三七通舒胶囊联合脑心通胶囊治疗脑梗死后血管性痴呆的临床疗效观察

Clinical effect of Sanqi Tongshu capsule combined Naoxintong capsule on vascular dementia after cerebral infarction

目的 探究三七通舒胶囊联合脑心通胶囊在治疗脑梗死后血管性痴呆(VD)中的临床应用效果。方法 将70例脑梗死后VD患者随机分成2组,对照组35例,试验组35例。对照组给予脑心通胶囊治疗,试验组给予三七通舒胶囊联合脑心通胶囊治疗。比较2组患者治疗后的临床疗效,治疗前后的行为、认知功能、神经因子水平、血管内皮功能以及药物不良反应的发生情况。结果 治疗后,试验组和对照组的总有效率分别为94.29%和77.14%,试验组与对照组相比,差异有统计学意义(P<0.05)。治疗后,试验组和对照组中枢特异性蛋白(S-100β)水平为(419.30±69.23)和(462.05±66.48)pg·L^(-1);神经元特异性烯醇化酶(NSE)水平值为(35.19±9.18)和(48.70±10.22)ng·L^(-1);神经生长因子(NGF)水平分别值为(18.73±2.57)和(16.78±5.44)ng·L^(-1),试验组与对照组相比,差异均有统计学意义(均P<0.05)。治疗后,试验组与对照组一氧化氮(NO)水平的值分别为(56.05±6.04)和(43.34±3.56)μmol·L^(-1);内皮素-1(ET-1)水平分别值为(63.27±4.08)和(80.78±5.95)ng·L^(-1),试验组与对照组相比,差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组日常生活量表(ADL)的评分别为(86.25±7.62)和(75.28±7.10)分;简易智能精神状态检查量表(MMSE)评分分别为(25.66±1.98)和(22.85±1.59)分;试验组与对照组相比,差异均有统计学意义(均P<0.05)。治疗后,试验组组与对照组生理功能评分分别为(85.14±6.25)和(81.12±3.48)分;两组的躯体功能评分为别为(86.96±8.53)和(83.68±3.51)分;情感功能评分分别为(90.78±4.68)和(84.53±3.37)分;社会功能评分分别为(88.62±4.70)和(82.14±3.35)分,试验组与对照组相比,差异均有统计学意义(均P<0.05)。试验组和对照组的总药物不良反应发生率分别为5.71%和8.57%,差异无统计学意义(P>0.05)。结论 三七通舒胶囊联合脑心通胶囊治疗脑梗死后血管性痴呆患者的效果显著,且安全性较高。

Objective To investigate the clinical effect of Sanqi Tongshu capsule combined with Naoxintong capsule in the treatment of vascular dementia(VD) after cerebral infarction. Methods Seventy patients with VD after cerebral infarction were randomly divided into control group(n=35) and treatment group(n=35). The control group was treated with Naoxintong capsule, and the treatment group was treated with Sanqi Tongshu capsule combined with Naoxintong capsule.The clinical efficacy, behavioral and cognitive function, neurological factors vascular endothelial function and the occurrence of adverse drug reactions before and after treatment were compared between the two groups. Results After treatment,the total effective rates of the treatment group and the control group were 94. 29% and 77. 14%,respectively. There was significant difference between the treatment group and the control group( P < 0. 05). After treatment,central-specific protein( S-100β) levels were( 419. 30 ± 69. 23) and( 462. 05 ± 66. 48) pg·L^(-1);neuron-specific enolase( NSE) levels were( 35. 19 ± 9. 18) and( 48. 70 ± 10. 22)ng·L^(-1);nerve growth factor( NGF) levels were( 18. 73 ± 2. 57) and( 16. 78 ± 5. 44) ng·L^(-1)in the treatment and control groups,respectively,and there were significant differences between the treatment group and the control group( all P < 0. 05). After treatment,the nitric oxide( NO) levels in the treatment group and the control group were( 56. 05 ± 6. 04) and( 43. 34 ± 3. 56) μmol · L-1,respectively;the endothelin-1( ET-1) levels were( 63. 27 ± 4. 08) and( 80. 78 ± 5. 95) ng · L-1,respectively,and there were significant differences between the treatment group and the control group( all P < 0. 05). After treatment,the activity of daily living scale( ADL) scores of the treatment group and the control group were( 86. 25 ± 7. 62) points and( 75. 28 ± 7. 10) points,respectively;the Mini-Mental State Examination( MMSE) scores were( 25. 66 ± 1. 98) points and( 22. 85 ± 1. 59) points,respectively,and there were significant differences between the treatment group and the control group( all P < 0. 05).After treatment,the physical function scores of the treatment group and the control group were( 85. 14 ± 6. 25) points and( 81. 12 ± 3. 48) points,the physical function scores of the two groups were( 86. 96 ± 8. 53) points and( 83. 68 ± 3. 51) points;the emotional function scores were( 90. 78 ± 4. 68) points and( 84. 53 ± 3. 37) points;the social function scores were( 88. 62 ± 4. 70) points and( 82. 14 ± 3. 35) points,respectively. There were significant differences between the treatment group and the control group( all P < 0. 05). The incidence of total adverse drug reactions in the treatment group and the control group was 5. 71% and 8. 57%,respectively,and the difference was no statistically significant( P > 0. 05). Conclusion Sanqi Tongshu capsule combined with Naoxintong capsule is effective and safe in the treatment of vascular dementia after cerebral infarction.