醒脑静联合丁苯猷治疗血管性痴呆的临床研究

Clinical study of Xingnaojing combined with butylphthalide in treatment of vascular dementia

目的观察醒脑静联合丁苯猷治疗血管性痴呆的临床疗效。方法选择桐乡市第一人民医院2014年8月1日至2017年12月1日收治120例血管性痴呆患者,所有患者均按病情给予相应的常规治疗,53例患者静脉滴注(静滴)丁苯猷氯化钠注射液(100 mL含丁苯猷25 mg与氯化钠0.9 g)治疗(单用组),每次100 mL,每日2次;另外67例患者在单用组治疗基础上将醒脑静注射液20 mL加入到200 mL葡萄糖注射液中静滴(联用组),每日1次;两组均治疗4周。观察两组治疗前后简易智能精神状态检查量表(M MSE)、日常生活活动能力(ADL)评分的变化及临床疗效、不良反应发生情况。结果两组治疗后M MSE、ADL评分均较治疗前升高,且联用组治疗后MMSE、ADL评分均明显高于单用组〔MMSE评分(分):26.77±1.30比25.64 ±2.81, ADL评分(分):74.77±3.30比59.23 ±4.21,均P<0.05〕。联用组治疗后总有效率明显高于单用组[97.0%(65/67)比81.1%(43/53),P<0.05〕。联用组和单用组不良反应发生率比较差异无统计学意义〔7.5%(5/67)比7.5%(4/53), P>0.05〕。结论醒脑静联合丁苯酰治疗血管性痴呆可在一定程度上改善患者认知功能及日常生活能力,且联合治疗较单独应用丁苯酥疗效更好,在治疗周期内未出现明显不良反应。

Objective To observe the clinical efficacy of Xingnaojing combined with butylphthalide in the treatment of vascular dementia (VD). Methods One hundred and twenty VD patients admitted to First People's Hospital of Tongxiang from August 1st 2014 to December 1st 2017 were enrolled, all the patients were given routine treatment according to their disease conditions, 53 cases were treated by intravenous drip of butylphthalide and sodium chloride injection (100 mL containing butylphthalide 25 mg and sodium chloride 0.9 g), 100 mL once, 2 times each day (single-use group);another 67 patients were treated with Xingnaojing 20 mL added into 200 mL glucose solution intravenous drip, once a day, on the basis of the treatment in the single-use group (combined group), and both groups were treated for 4 weeks. The changes of mini-mental state examination (MMSE) and activity of daily life (ADL) scores, clinical efficacy and adverse reactions were observed before and after treatment in the two groups. Results The MMSE and ADL scores in both groups were higher after treatment than those before treatment, and the MMSE and ADL scores in the combined group were significantly higher than those in the single-use group (MMSE scores: 26.77 ± 1.30 vs. 25.64±2.81, ADL: 74.77 ±3.30 vs. 59.23 ±4.21, both P < 0.05);the clinical efficacy of the combined group was significantly higher than that of the single-use group [97.0%(65/67) vs. 81.1%(43/53), P < 0.05], however, there was no significant difference in the incidence of adverse reactions between the combined group and the single-use group [7.5%(5/67) vs. 7.6%(4/53), P > 0.05 ]. Conclusions After treatment of VD with the combination of Xingnaojing and butylphthalide, the cognitive function and daily living ability of the patients are improved to some extent, the combined treatment is more effective than the single application of butylphthalide, and no obvious adverse reaction occurs during the therapeutic course.