摘要
目的观察丁苯酞联合多奈哌齐对阿尔茨海默病(AD)患者认知功能及脑血管储备(CVR)功能的影响。方法连续收集2015年1月-2016年12月湖北省中西医结合医院神经内科门诊或住院的AD患者60例,随机数字表法分为对照组和观察组各30例。对照组给予多奈哌齐口服治疗,观察组给予多奈哌齐及丁苯酞软胶囊口服治疗,总疗程均90 d。治疗前后应用经颅多普勒(TCD)屏气试验检测屏气指数(BHI)评价CVR功能,同时进行神经电生理检测P300及简易精神状态量表(MMSE)评定患者认知功能,并观察治疗过程中的不良反应。结果 (1)观察组患者总有效率为90.00%,显著高于对照组的66.67%,差异有统计学意义(χ~2=4.812,P=0.028)。(2)与治疗前比较,对照组治疗后90 d MMSE评分、P300波幅及潜伏期均有显著变化(t=2.309、2.649、2.325,P<0.05),BHI无显著变化(t=1.853>0.05);观察组治疗后90 d MMSE评分、P300波幅、潜伏期及BHI均有显著变化(t=3.909、3.144、4.087、3.762,P<0.01)。(3)与对照组比较,观察组治疗后90 d MMSE评分、P300波幅、潜伏期及BHI均有显著差异(t=2.543、2.426、2.294、2.894,P<0.05)。(4)对照组发生不良反应2例(6.67%),观察组未见明确不良反应。结论丁苯酞联合多奈哌齐治疗AD疗效显著,能显著提高AD患者认知功能及CVR功能.是一种安全有效的治疗方法。
Objective To evaluate the impact of butyphthalide combined with Donepezil on cognitive function and cerebrovascular reserve（CVR）in patients with Alzheimer s disease（AD）. Methods Sixty patients with AD were randomly divided into control group（n =30） and observation group（n =30）. The control group was treated with Donepezil orally, and the observation group was treated with Donepezil and butyphthalide soft capsule. Both group received 90 days ＇ treatment.Transcranial Doppler（TCD） breath holding test for breath holding index（ BHI） to evaluate the function of CVR before and after treatment, meanwhile, evaluation of cognitive function in patients with P300 and the mini mental state examination（MMSE）was conducted, and the adverse reactions during the treatment were observed. Results（1） The total effective rate of the patients in the observation group was 90. 00%, which was significantly higher than 66. 67% of the control group. The difference was statistically significant（ χ^2=4. 812,P=0. 028）.（ 2） Compared with pre-treatment, there were significant changes in MMSE score and P300 in the control group 90 days after treatment（t=2.309, t=2.649 t =4.325,P〈0.05）, and no significant change in BHI（t=1. 853,P〉0. 05）; there were significant changes in MMSE score, P300 and BHI in the observation group 90 days after treatment.（t = 3.909, t =3. 144, t =4. 087, t=3. 762,P〈0. 01）.（3） Compared with the control group,there were significant differences in MMSE score, P300 and BHI in the treatment group 90 days after treatment（t =2.543, t =3.426, t= 2. 294, t = 2. 894,P〈0. 05）.（4）There were 2 cases（6.67%） in the control group occurred with adverse reactions;the observation group had no adverse reactions. Conclusion Butyphthalide combined with Donepezil is a safe and effective method for the treatment of AD. This method could significantly improve the cognitive function and CVR function of AD patients.
作者
孙国兵
付斌
谭倩
晏小琼
郭珍立
SUN Guobing;FU Bin;TAN Qian;YAN Xiaoqiong;GUO Zherdi(Department of Neurology,Hubei Province Hospital of the Integrated Chbwse and Western Medicbw,Wuhan 430015,China)
出处
《疑难病杂志》
CAS
2018年第8期781-785,共5页
Chinese Journal of Difficult and Complicated Cases
基金
湖北省卫生计生委中医药中西医结合科研重点项目(2017-20号-ZD12)
关键词
丁苯酞
阿尔茨海默病
认知功能
脑血管储备功能
Butylphthalide
Alzheimer＇s disease
Cognitive function
Cerebrovascular reserve function
