, Gorelick PB, Bick KL, Pajeau AK, Bell MA, DeCarli C, Culebras A, Korczyn AD, Bogousslavsky J, Hartmann A, Scheinberg P. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS^ AIREN International Workshop. Neurology. 1993; 43(2):250-260.
[12] Rosen WG, Terry RD, Fuld PA, Katzman R, Peck A . Pathological verification of ischemic score in differentiation of dementias. Ann Neurol. 1980 ; 7(5):486-488.
doi: 10.1002/(ISSN)1531-8249
[13] Folstein MF, Folstein SE, McHugh PR. “Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. [J] Psychiatr Res. 1975; 12(3):189-198.
doi: 10.1016/0022-3956(75)90026-6
[14] Hamilton M . A rating scale for depression.[J] Neurol Neurosurg Psychiatry. 1960; 23:56-62.
doi: 10.1136/jnnp.23.1.56
[15] Tian JZ, Han MX, Tu JW, Yang CZ, Yang HM, Zou YH, Liu H. The diagnositic criteria,syndromes differentiation and outcome measures for vascular dementia. Beijing Zhong Yi Yao Da Xue Xue Bao. 2000; 23(5): 18-23. Chinese.
doi: 10.3321/j.issn:1006-2157.2000.05.007
田金洲, 韩明向, 涂晋文, 杨承芝, 杨惠民, 邹忆怀, 刘恒 . 血管性痴呆的诊断､辨证及疗效判定标准.北京中医药大学学报. 2000; 23(5):18-23.
doi: 10.3321/j.issn:1006-2157.2000.05.007
[16] Rosen WG, Mohs RC, Davis KL . A new rating scale for Alzheimer 5 s disease. Am [J] Psychiatry. 1984 ; 141(11):1356-1364.
[17] Lawton MP, Brody EM . Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179-186.
doi: 10.1093/geront/9.3_Part_1.179 pmid: 5349366
[18] Tian JZ, Liu H. Research method of the senile dementia in Chinese medicine. Zhongguo Yi Yao Xue Bao. 2000; 15(5) : 52-54. Chinese.
田金洲, 刘姮 . 老年期痴呆的中医药研究思路.中国医药学报. 2000; 15(5) : 52-54.
[19] Jiang P, Chen M, Lii J, Chen C, Jiao BH. Effect of tanshinone II A on MMP-2 and iNOS expression and free radical release in hippocampus of rat Alzheimer 5 s disease mode. Di Er Jun Yi Da Xue Xue Bao. 2010; 31(4):380-384. Chinese with abstract in English.
蒋平, 陈鸣, 吕军, 陈卿, 焦炳华 . 丹参酮Ⅱ A对阿尔茨海默病模型大鼠海马MMP-2､iNOS表达及自由基释放的影响.第二军医大学学报. 2010; 31(4):380-384.
[20] Zhu YL, Yang WQ. Effects of Compound Tablet of Red Sage Root on the expression of VEGF in brain of rat during chronic cerebral ischemia. Zhongguo Shi Yong Shen Jing Ji Bing Za Zhi. 2007 ; 10(6):26-27. Chinese with abstract in English.
朱永林, 杨伟琴 . 复方丹参片对慢性脑缺血大鼠脑内 VEGF表达的影响.中国实用神经疾病杂志. 2007; 10(6):26-27.
[21] Ferris SH . Cognitive outcome measures. Alzheimer Dis Assoc Disord. 1999; 13(suppl 3) : S140-S142.
[1] Sherman Gu, Arthur Yin Fan. Controversial conclusions from two randomized controlled trials for acupuncture's effects on polycystic ovary syndrome or in vitro fertilization support. Journal of Integrative Medicine, 2020, 18(2): 89-91.
[2] Gerli E.G. Herr, Fábio Goulart da Silva, Francisco José Cidral-Filho, Fabricia Petronilho, Lucinéia Gainski Danielski, Mariana Pereira de Souza Goldim, Afonso Shiguemi Inoue Salgado, Franciane Bobinski, Daniel Fernandes Martins, Eliane R. Winkelmann. Effects of the use of bioceramic wraps in patients with lower limb venous ulcers: A randomized double-blind placebo-controlled trial. Journal of Integrative Medicine, 2020, 18(1): 27-.
[3] Xin-yu Yue, Zhuo-qi Feng, Xi-yi Yu, Jia-min Hu, Xiao-Jing He, Shi Shu. Fire-needle acupuncture for upper limb spastic paralysis after stroke: Study protocol for a randomized controlled trial. Journal of Integrative Medicine, 2019, 17(3): 167-172.
