银杏叶制剂联合功能训练和高压氧治疗缺血性脑卒中认知功能障碍的临床效果研究

Study of the Clinical Effect of Ginkgo Leaf Preparation,Function Training and Hyperbaric Oxygen for Patients with Cognitive Impairment Caused by Ischemic Stroke

目的探讨银杏叶制剂联合功能训练和高压氧治疗缺血性脑卒中认知功能障碍的临床效果。方法选择2011年12月至2014年7月恩施市中心医院收治的缺血性脑卒中认知功能障碍患者60例为研究对象,采取随机数字法分为对照组(32例)和观察组(28例)。对照组采用常规治疗,包括脱水降颅压、抗血小板聚集、功能训练和高压氧联合治疗;观察组在对照组常规治疗的基础上采用银杏叶制剂(60 m L静脉滴注,每日1次)治疗。比较两组患者治疗前后简易精神状态检查量表(MMSE)、Epworth嗜睡量表(ESS)、Fugl-Meyer评分(FMA)及Barthel指数(BI)评分;治疗前后P300潜伏期及波幅变化情况;治疗后生活质量评分。结果治疗后,观察组MMSE、ESS、FMA及BI评分显著高于对照组[(28±5)分比(23±4)分、(9.93±1.02)分比(13.31±2.61)分、(81±12)分比(57±9)分、(64±16)分比(53±15)分](P<0.05)。治疗后,观察组P300潜伏期短于对照组,P300波幅高于对照组[(364±30.1)ms比(322±27.3)ms,(6.1±1.2)ms比(10.2±1.9)ms](P<0.05)。治疗后,观察组躯体功能自理能力、工具性生活自理能力评分低于对照组[(6.12±4.36)分比(8.15±9.51)分、(14.08±5.31)分比(15.25±3.18)分](P<0.05)。结论银杏叶制剂联合功能训练和高压氧治疗缺血性脑卒中认知功能障碍患者的临床效果较好,应加以推广及应用。

Objective To study the clinical effect of ginkgo leaf preparation, function training and hyperbaric oxygen for patients with cognitive impairment caused by ischemic stroke. Methods Sixty patients with ischemic stroke caused cognitive impairment in Enshi Central Hospital were chosen between Dec. 2011 and Jul 2014 were included in the study,who were divided into a control group（ n = 32 ） and an observation group （n = 28 ） according to a random digital. The control group was given conventional treatment （dehydration reducing intracranial pressure, anti-platelet aggregation, functional training and hyperbaric oxygen , etc ）, the observation group was given ginkgo leaf preparation （ intravenously dripping for 60 mL per day）,on the basis of the conventional treatment. The mini mental state examination （MMSE） scale, Epworth sleeping scale （ESS） , Fugl-Meyer assessment （ FMA ） and Barthel index （BI） score, P300 latency and amplitude changes, and the quality of life scores of the two groups before and after treatment were compared. Results After treatmen, the MMSE, ESS, FMA and BI score of the observation group were higher than those in the control group [ （28 ± 5 ） score vs （23 ± 4） score, （9.93 ± 1.02） score vs （ 13.31 ± 2.61 ） score, （81 ± 12） score vs （57 ± 9 ） score, （64 ± 16） score vs （ 53 ± 15 ） score ] （ P 〈 0.05 ）. After treatment, the P300 latency of the observation group was shorter than that of the control group,while the P300 amplitude of the observation group was higher than that of the control group [ （ 364 ± 30.1 ） ms vs （322 ±27.3） ms,（6.1 ±1.2 ） ms vs （10.2 ±1.9） ms] （P〈0.05）. After treatment,the scores of physical function selfcare ability and instrumental self-care ability of the observation group were lower than those of the control group[ （6.12 ± 4.36） point vs （8.15±9.51） score,（14.08 ±5.31） score vs （15.25 ±3.18） score]（P〈0.05）. Conclusion Folium ginkgo preparations combined with functional training and hyperbaric oxygen have a good clinical effect for patients with ischemic stroke caused cognitive impairment,which could be promoted and applied.