Efficacy of Huoxue Tongqiao Decoction combined with aniracetam in treating post-stroke cognitive impairment in elderly patients with ischemic stroke and its effects on serum levels of superoxide dismutase, glutathione peroxidase and nitric oxide

Abstract

Objective: To evaluate the clinical efficacy of Huoxue Tongqiao (blood‐invigorating and orifice‐unblocking) Decoction (HXTQD) combined with aniracetam in the treatment of post‐ischemic stroke cognitive impairment (PISCI) in elderly patients and to investigate its effects on related serum biochemical markers.

Methodology: This was a retrospective study. A total of 80 elderly patients with PSCI admitted to Baoding NO.1 Central Hospital between January 2022 to December 2024 were enrolled and randomly assigned to either the control group or the observation group using a random number table. All patients received standard internal medicine management. In addition, the control group was treated with aniracetam, while the observation group was orally administered HXTQD in combination with aniracetam. Both groups underwent continuous treatment for three months. Traditional Chinese Medicine (TCM) syndrome scores, Montreal Cognitive Assessment (MoCA) scores, Mini‐Mental State Examination (MMSE) scores, Activities of Daily Living (ADL) scores, cerebral hemodynamic parameters (bilateral middle cerebral artery mean flow velocity [Vm], resistance index [RI], pulsatility index PI]) and serum biochemical markers (superoxide dismutase [SOD], glutathione peroxidase [GSH‐Px] and nitric oxide [NO]) were assessed before and after treatment. The overall response rate (ORR) was compared between the two groups.

Results: After treatment, both groups showed significant improvements in MoCA, MMSE and ADL scores, Vm and serum levels of SOD, GSH‐Px and NO (all P < 0.05), with the observation group demonstrating significantly greater improvements than the control group (P < 0.05). TCM syndrome scores, RI and PI decreased in both groups, with more pronounced reductions noted in the observation group (P < 0.05, respectively). The ORR in the observation group was 92.50%, significantly higher than the 72.50% in the control group (P < 0.05). No adverse reactions were reported in either group.

Conclusion: The combination of HXTQD and aniracetam can significantly improve cognitive function and cerebral perfusion in elderly patients with post‐ischemic stroke cognitive impairment, potentially by regulating serum SOD, GSH‐Px and NO levels.