丁苯酞对轻度认知功能损害患者的治疗作用及机制

Effect of dl-3-budylphthalinde capsule on patients with mild cognitive impairment and its mechanism

目的探讨dl-3-正丁基苯酞软胶囊对轻度认知功能损害患者的治疗作用及初步机制。方法选择60例轻度认知功能损害患者,随机分为治疗组和对照组,每组30例,治疗组给予dl-3-正丁基苯酞软胶囊口服,200mg/次,3次/d;治疗组给予曲克芦丁片口服,180mg/次,3次/d;同时2组均口服脑复康片,1.2/次,3次/d,疗程均为2个月。治疗前后分别对2组患者进行简易智能精神状态量表(mini-mental state examinationscale,MMSE)评分,并利用氢质子磁共振波谱(1H-magnetic resonance spectroscopy,1H-MRS)的方法,分别检测左侧颞叶海马区域NAA、mI及Cho物质代谢变化。同时对2组患者治疗前后MMSE评分和NAA、mI及Cho代谢物含量进行相关分析。结果与对照组及同组治疗前(MMSE评分24.87±0.73,NAA/Cr1.224±0.228)比较,治疗组治疗后MMSE评分28.94±0.89显著增加,左侧颞叶海马区域NAA/Cr1.537±0.315显著升高;mI/Cr和Cho/Cr在各组间均无明显差异。各组患者MMSE评分与NAA/Cr均呈正相关(r=0.709、0.682、0.657、0.673),与mI/Cr及Cho/Cr无明显相关关系。结论dl-3-正丁基苯酞软胶囊可改善轻度认知功能损害患者认知功能,其机制可能与改善脑内代谢有关。

Objective To explore the therapeutic effect of dl-3-budylphthalinde capsule on patients with mild cognitive impairment and its mechanism. Methods Sixty patients with mild cognitive impairment were randomly divided into treatment group and control group, 30 cases in each group. The patients were administered with dl-3-budylphthalinde capsule 200rag once, 3 times a day in treatment group and Troxerutin tablets 180mg once, 3 times a day in control group for 2 months, respectively. Meanwhile, all patients in both groups were treated with Piracetam tablets 1.2g once, 3 times a day. All patients were examined with MMSE and 1 H-magnetic resonance spectroscopy before and after treatment to find the changes of MMSE scores and the levels of NAA,mI and Cho in left hippocampus. At the same time, correlative coefficients between MMSE scores and levels of NAA,mI and Cho were calculated. Results Compared with control group and the same group before treatment（MMSE scores 24. 87±0. 73, NAA/Cr 1. 224±0. 228）, MMSE scores 28.94±0.89 and NAA/Cr 1. 537±0. 315 in left hippocampus significantly increased in patients of treatment group after treatment. However, there was no significant difference for mI/Cr and Cho/Cr between the two groups. There was a significant positive correlation between MMSE scores and NAA/Cr （r = 0. 709,0. 682,0. 657,0. 673）, and no significant correlation between MMSE scores and mI/Cr and Cho/Cr in each group. Conclusion dl-3-budylphthalinde capsule can improve the cognitive ability of the patients with mild cognitive impairment and its mechanism may be related to the metabolic changes in brain caused by the medicine.