银杏叶提取物联合丁苯酞对帕金森痴呆病人认知功能、神经功能的影响

Effects of Ginkgo Biloba Extract Combined with Butylphthalide on Cognitive Function and Neurological Function in Patients with Parkinson′s Dementia

目的观察银杏叶提取物联合丁苯酞对帕金森痴呆病人认知功能、神经功能的影响。方法选取2017年5月—2018年10月北京世纪坛医院神经内科收治的80例帕金森痴呆病人,根据治疗方案分为观察组和对照组,每组40例。所有病人入组后均给予改善肌张力、抗抑郁等常规治疗,对照组在常规治疗基础上给予丁苯酞软胶囊治疗,观察组在对照组基础上给予银杏叶提取物片治疗,两组均连续用药8周。统计并比较两组治疗前、治疗4周后、治疗8周后帕金森病评定量表(UPDRS)、蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)、日常生活活动能力(ADL)评分及血清C反应蛋白(CRP)水平,采用酶联免疫吸附法测定血清重组人帕金森病蛋白7(PARK7)、神经营养因子-3(NT-3)、脑源性神经营养因子(BDNF)水平。结果治疗4周后,两组UPDRS评分较治疗前降低,观察组MoCA、MMSE、ADL评分较治疗前升高,差异均有统计学意义(P<0.05);治疗8周后,两组UPDRS评分较治疗4周后降低,两组ADL评分较治疗前升高,观察组MoCA、MMSE评分较治疗4周后升高,差异均有统计学意义(P<0.05);且观察组UPDRS评分低于对照组,MoCA、MMSE、ADL评分均高于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组CRP、PARK7水平较治疗前降低,NT-3、BDNF水平较治疗前升高,差异均有统计学意义(P<0.05);治疗8周后,两组CRP、PARK7水平较治疗4周后降低,NT-3、BDNF水平较治疗4周后升高,差异均有统计学意义(P<0.05);且观察组CRP、PARK7水平低于对照组,NT-3、BDNF水平均高于对照组,差异均有统计学意义(P<0.05)。结论银杏叶提取物能有效改善帕金森痴呆病人认知功能和神经功能,提高生活能力,其机制可能是通过降低氧化应激对神经系统的损伤而发挥作用。

Objective To observe the effects of ginkgo biloba extract combined with butylphthalide on cognitive function and neurological function in patients with Parkinson′s dementia.Methods Eighty patients with Parkinson′s dementia were divided into observation group and control group according to the treatment plan,40 case in each group.Two groups were treated with routine treatment to improve muscle tone and antidepressant for 8 weeks.The control group was treated with butylphthalide soft capsule on the basis of routine treatment,and the observation group was treated with ginkgo biloba extract tablets on the basis of the control group.Parkinson′s Disease Rating Scale(UPDRS),Montreal Cognitive Assessment Scale(MoCA),Simple Mental State Scale(MMSE),Activity of Daily Living(ADL)score,and C-reactive protein(CRP)were compared between two groups.Recombinant human Parkinson disease protein 7(PARK7),neurotrophic factor-3(NT-3),brain-derived neurotrophic factor(BDNF)were measured by enzyme-linked immunosorbent assay.Results After 4 weeks,UPDRS scores of two groups were lower,and ADL of two groups were higher than those before treatment,MoCA and MMSE in the observation group were higher than those before treatment(P<0.05).After 8 weeks,UPDRS scores of two groups were lower than those after 4 weeks,and MoCA,MMSE and ADL scores were higher than those after 4 weeks(P<0.05).UPDRS score of the observation group was lower than that of the control group,and MoCA,MMSE and ADL scores of the observation group were higher than those of the control group(P<0.05).After 4 weeks,the levels of CRP and PARK7 in two groups were lower than those before treatment,and the levels of NT-3 and BDNF were higher than those before treatment(P<0.05).After 8 weeks,the levels of CRP and PARK7 in two groups were lower than those after 4 weeks,and the levels of NT-3 and BDNF were higher than those after 4 weeks(P<0.05).The levels of CRP and PARK7 in the observation group were lower than those in the control group,the levels of NT-3 and BDNF in the observation group were higher than those in the control group(P<0.05).Conclusion Ginkgo biloba extract could effectively improve the cognitive function and neurological function of patients with Parkinson′s dementia,and improve the living ability of patients.Its effect may be related reducing oxidative stress damage on the nervous system.