通心络胶囊对脑卒中后不同程度血管性认知功能障碍并偏瘫患者功能结局的影响

Evaluate the functional outcome of Tongxinluo capsules on the different degree of vascular cognitive impairment after stroke and hemiplegia

目的观察通心络胶囊对脑卒中后不同程度血管性认知功能障碍患者认知功能、运动功能、日常生活能力(ADI)的影响及康复效益。方法将符合入选条件的患者按病因分为血管性痴呆(VD)患者(n=53例)和非痴呆性认知功能障碍(VCIND)患者(n=70例),然后VD和VCIND患者再随机分为治疗组(VD_1组、VCIND_1组)和对照组(VD_2组、VCIND_2组)。所有患者均进行认知功能训练、运动功能及ADL训练。VD_1组、VCIND_1组在上述治疗基础上服用通心络胶囊4粒,每日3次,连服12周。在治疗和训练前后用神经行为认知状况评估量表(NCSE)、简化Fugl-Meyer运动功能评分表、Barthel指数(BI)进行相应的评价,采用ADL能力的改善值与住院天数比值进行康复效益评定。结果 (1)NCSE评分:与治疗前比较,VCIND_1组多项认知功能指标评分升高(P<0.05),且优于VCIND_2组(P<0.05),VD_1组仅定向力评分增加。(2)Fugl-Meyer评分和Barthel指数评分:与治疗前比较,VCIND_1组升高(P<0.05),且优于VCIND_2组(P<0.05),VD_1组仅Fugl-Meyer评分升高(P<0.05)。(3)康复效益:VCIND_1组优于VD_1组(P<0.05)。结论 VCIND和VD患者在康复治疗基础上配合通心络胶囊口服,可促进不同程度血管性认知功能、运动功能和ADL能力障碍的改善,提高患者的康复效果,且VCIND患者优于VD患者。

Objective To compared with the cognitive function,motor function,ADL and rehabilitation efficacy,observe the therapeutic effects of Tongxinluo capsules on patients after stroke with different degree of vascular cognitive impairment without dementia（VCIND） and with dementia（VD）.Methods Total of 123 participants including VD（n =53） and VCIND（n =70） were enrolled in the study.Patients were divided into treatment group（VD1group,VCIND1group）and control group（VD2 group,VCIND2 group）randomly.All patients received cognitive training,physical therapy and ADL training. Patients in treatment group were administrated with Tongxinluo capsules（4 pills once,3 times a day）.The treatment lasted for 12 weeks.The neurobehavioral cognitive status exam assessment（NCSE） was used to assess cognitive function,the Fugl-Meyer motor assessments were used to assess motor function,the Barthel index（BI） were used to assess ADL and the rehabilitation efficacy was evaluated by the ratio between the changed value of ADL and the hospitalized days before and after the treatment. Results After treatment with Tongxinluo capsules in VCIND1,the NCSE scores increased significantly（P〈0.05）,while the NCSE scores in VD1 increased only in orientation with the significant difference（P〈0.05）.After training and treatment with Tongxinluo capsules in VCIND_1,the improvement of motor functions and ADL were significant difference（P〈0.05）, while in VD_1 only the improvement of motor functions were significant（P〈0.05）.The rehabilitation efficacy in VCIND_1 were significant difference compared with those in VD_1（P〈0.05）.Conclusion These results revealed that the NCSE scores,the improvement of motor functions and ADL in VCIND were better than VD,the rehabilitation efficacy in VCIND was superior to VD.Tongxinluo capsules is helpful for increasing the functional outcome and the rehabilitation efficacy in VCIND and VD.