老年卒中后认知障碍伴失眠行酸枣仁汤加减联合奥拉西坦胶囊治疗的效果观察

Therapeutic Effect of Combination of Suanzaoren Tang Decoction and Olaxetan Capsule in Treating Post-stroke cognitive impairment accompanied with insomnia in the elderly

目的:分析老年卒中后认知障碍(PSCI)伴失眠行酸枣仁汤加减联合奥拉西坦胶囊治疗的效果观察。方法:选取2021年1月—2022年12月吴川市中医医院收治的老年卒中后PSCI伴失眠60例为研究对象,随机均分为对照组与观察组,各30例。对照组行奥拉西坦治疗,观察组在对照组基础上联合酸枣仁汤加减治疗。比较两组认知障碍症状及卒中后遗症。结果:治疗后,观察组异常情绪、睡眠缺失、异常行为、定向障碍、活动障碍、记忆障碍评分均低于对照组,差异有统计学意义(P<0.05);观察组神经功能缺损评分、神经精神科问卷、匹兹堡睡眠指数评分低于对照组,简易智力状态检查、Fugel-Meyer评分高于对照组,差异具有统计学意义(P<0.05)。结论:在老年PSCI伴失眠行酸枣仁汤加减联合奥拉西坦方案治疗,可显著改善患者的临床症状,促进患者的卒中后遗症恢复,具有重要临床应用价值。

Objective:To analyze the therapeutic effect of combination of Suanzaoren Tang Decoction and olaxetan capsule in treating post-stroke cognitive impairment(PSCI)accompanied with insomnia in the elderly.Methods:60 cases of PSCI accompa⁃nied with insomnia admitted to Wuchuan Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were randomly divided into the control group and the observation group,each with 30 cases.The control group was treated with olanzap⁃ine,and the observation group was treated with the addition of Suanzaoren Tang Decoction on the basis of the control group.The cognitive impairment symptoms and stroke sequela symptoms of the two groups were compared.Results:After treatment,the scores of abnormal mood,sleep disorder,abnormal behavior,orientation disorder,activity disorder,and memory disorder of the ob⁃servation group were lower than those of the control group,and the difference was statistically significant(P<0.05);the scores of neurological deficit,neuropsychiatric questionnaire,and Pittsburgh sleep Quality index of the observation group were lower than those of the control group;the scores of Simple Mental Status Examination and Fugel-Meyer score were higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion:The treatment of PSCI accompanied with in⁃somnia in the elderly with the combination of Suanzaoren Tang Decoction and Olanzapine can significantly improve the clinical symptoms of the patients and promote the recovery of post-stroke sequelae.