Effect of combined use of Buyang Huanwu decoction and olanzapine on clinical symptoms, neurological function, and degree of dementia in patients with vascular dementia after cerebral ischemic stroke

Purpose: To determine the efficacy and safety of Buyang Huanwu Decoction (BHD) + olanzapine in the treatment of vascular dementia (VD) after cerebral ischemic stroke (CIS).Methods: Ninety patients with VD after CIS were assigned to 2 groups: a conventional group treated with olanzapine, and a combination group given olanzapine + BHD. Traditional Chinese medicine (TCM) symptom score was evaluated in each group. Neurological function, degree of dementia, and activities of daily living (ADL) were evaluated using National Institute of Health Stroke Scale (NIHSS), Clinical Dementia Rating (CDR) scale, and ADL scale, respectively. Levels of inflammatory factors, oxidative stress, and neurotrophic factors in peripheral blood were also determined. Middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and vertebral artery (VA) blood flow velocity (BFV) were assessed. Therapeutic effects and adverse reactions (ARs) were recorded as well.Results: The TCM symptom, NHSS, and CDR scores were decreased in the combination group, while ADL scores were increased (p < 0.05). Levels of hs-CRP, IL-6, and malondialdehyde (MDA) also decreased, while IL-10, GPx, SOD, NT3, MCA, ACA, PVA, and VA BFV, and BDNF levels increased (p < 0.05). Clinical effectiveness (CE) levels in the conventional and combination groups were 73.3 and 93.3 %, while the incidence of ARs were 11.11 and 6.7 %, respectively (p < 0.05).Conclusion: Olanzapine + BHD mitigates clinical symptoms, enhances neurological function, decreases the degree of dementia, and increases ADL in patients with vascular dementia after CIS. Moreover, it improves cerebral blood flow, and it is safe to use. An increase in sample size will be needed to compare the long-term efficacy of olanzapine alone, and that of its combination with BHD in the treatment of VD after CIS.