丁苯酞软胶囊改善帕金森痴呆患者认知功能和日常生活能力的效果及其对相关因子的影响

The effect of butylphthalide soft capsule for improving cognitive function and activities of daily living of Parkinson's dementia

目的观察丁苯酞软胶囊改善帕金森痴呆(PDD)患者认知功能和日常生活能力的效果。方法 2013年6月—2015年6月湖北医药学院附属十堰市人民医院神经内科收治帕金森痴呆患者84例,按照随机数字表法分为观察组及对照组各42例。2组均予常规治疗,对照组加用盐酸多奈哌齐口服,观察组在对照组基础上加服丁苯酞软胶囊,治疗时间均为12周。观察2组治疗效果;记录2组治疗前后帕金森病评定量表(UPDRS)、简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)及日常生活能力(ADL)评分;同时测定2组治疗前后血清C-反应蛋白(CRP)、重组人帕金森病蛋白7(PARK7)、神经营养因子-3(NT-3)水平。结果治疗后,观察组总有效率为95.24%,显著高于对照组的76.19%(X^2=6.222,P<0.05);观察组UPDRS总评分低于对照组[(20.32±5.26)分vs.(35.12±5.11)分,P<0.05],而MMSE、MoCA、ADL评分均显著高于对照组[分别为(28.92±4.78)分、(27.89±4.36)分、(75.39±4.58)分和(26.02±5.02)分、(24.12±2.78)分、(62.58±5.78)分],差异均有统计学意义(P<0.05);观察组CRP、PARK7均低于对照组[分别为(3.98±0.36)mg/L、(14.32±2.15)μg/L和(6.35±0.48)mg/L、(25.26±4.63)μg/L],而NT-3水平高于对照组[(32.25±3.78)μg/L vs.(24.98±4.23)μg/L],差异均有统计学意义(P<0.05)。结论丁苯酞软胶囊能有效改善PDD患者肢体功能运动及脑神经功能,可明显降低患者血清CRP、PARK7水平,提高NT-3水平,对PDD具有良好治疗效果,值得临床应用。

Objective To observethe effect of Butylphthalide Soft Capsules for improve Parkinsons dementia（PDD）patients＇ cognitive function and ability of daily life.Methods From June 2013 to June 2015,in department of neurology,Hubei Medical College Affiliated Shiyan Peopled Hospital,84 cases of Parkinson dementia patients were randomly divided into observation group and control group of 42 cases in each group.In the two groups,patients were given conventional therapy,while the control group was treated with oral donepezil hydrochloride,observation group also added butylphthalide soft capsule.The treatment time was 12 weeks.Observe the therapeutic effect of the two groups.2 groups before and after treatment,Parkinsons Disease Hating Scale（UPDRS） and mini mental state（MMSE）,Montreal cognitive assessment scales（MoCA）and the ability of daily life（ADL） score were assessed;simultaneous determination before and after treatment in two groups of serum C reactive protein（CRP）,recombinant human Parkinsons disease protein 7（PARK7）,neurotrophic factor 3（NT-3）levels were records.Results After treatment,the total effective rate of observation group was 95.24%,which was significantly higher than the control group of 76.19%（x^2=6.222,P〈0.05）;the observation group UPDRS total score lower than the control group（20.32 ±5.26） vs.（35.12 ±5.11）,P〈0.05）,MMSE,MoCA,ADL scores were significantly higher than those in the control group,respectively,（28.92 ±4.78）,（27.89 ±4.36）,（75.39±4.58） and（26.02 ±5.02）,（24.12±2.78）,（62.58 ±5.78） points,the differences were statistically significant（P〈0.05）;the observation group＇s CRP and PARK7 were lower than those of the control group,respectively[（3.98 ±0.36） mg/L,（14.32±2.15） μg/L and（6.35±0.48）mg/L,（25.26±4.63）μg/L];while the level of NT-3 was higher than that of the control group[（32.25±3.78）μg/Lvs.（24.98±4.23）μg/L],the differences were statistically significant（P〈0.05）.Conclusion Butylphthalide soft capsule can effectively improve the PDD patients＇ limb motor function and cranial nerve function,it can significantly decrease the levels of serum CRP and PARK7 and improve the NT-3 level,for the PDD patients,it has good therapeutic effect,its worthy of clinical application.