丁苯酞联合多奈哌齐对阿尔茨海默病患者认知功能及脑血管储备功能的影响

Effects of Butyphthalide Combined with Donepezil on Cognitive Function and Cerebrovascular Reserve in Patients with Alzheimer's Disease

目的探讨丁苯酞联合多奈哌齐对阿尔茨海默病(alzheimer's disease,AD)患者认知功能及脑血管储备(cerebrovascular reserve,CVR)功能的影响。方法选择2016年2月—2017年11月就诊于我院门诊或住院的AD患者76例,采用随机数字表法分为观察组35例及对照组41例。对照组在常规治疗基础上给予多奈哌齐口服治疗,观察组在对照组基础上加用丁苯酞软胶囊,两组总疗程均为90 d。比较两组治疗前后简易精神状态量表(MMSE)评分及行神经电生理检测记录P300波幅和潜伏期变化,评定患者认知功能;两组治疗前后应用经颅多普勒屏气试验检测屏气指数(breath holding index,BHI),评价患者CVR功能;并观察治疗过程中的不良反应。结果与治疗前比较,两组治疗后MMSE评分显著增加,P300波幅显著升高,P300潜伏期显著缩短,差异均有统计学意义(P<0.05或P<0.01);与对照组治疗后比较,观察组治疗后MMSE评分增加,P300波幅升高,P300潜伏期缩短,差异均有统计学意义(P<0.05)。与治疗前比较,观察组治疗后BHI有显著变化(P<0.05),对照组治疗后BHI无显著变化(P>0.05);与对照组治疗后比较,观察组治疗后BHI显著升高(P<0.01)。结论丁苯酞联合多奈哌齐治疗能显著提高AD患者的认知功能及CVR功能,是一种安全有效的治疗方法。

Objective To evaluate the impact of Butyphthalide combined with Donepezil on cognitive function and cerebrovascular reserve(CVR)in patients with Alzheimer's disease(AD).Methods From February 2016 to November 2017,76 AD outpatients or inpatients were treated in our hospital and then enrolled in the study.The random number table method was used to divide those patients into the observation group(n=35)and the control group(n=41).The control group was given oral treatment on the basis of conventional treatment,and the observation group was treated with Butyphthalide Soft Capsules on the basis of control group.The total course of treatment in the two groups was 90 d.According to neuroelectrophysiological tests,the changes in P300 amplitude and latency period as well as the score of the mini-mental state scale(MMSE)in the two groups before and after treatment were recorded and compared to evaluate the patient's cognitive function.Transcranial Doppler screen test was used to detect the screen index(BHI)before and after treatment,thereby evaluating CVR function of patients.In addition,adverse reactions during treatment were observed.Results Compared with that before treatment,the MMSE score and the P300 amplitude of the two groups were significantly increased,while the latency of P300 was significantly shortened(P<0.05 or P<0.01).Compared with the control group,the MMSE score and P300 amplitude of the observation group were increased,whereas the P300 latency was shortened after treatment(P<0.05).Compared with those before treatment,the observation group had significant changes in BHI after treatment(P<0.05),but no significant change in BHI in control group(P>0.05).Compared with the control group,the BHI was significantly increased in observation group after treatment(P<0.01).Conclusion Butylphthalide combined with donepezil can significantly improve the cognitive function and CVR function of AD patients,which is a safe and effective treatment.