丁苯酞序贯治疗对急性脑梗死合并认知功能障碍患者的临床观察

Clinical Observation of Sequential Therapy with Dl-3-butylphthalide in Patients of Acute Cerebral Infarction Complicated with Cognitive Impairment

目的:研究丁苯酞序贯治疗方法对急性脑梗死合并有认知功能障碍患者的临床疗效及其安全性评价。方法:前瞻性连续入选2016年1月-2017年1月宁夏医科大学总医院神经内科及全科医学科60例急性脑梗死合并认知功能障碍患者,按照随机数字表法分为试验组和对照组,每组30例。对照组采用常规治疗,试验组在观察组基础上加用丁苯酞氯化钠注射液和丁苯酞软胶囊。在治疗前和治疗后14 d、3个月观察两组神经功能缺损评分(NIHSS评分)、简易精神状态量表(MMSE)评分,并观察两组治疗后药物不良反应。结果:(1)治疗前两组NIHSS评分无明显差异(P>0.05)。治疗后14 d两组NIHSS评分均较治疗前下降(P<0.05);试验组NIHSS评分下降明显(P<0.05)。治疗后3个月两组NIHSS评分均较治疗后14 d下降(P<0.05),试验组下降明显(P<0.05)。(2)治疗前两组MMSE评分无明显差异(P>0.05)。治疗后14 d两组MMSE评分均较治疗增高,但差异均无统计学意义(P>0.05)。治疗后3个月两组MMSE评分均较治疗前增高(P<0.05);试验组增高明显(P<0.05)。(3)两组均未发现明显不良反应。结论:丁苯酞序贯治疗可能改善急性脑梗死患者早期神经功能缺损症状及认知功能障碍,安全性相对较好。

Objective： To explore the clinicalefficacy and safety of sequential D1-3-butylphthalide in the treatment of acute cerebral infarction patients complicated with cognitive impairment.Method： A total of 60 cases of acute cerebral infarction with cognitive impairment from January 2016 to January 2017 were randomly divided into the experimental group and the control group according to random number table method, 30 cases in each group.The control group was treated with routine treatment, the experimental group Was treated, with Butylphthalide and Sodium Chloride Injection and Butylphthalide Soft Capsules on the basis of conventional treatment.Neurological deficit score （ NIHSS score ）and Mini ,Mental State Scale （ MMSE ） score of two groups ,were observed before, fourteenth day and 3 months after treatment, and related adverse events of two groups were Observed.Result： （ 1 ） There were no statistical significance in NIHSS score of two groups before treatment （ P〉0.05 ） ,NIHSS score of two groups after 14 daystreatment were decreased than before treatment, the differences were statistically significant （ P〈0.05 ） .NIHSS score of the experimental group decreased more significantly, the difference was statistically significant （P〈0.05） .NIHSS score of two groups after 3 months were decreased than 14 days after treatment （ P〈0.05 ） .NIHSS score of,the experimental group were decreased more significantly （ P〈0.05 ） . （ 2 ） There were no statistical significance in MMSE score of two groups before treatment （ P〉0.05 ）.MMSE score of two groups increased in 14 days after treatment, but the differences were no statistically significant （ P〉0.05 ） .MMSE score of two groups after 3 months were higher than before treatment （ P〈0.05 ）, MMSE seore of the experimental group increased more significantly （P〈0.05） （ 3 ） The adverse events were not found in the two groups.Conclusion： The sequential treatment of Butyphthalide could significantly improve the early defect of neurological symptoms and cognitive dysfunction in patients with acute cerebral infarction, its security is relatively good.