丁苯酞治疗老年遗忘型轻度认知功能障碍患者的效果及安全性分析

Analysis of the Efficacy and Safety of Butylphthalide in Elderly Patients with Amnestic Mild Cognitive Impairment

目的:研究老年遗忘型轻度认知功能障碍(amnestic mild cognitive impairment,a MCI)患者应用丁苯酞治疗的疗效及安全性。方法:入组61例笔者所在医院就诊的老年a MCI患者,随机分为丁苯酞治疗组(31例)和银杏叶片对照组(30例),前者用丁苯酞口服治疗,后者用银杏叶片口服治疗,治疗3个月后,比较两组患者主观记忆改善情况,比较两组简明精神状态测试量表(MMSE)、听觉词语学习测试的延迟回忆(AVLT-DR)及日常生活能力量表(ADL)得分情况及不良事件发生情况。结果:丁苯酞治疗组有64.52%的主观记忆改善率,治疗后MMSE、ADL评分无明显改变(P>0.05),但AVLT-DR评分明显升高(t=-4.23,P<0.05),而银杏叶片对照组仅有16.67%的主观记忆改善率,治疗前后MMSE、AVLT-DR、ADL无明显改变(P>0.05);在丁苯酞治疗组中有1例、银杏叶片对照组中有2例发生轻度胃部不适感,均自行恢复。结论:丁苯酞能有效改善老年a MCI患者记忆能力,安全性良好,具有临床推广价值。

Objective:To analyze the efficacy and safety of Butylphthalide in elderly patients with amnestic mild cognitive impairment(aMCI).Method:61 elderly aMCI patients with age and education matched from our hospital were included in this study and randomly divided into tow groups.31 patients were included into Butylphthalide treatment group with a Butylphthalide oral therapy and 30 patients were included into Ginkgo Leaf Tablet control group with a Ginkgo Leaf Tablet oral therapy.After three months,the subjective memory improvement and scores of Mini-Mental State Examination(MMSE),Delayed Recall of Auditory Verbal Learning Test(AVLT-DR)and Activity of Daily Living Scale(ADL)were compared with pre-treatment in each group.We also assessed the rate of adverse events during the treatment in both group.Result:After three months,the performances of patients in Butylphthalide treatment group were significantly improved in AVLT-DR(t=-4.23,P<0.05),while not significantly changed in MMSE and ADL(P>0.05),and 64.52%patients showed subjective memory improvement.But in Ginkgo Leaf Tablet control group,the scores of MMSE,AVLT-DR and ADL were all not significantly changed before and after therapy,and only 16.67%patients showed subjective memory improvement.Only one patient in Butylphthalide treatment group and two patients in Ginkgo Leaf Tablet control group had a mild stomach upset,but they all recovered spontaneously.Conclusion:Butylphthalide can effectively improve memory of elderly aMCI patients with a good safety,and is worth of clinical application.