[4] Ya-ru Huangfu, Wei Peng, Bao-jun Guo, Zhi-fu Shen, Li Li, Shi-wei, Liu, Hui Zheng, You-ping Hu. Effects of acupuncture in treating insomnia due to spleen-stomach disharmony syndrome and its influence on intestinal microbiome: Study protocol for a randomized controlled trial. Journal of Integrative Medicine, 2019, 17(3): 161-167.
[5] Pádraic J.Dunne, Julie Lynch, Lucia Prihodova, Caoimhe O'Leary, Atiyeh Ghoreyshi, Sharee A. Basdeo, Donal J.Cox, Rachel Breen, Ali Sheikhi, Áine Carroll, Cathal Walsh, Geraldine McMahon, Barry White. Burnout in the emergency department: Randomized controlled trial of an attention-based training program. Journal of Integrative Medicine, 2019, 17(3): 173-180.
[6] J.M. Oliver-Baxter, H.S. Whitford, D.A. Turnbull, M.J. Bond. Effects of vitamin supplementation on inflammatory markers and psychological wellbeing among distressed women: A randomized controlled trial. Journal of Integrative Medicine, 2018, 16(5): 322-328.
[7] Parunkul Tungsukruthai, Preecha Nootim, Wiwan Worakunphanich, Nareerat Tabtong. Efficacy and safety of herbal steam bath in allergic rhinitis: A randomized controlled trial. Journal of Integrative Medicine, 2018, 16(1): 39-44.
[8] Zahra Hajmohammadi, Mojtaba Heydari, Majid Nimrouzi, Pouya Faridi, Mohammad Javad Zibaeenezhad, Gholamhossein Ranjbar Omrani, Mesbah Shams . Rhus coriaria L. increases serum apolipoprotein-A1 and high-density lipoprotein cholesterol levels: A double-blind placebo-controlled randomized clinical trial. Journal of Integrative Medicine, 2018, 16(1): 45-50.
[9] Laura Belland, Laura Rivera-Reyes, Ula Hwang. Using music to reduce anxiety among older adults in the emergency department: A randomized pilot study. Journal of Integrative Medicine, 2017, 15(6): 450-455.
[10] Hilal Yuksel, Yasemin Cayir, Zahide Kosan, Kenan Tastan. Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: A randomized controlled trial. Journal of Integrative Medicine, 2017, 15(6): 456-461.
[11] Yoshiharu Motoo, Takashi Hakamatsuka, Nobuo Kawahara, Ichiro Arai, Kiichiro Tsutani. Standards of Reporting Kampo Products (STORK) in research articles. Journal of Integrative Medicine, 2017, 15(3): 182-185.
[12] Maria T.Chao, AlexandraChang, SanjayReddy, James D.Harrison, JosephAcquah, MiriaToveg, TrilceSantana, Frederick M.Hecht. Adjunctive acupuncture for pain and symptom management in the inpatient setting: Protocol for a pilot hybrid effectiveness-implementation study. Journal of Integrative Medicine, 2016, 14(3): 228-238.
[13] Nouran A. Aleyeidi, Khaled S. Aseri, Shadia M. Matbouli, Albaraa A. Sulaiamani, Sumayyah A. Kobeisy. Effects of wet-cupping on blood pressure in hypertensive patients: A randomized controlled trial. Journal of Integrative Medicine, 2015, 13(6): 391-399.
[14] Maria Sousa Cláudia, Coimbra Daniela, Machado Jorge, J. Greten Henry. Effects of self-administered exercises based on Tuina techniques on musculoskeletal disorders of professional orchestra musicians: A randomized controlled trial. Journal of Integrative Medicine, 2015, 13(5): 314-318.
[15] Marco Gemma, Elisa Nicelli, Luigi Gioia, Elena Moizo, Luigi Beretta, Maria Rosa Calvi. Acupuncture accelerates recovery after general anesthesia: A prospective randomized controlled trial. Journal of Integrative Medicine, 2015, 13(2): 99-104.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. An explanation on "guiding principles of clinical research on mild cognitive impairment (protocol)". Journal of Chinese Integrative Medicine, 2008, 6(1): 15-21
[4] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[5] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[6] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[7] Yi-ting He, Qing-lin Zha, Jian-ping Yu, Yong Tan, Cheng Lu, Ai-ping Lv. Principal factor analysis of symptoms of rheumatoid arthritis and their correlations with efficacy of traditional Chinese medicine and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 32-36
[8] Jun Cai, Hua Wang, Sheng Zhou, Bin Wu, Hua-rong Song, Zheng-rong Xuan. Effect of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation: A randomized controlled trial. Journal of Chinese Integrative Medicine, 2008, 6(1): 37-40
[9] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[10] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
Journal of Integrative Medicine, ISSN: 2095-4964 CN 31-2083/R
Copyright © Journal of Integrative Medicine
Powered by Beijing Magtech Co. Ltd
沪公网安备31010602003416号      沪ICP备18017633号-3