银杏内酯注射液联合尼莫地平片治疗中风后轻度认知功能障碍临床研究

Clinical Study on Ginkgolides Injection Combined with Nimodipine Tablets for Mild Cognitive Impairment After Stroke

目的:观察中风基础防治措施联合银杏内酯注射液与尼莫地平片治疗中风后轻度认知功能障碍的疗效以及对脑血流动力学的影响。方法:纳入88例中风后轻度认知功能障碍瘀血阻络证患者,采取随机数字表法分为对照组和观察组各44例。2组均予中风基础防治措施和尼莫地平片治疗,观察组加予银杏内酯注射液治疗。2组疗程均为2周。观察2组患者治疗前、治疗2周后认知功能[简易智能精神状态检查量表(MMSE)评分]、日常生活能力(Barthel指数评分)以及脑血流动力学的变化,比较2组治疗后的临床疗效。结果:治疗2周后,观察组临床疗效总有效率高于对照组(P<0.05)。2组MMSE定向力、记忆力、注意力与计算力、回忆能力、语言能力评分及总分均较治疗前增加(P<0.01),观察组5项评分及总分均高于对照组(P<0.01)。2组Barthel指数评分均较治疗前增加(P<0.01),观察组Barthel指数评分高于对照组(P<0.01)。2组椎动脉、大脑中动脉、大脑前动脉阻力指数(RI)值均较治疗前降低(P<0.01),观察组椎动脉、大脑中动脉、大脑前动脉RI值均低于对照组(P<0.01)。结论:在常规中风防治措施基础上加用银杏内酯注射液联合尼莫地平片,可改善中风后轻度认知功能障碍患者的脑部血液循环、认知功能和生活能力,提高临床疗效。

Objective:To observe the curative effect of basic prevention measures for stroke combined with ginkgolides injection and nimodipine tablets for mild cognitive impairment after stroke and its effect on cerebral hemodynamics.Methods:A total of 88 cases of patients with mild cognitive impairment after stroke with static blood obstructing the collaterals syndrome were divided into the control group and the observation group according to the random number table method,44 cases in each group.Both groups were treated with basic prevention measures for stroke and nimodipine tablets,and the observation group was additionally treated with ginkgolides injection.Both groups were treated for two weeks.Before treatment and after two-week treatment,the changes in cognitive function[Mini-Mental State Examination(MMSE)],activities of daily living(Barthel Index score)and hemodynamics in the two groups were observed.After treatment,the clinical effect in the two groups was compared.Results:After two-week treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).The scores of orientation,memory,attention and calculation ability,recollection ability and language ability in MMSE as well as the total scores in the two groups were increased when compared with those before treatment(P<0.01),the above five scores and the total scores in the observation group were higher than those in the control group(P<0.01).The Barthel Index scores in the two groups were increased when compared with those before treatment(P<0.01),and the Barthel Index score in the observation group was higher than that in the control group(P<0.01).The values of resistance index(RI)in vertebral artery,middle cerebral artery and anterior cerebral artery in the two groups were decreased when compared with those before treatment(P<0.01);the RI values in vertebral artery,middle cerebral artery and anterior cerebral artery in the observation group were lower than those in the control group(P<0.01).Conclusion:Based on basic prevention measures for stroke,the additional application of ginkgolides injection combined with nimodipine tablets can improve the cerebral blood circulation,cognitive function,activities of daily living and clinical effect of patients with mild cognitive impairment after stroke.