通心络治疗血管性痴呆的疗效观察

The therapeutic effect of Tongxinluo capsule on vascular dementia

目的观察通心络胶囊治疗血管性痴呆(VD)的疗效及对脑血流、脑电图的影响。方法120例VD患者随机分为A组(60例)和B组(60例)。A组予通心络胶囊4粒口服,每日3次;B组予盐酸多奈哌齐5mg口服,每日1次。2组均12周为1个疗程。按简易精神状态量表(MMSE)、韦克斯勒记忆量表(WMS)及日常生活自理量表(ADL)行治疗前后疗效评定;检测经颅多普勒超声(TCD)、脑电图(EEG)的变化,并观察不良反应。结果A组60例均完成1个疗程,B组有2例失访,58例完成1个疗程。A组治疗总有效率为66.7%,B组为60.3%,差异无统计学意义(P>0.05);与治疗前比较,治疗后2组MMSE、WMS、ADL积分均显著提高(P<0.01),颈内动脉系和椎基底动脉系血流平均速度均增加(P<0.01),α波频和波幅、θ波频均增加,θ波幅减低(P均<0.01)。2组患者均未见明显不良反应。结论通心络胶囊治疗VD疗效与多奈哌齐相当,可用于VD的治疗。

Objective To observe the therapeutic effect of Tongxinluo capsule on vascular dementia （VD） and the changes of cerebral blood flow and electroencephalogram. Methods One hundred and twenty cases with VD were randomly divided into group A （60 cases） and group B （60 cases）. Cases in group A were treated with Tongxinluo capsule （4 tables, po, tid）, while group B were treated with donepezil hydrochloride （5mg, po, qd）, lasted 12 weeks. The changes of MMSE, WMS, ADL scoring were evaluated and compared between before and after therapy. And the changes of TCD and EEG were monitored in all patients. Results The patients in group A were followed up completely, and 2 cases in group B were lost. The total effective rate of A and B group was similar （66.7% vs 60.3%, respectively, P 〉 0.05）.Mter 12 weeks treatment, the scores of MMSE, WMS and ADL in beth groups were higher than those before treatment （ P 〈 0.01 ）. The mean cerebral blood flow of internal carotid artery and vertebral basilar artery were improved after treatment （ P 〈 0.01 ）. It showed that in EEG, frequency and amplitude of a wave and frequency of θ wave were increased, while amplitude of θwave was decreased after treatment in both groups （ P 〈 0.01 for each）. Both group had few side effects. Conclusion There was no significant difference between Tongxinluo capsule and donepezil hydrochloride in treating vascular dementia.