奥拉西坦注射液联合重复经颅磁刺激、康复训练治疗血管性认知障碍的效果观察

Efficacy of oxiracetam injection combined with repeated transcranial magnetic stimulation and rehabilitation training in the treatment of vascular cognitive impairment

目的探讨奥拉西坦注射液联合重复经颅磁刺激、康复训练治疗血管性认知障碍患者的临床效果。方法抽取2019年1月至2020年1月洛阳中心医院接诊的血管性认知障碍患者200例,经奇偶数法分为治疗组和对照组,每组100例。两组均给予常规治疗、康复训练及重复经颅磁刺激治疗,治疗组加用奥拉西坦注射液治疗。治疗3周后,比较两组认知功能、精神状态、神经功能缺损程度、血清生化指标水平及不良反应发生情况。结果治疗3周后,两组蒙特利尔认知评估量表、简易精神状态量表评分与治疗前比较均升高(P均<0.05),神经功能缺损程度改善情况均优于治疗前(P均<0.05),且治疗组各指标优于对照组(P<0.05)。治疗后,两组血清生化指标白细胞介素-18、肿瘤坏死因子-α、基质金属蛋白酶9水平均下降(P均<0.05),血管内皮生长因子水平均升高(P均<0.05),且治疗组上述指标改善程度优于对照组(P<0.05)。治疗期间,治疗组不良反应发生率为2%(2/100),对照组患者未见明显不良反应,两组比较差异未见统计学意义(P>0.05)。结论奥拉西坦注射液联合重复经颅磁刺激、康复训练治疗血管性认知障碍患者疗效显著,可改善患者的认知功能、精神状态及神经功能缺损程度。

Objective To investigate the efficacy of oxiracetam injection combined with repeated transcranial magnetic stimulation and rehabilitation training in the treatment of vascular cognitive impairment.Methods A total of 200 patients treated in Luoyang Central Hospital from January 2019 to January 2020 were selected.And they were divided into treatment group and control group by odd and even number method,with 100 cases in each group.Both groups were given conventional treatment,rehabilitation training,and repeated transcranial magnetic stimulation(rTMS).The treatment group was additionally given oxiracetam injection,based on the treatment of the control group.After 3 weeks of treatment,the cognitive function,mental status,neurological deficit degree,levels of serum biochemical indicators,and adverse reactions were compared between the two groups.Results After 3 weeks of treatment,the scores of Montreal Cognitive Assessment Scale(MoCA)and Mini-Mental State Examination(MMSE)of the two groups significantly increased,compared with those before treatment(P<0.05),while the improvement in neurological deficit were better than that before treatment(P<0.05);and the above indexes of the treatment group were better than those of the control group(P<0.05).After treatment,the levels of serum biochemical indicators,including interleukin-18(IL-18),tumor necrosis factor-α(TNF-α),and matrix metalloproteinase 9(MMP9),significantly decreased(P<0.05),while the level of vascular endothelial growth factor(VEGF)significantly increased(P<0.05);and the improvement of the above indexes in the treatment group was better than that in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the treatment group was 2%(2/100);there was no significant adverse reaction in the control group;and the difference between the two groups was not statistically significant(P>0.05).Conclusions Oxiracetam injection combined with repetitive transcranial magnetic stimulation and rehabilitation training has a significant effect on patients with vascular cognitive impairment,which can improve their cognitive function,mental state and neurological deficit degree.