复方菖蒲益智汤联合尼莫地平治疗中风后轻度认知功能障碍的临床研究

Clinical Research of Compound Changpu Yizhi Decoction Combined with Nimodipine in the Treatment of Mild Cognitive Impairment after Stroke

目的:考察复方菖蒲益智汤联合尼莫地平对中风后轻度认知功能障碍(MCI)患者临床症状、认知功能和脑血管血流速度的影响,以及用药安全性。方法:选择2013年2月-2015年10月在我院就诊的中风后MCI患者84例作为研究对象,采用随机数字表法分为观察组和对照组,各42例。两组患者均给予脑卒中基础预防治疗;对照组患者在此基础上给予尼莫地平片30 mg,tid,po;观察组患者在对照组治疗基础上加服复方菖蒲益智汤,每日1剂,分早晚温服。两组患者疗程均为3个月。分别于治疗前后采用血管性痴呆中医辨证量表比较两组患者的临床症状、采用简易智能量表(MMSE)比较两组患者的认知功能,并比较两组患者治疗前后的脑血管血流速度和不良反应发生情况。结果:治疗前,两组患者的各项临床症状评分、认知功能评分和主要动脉的血流速度比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的临床症状评分均明显降低,认知功能评分均明显升高,脑血管血流速度均明显加快,与治疗前比较,差异均有统计学意义(P<0.05)。观察组患者的记忆、疼痛、面色、舌质、脉象评分,以及附加分和总分均明显低于对照组;定向能力、回忆能力、语言能力以及综合认知功能评分均明显高于对照组;大脑前动脉、中动脉、后动脉、椎动脉和基底动脉的血流速度均明显快于对照组,差异均有统计学意义(P<0.05)。观察组与对照组患者的不良反应发生率分别为11.90%、9.52%,组间比较差异无统计学意义(P>0.05)。结论:复方菖蒲益智汤联合尼莫地平有助于缓解中风后MCI患者的临床症状,改善其脑部血液循环,提高其认知功能,且安全性较好。

OBJECTIVE： To investigate the effects of Compound changpu yizhi decoction combined with nimodipine on clinical symptoms, cognitive function and cerebral blood flow velocity of patients with mild cognitive impairment （MCI） after stroke, and its medication safety. METHODS： 84 MCI patients after stroke in our hospital from Feb. 2012 to Oct. 2014 were selected as re- search objects and randomly divided into observation group and control group, 42 cases in each group. All patients received basic preventive treatment; control group was additionally given Nimodipine tablet 30 mg, tid, po; based on it, observation group was given Compound changpu yizhi decoction, one dose a day, taking with warm water every morning and evening. They were treated for 3 months. Clinical symptoms of patients were compared by vascular dementia TCM syndrome table before and after treatment, mini-mental state examination （MMSE） was used to compare the cognitive function of patients before and after treatment, cerebral blood flow velocity before and after treatment and incidence of adverse reactions in 2 groups were compared. RESULTS： Before treatment, there was no statistical significance in clinical symptom scores, cognitive function score and blood flow velocity of main artery between 2 groups （P〉0.05）. Clinical symptom scores of 2 groups were decreased significantly, while cognitive function and cerebral blood flow velocity were increased significantly; there was statistical significance, compared to before treatment （P〈 0.05）. Memory scores, pain scores, complexion scores, tongue scores, pulse scores, additional scores and total scores in observa- tion group were obviously lower than control group; orientation ability scores, recall ability scores, language skills scores and com- prehensive cognitive function scores in observation group were obviously higher than control group; blood flow velocities of anterior cerebral artery, middle cerebral artery, posterior cerebral artery, vertebral artery and basilar artery in observation group were obviously faster than control group, with statistical significances （P〈0.05）. The incidence of ADR in observation group and contral group were 11.90% and 9.52%, there was no statistical significance between 2 groups （P〉0.05）. CONCLUSIONS： Compound changpu yizhi decoction combined with nimodipine helps to relieve clinical symptoms of MCI patients after stroke, improve cerebral blood circulation and cognitive function, with good safety.