丁苯酞胶囊治疗卒中后血管性痴呆的效果研究

Study on Effect of Butylphthalide Capsule on Vascular Dementia after Stroke

目的: 探究采用丁苯酞胶囊治疗卒中后血管性痴呆的临床疗效。 方法: 前瞻性选取2015年7月至2017年12月于我院住院治疗的血管性痴呆患者70例,按简单随机数字表法分为两组,每组35例,其中对照组口服尼莫地平进行常规治疗,观察组口服尼莫地平的同时口服丁苯肽胶囊进行治疗。观察比较两组患者的临床疗效及治疗期间不良反应的发生情况;治疗前后对患者进行简易精神状态量表(MMSE)评估认知功能,痴呆严重程度(CDR)评价疗效,日常生活活动能力量表(ADL)评估日常生活能力;比较治疗前后患者血清中MMSE、CDR、ADL水平变化。 结果: 两组患者的临床疗效比较,观察组治疗总有效率显著高于对照组(P<0.05)。重复测量方差分析显示,MMSE、CDR、ADL评分时间因素及时间因素和分组的交互作用均有统计学意义(P<0.05),说明观察组治疗前后MMSE、CDR、ADL评分的差别与对照组治疗前后的差别不同,观察组治疗前后MMSE、CDR、ADL评分差值明显大于对照组。重复测量方差分析显示,SOD、MDA、BDNF水平时间因素及时间因素和分组的交互作用均有统计学意义(P<0.05),说明观察组治疗前后SOD、MDA、BDNF水平的差别与对照组治疗前后的差别不同,观察组治疗前后SOD、MDA、BDNF水平差值明显大于对照组。未出现与本研究相关的严重不良反应。 结论: 丁苯酞胶囊治疗卒中后血管性痴呆临床疗效良好,能够明显改善患者的痴呆程度、认知功能和日常生活能力,治疗期间未发生不良反应,在临床治疗中安全有效,值得临床应用推广。

Objective: To investigate the clinical effect of butylphthalide capsule in the treatment of post-stroke vascular dementia. Methods: 70 patients with vascular dementia hospitalized in our hospital from July 2015 to December 2017 were prospectively selected. They were divided into two groups according to simple random number table, 35 cases in each group. The control group received nimodipine orally for routine treatment.The clinical efficacy and adverse reactions during treatment were observed and compared between the two groups, cognitive function was evaluated by simple mental state scale (MMSE), (CDR) was used to evaluate the curative effect of dementia severity, and activity of daily living scale (ADL) was used to evaluate daily students before and after treatment. The changes of serum MMSE, CDR, ADL level before and after treatment were compared. Results: Compared with the clinical efficacy of the two groups, the total effective rate of the observation group was significantly higher than that of the control group (P< 0.05). The analysis of variance of repeated measurements showed that the interaction of time factor and time factor of MMSE, CDR, ADL score and grouping had statistical significance (P< 0.05). It showed that the differences of MMSE, CDR and ADL score before and after treatment in the observation group was different from those before and after the control group. The difference of MMSE, CDR and ADL score in the observation group was significantly greater than that in the control group before and after the treatment. The analysis of variance of repeated measurements showed that the interaction of time factors and time factors of SOD, MDA and BDNF levels and groups had statistical significance (P< 0.05). It showed that the differences of SOD, MDA and BDNF levels before and after treatment in the observation group were different from those before and after treatment in the control group. The differences of SOD, MDA and BDNF levels in the observation group before and after treatment were significantly greater than those in the control group. There were no serious adverse reactions related to this study. Conclusion: Butylphthalide capsule is effective in the treatment of post-stroke vascular dementia. It can significantly improve the degree of dementia, cognitive function and ability of daily living. No adverse reactions occurred during the treatment. It is safe and effective in clinical treatment, and is worthy of clinical application and promotion.