健脑合剂治疗血管性痴呆38例及对临床电生理和循环动力学影响的临床研究

Treatment of Vascular Dementia by Jiannao Heji and Its Influence on Clinical Electrophysiology and Circulatory Dynamics: A Report of 38 Cases

目的:观察健脑合剂治疗血管性痴呆(VD)的临床疗效及其对患者临床电生理、循环动力学的影响。方法:采用数字法随机对照研究,将68例患者分为健脑合剂治疗组38例,舒脑宁、脑复康对照组30例。观察比较2组临床疗效及治疗前后脑电地形图及脑血流速度指标的变化。结果:治疗组治疗后临床症状明显改善,总有效率为52.63％,优于对照组的43.33％(P<0.01)。对轻、中、重度的痴呆均有效,尤其对轻、中度疗效更为突出。脑血流速度指标除阻力指数(RI)和搏动指数(PI)外,其余指标与治疗前比较,差异均有显著性意义(P<0.05,P<0.01),尤其对大脑中动脉(MCA)和血流速度异常降低的左侧椎动脉(VA)和基底动脉(BA)的血流有显著的增高作用。对照组治疗后的平均血流速度也有一定的增高(P<0.05)。组间比较,治疗组优于对照组(P<0.05,P<0.01)。治疗组和对照组对脑电地形图的疗效总有效率分别为65.79％和16.67％,差异有非常显著性意义(P<0.01)。结论:经颅多普勒超声诊断和脑电地形图检测为VD的早期诊断提供了依据,健脑合剂治疗能加快脑循环流速,并显著改善VD患者脑部中枢神经细胞的功能活动状态。

Objective: To observe the curative effect of Jiannao Heji (JH) for vascular dementia (VD) and its influence on clinical electrophysiology and circulatory dynamics. Methods: Digital randomized control trial was adopted. 68 cases were observed, 38 cases being treated by JH as treatment group 30 cases by Shunaoning and Nao-fukang as control group. Electroencephalotopogram and speed index of cerebral blood flow were detected before and after treatment. Results: In treatment group, the clinical symptoms were markedly improved after treatment, the total effective rate being 52. 63% and higher than 43. 33% in control group ( P < 0. 01). It was effective for all cases, especially the mild and middle cases. Other than RI and PI, the speed indexes of cerebral blood flow were improved after treatment (P<0.05, P<0.01), especially MCA and left VA and BA blood flow with markedly decreased speed. In control group, the average blood flow speed was increased after treatment ( P < 0. 05), but not so obvious as the treatment group ( P < 0. 05 , P < 0. 01). The total effective rate showed in electro en-cephalotopogram was 65. 79% and 16. 67% in treatment group and control group respectively (P < 0. 01) . Conclusion: The skull Doppler ultrasonic diagnosis and electroencephalotopography are available for the early diagnosis of VD. JH can accelerate the cerebral blood flow and markedly improve the functional activity of cerebral central nerve cells in VD.