清开灵注射液联合奥拉西坦治疗血管性痴呆的临床研究

Clinical study of Qingkailing Injection combined with oxiracetam in treatment of vascular dementia

目的探讨清开灵注射液联合奥拉西坦治疗血管性痴呆的临床效果。方法选取2015年6月—2017年12月亳州市人民医院收治的126例血管性痴呆患者,随机分为对照组和治疗组,每组各63例。对照组静脉滴注奥拉西坦注射液,4 g加入250 mL生理盐水中均匀混合后给药,1次/d。治疗组在对照组治疗基础上静脉滴注清开灵注射液,40 mL用250 mL生理盐水充分稀释后给药,1次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组治疗前后简易精神状态检查(MMSE)评分、神经精神症状问卷(NPI)评分、日常生活能力量表(ADL)评分、颈内动脉与椎动脉收缩期最大峰值流速(V_(max))、平均血流量(Q_m)、白介素(IL)-1β、超敏C反应蛋白(hs-CRP)、丙二醛(MDA)、血管内皮生长因子(VEGF)、tau蛋白的变化情况。结果治疗后,对照组和治疗组的总有效率分别为79.4%、92.1%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者MMSE评分、颈内动脉和椎动脉的V_(max)、Q_m显著增高,但NPI、ADL评分均显著减低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组MMSE评分、颈内动脉和椎动脉的V_(max)、Q_m显著高于对照组,NPI、ADL评分均显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清IL-1β、hs-CRP、MDA、tau蛋白水平均显著降低,血清VEGF水平均显著上升,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组IL-1β、hs-CRP、MDA、tau蛋白显著低于对照组,血清VEGF水平显著高于对照组,两组比较差异具有统计学意义(P<0.05)。结论清开灵注射液联合奥拉西坦治疗血管性痴呆具有较好的临床疗效,能明显改善患者认知功能,增加脑血流灌注,减轻炎性及氧化应激损伤,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Qingkailing Injection combined with oxiracetam in treatment of vascular dementia. Methods Patients（126 cases） with vascular dementia in Bozhou People＇s Hospital from June 2015 to December 2017 were randomly divided into control（63 cases） and treatment（63 cases） groups. Patients in the control group were iv administered with Oxiracetam Injection, 4 g was added to 250 mL normal saline, once daily. Patients in the treatment group were iv administered with Qingkailing Injection on the basis of the control group, 40 mL was added to 250 mL normal saline, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the changes of MMSE score, NPI score, ADL score, internal carotid and vertebral arteries V_（max） and Q_m, IL-1β, hs-CRP, MDA, VEGF, tau proteins in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group were 79.4% and 92.1%, and there were differences between two groups（P〈0.05）. After treatment, and there were differences in the same group（P〈0.05）. After treatment, MMSE score, internal carotid and vertebral arteries V_（max） and Q_m in two groups were significantly increased, but NPI score and ADL score were significantly decreased, and there were differences in the same group（P〈0.05）. After treatment, MMSE score, internal carotid and vertebral arteries V_（max） and Q_m in the treatment group were higher than those in the control group, but NPI score and ADL score were significantly lower than those in the control group, and there were differences between two groups（P〈0.05）. After treatment, IL-1β, hs-CRP, MDA, and tau protein in two groups were significantly decreased, but VEGF was significantly increased, and there were differences in the same group（P〈0.05）. After treatment, IL-1β, hs-CRP, MDA, and tau protein in the treatment group were significantly lower than those in the control group, but VEGF was higher than those in the control group, and there were differences between two groups（P〈0.05）. Conclusion Qingkailing Injection combined with oxiracetam has significant clinical effect in treatment of vascular dementia, and can significantly improve cognitive function, also can increase cerebral blood flow perfusion, and reduce the injury of inflammatory and oxidative stress, which has a certain clinical application value.