丁苯酞软胶囊与尼莫地平对卒中后血管性痴呆患者的疗效

Effect of Butylphthalide Soft Capsules and Nimodipine on Patients with Vascular Dementia after Stroke

目的探讨丁苯酞软胶囊(NBP)及尼莫地平(NMD)治疗卒中后血管性痴呆(VD)的有效性和安全性。方法选择2013年5月至2015年8月在广州军区广州总医院治疗的VD患者96例,按随机数字法分为NBP组和NMD组,各48例。NBP组口服丁苯酞软胶囊治疗,NMD组口服尼莫地平治疗,治疗周期6个月。治疗前及治疗后3个月和6个月随访,利用认知功能量表(MMSE、MOCA)和日常生活能力量表(ADL)对疗效进行评价,并比较2组不良反应发生情况。结果 2组治疗前,MMSE、MOCA和ADL评分相比差异不具有统计学意义(P>0.05);治疗后3个月及6个月,NBP组MMSE、MOCA评分均明显高于NMD组,而ADL评分明显低于NMD组(P<0.01);NBP组不良反应发生率为10.4%,明显低于NMD组(22.9%)(P<0.05)。结论 NBP与NMD均能明显改善卒中后血管性痴呆患者的认知功能和日常生活能力,但NBP效果更显著,且安全性更高。

Objective To observe and explore the effectiveness of butylphthalide soft capsules （NBP） and nimodipine （NMD） in patients with vascular dementia （VD） after stroke. Methods A total of 96 patients with VD in General Hospital of Guangzhou Military Command were selected between May 2012 and August 2015. They were randomized into two groups of 48 patients： the NBP group and NMD group. The NBP group was treated orally with NBP while the NMD group was treated orally with NMD for 6 months respectively. The efficacy was evaluated by the cognitive function scale （MMSE, MOCA） and daily life ability scale （ADL score） before treatment and at 3 months and 6 months after treatment. The incidence of adverse reactions in both groups was recorded. Results The difference in MMSE, MOCA and ADL scores before treatment between the two groups was not statistically significant （ P〉0.05 ）, but MMSE and MOCA scores in the NBP group were significantly higher than those of the NMD group 3 months and 6 months after treatment, , while ADL score was significantly lower than that of the NMD group （P〈0. 01 ）. The adverse reaction rate was 10.4% （5/48） and 22.9% （11/48） respectively in the NBP group, and 22.9% （11/48） in the NMD group. The difference was statistically significant （ P〈0.05 ）. Conclusion Both NBP and NMD treatment ean significantly improve the cognitive function and daily life ability of VD patients, and the curative effect is remarkable, but NBP is more effective and safer than NMD.