中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2005年
16期
231-233
,共3页
陈文武%田爱兰%翟蕾%翟秀玲%张永利
陳文武%田愛蘭%翟蕾%翟秀玲%張永利
진문무%전애란%적뢰%적수령%장영리
痴呆,血管性/药物疗法%智力测验%神经症性障碍
癡呆,血管性/藥物療法%智力測驗%神經癥性障礙
치태,혈관성/약물요법%지력측험%신경증성장애
背景:目前国内外对痴呆症治疗方法和药物较多.杏丁和吡拉西坦(脑复康)是一种循环障碍改善剂和神经细胞保护剂,可减慢脑组织功能减退,对认知功能障碍具有改善作用.目的:观察杏丁与吡拉西坦联合应用治疗血管性痴呆对认知功能的改善作用.设计:以患者为观察对象的病例对照研究.单位:河南大学第一附属医院神经科.对象:2000-10/2002-03河南大学第一附属医院神经内科住院血管性痴呆患者91例,随机分为治疗组48例和对照组43例.干预:治疗组以杏丁注射液20 mL加吡拉西坦8 g分别加入50 g/L葡萄糖注射液250 mL中静脉滴注,1次/d,14 d为1个疗程;对照组以吡拉西坦8 g加入50 g/L葡萄糖注射液250 mL静脉滴注,1次/d,14 d为1个疗程.两组其他治疗药物无差别.两组于治疗结束后1个月以复查简明智能状态检查量表,长谷川痴呆修改量表评估对认知功能的改善,以神经功能缺损评分分析神经功能症状的改善.主要观察指标:①两组患者简明智能状态检查量表,长谷川痴呆修改量表及神经功能缺损评分.②疗效分析.结果:91例患者均进入结果分析.两组治疗前简明智能状态检查量表和长谷川痴呆修改量表评分相比差异均无显著性意义,治疗组治疗后简明智能状态检查量表和长谷川痴呆修改量表评分[(23.26±5.12)分和(2.78±3.46)分]与对照组[(19.14±3.21)分和(15.21±2.29)分]比较,差异有显著性意义(t=4.79,15.44,P＜0.01),治疗组治疗后神经功能缺损积分13.68±7.83与对照组17.33±8.81比较,差异有显著性意义,治疗组总有效率(总显效率+进步)为92%,对照组总有效率为56%,两组相比差异亦有显著性意义(X2=15.48,P＜0.01).结论:治疗组治疗后简明智能状态检查量表评分高于对照组,长谷川痴呆修改量表评分低于对照组,说明杏丁联合吡拉西坦治疗血管性痴呆能显著改善其认知功能.
揹景:目前國內外對癡呆癥治療方法和藥物較多.杏丁和吡拉西坦(腦複康)是一種循環障礙改善劑和神經細胞保護劑,可減慢腦組織功能減退,對認知功能障礙具有改善作用.目的:觀察杏丁與吡拉西坦聯閤應用治療血管性癡呆對認知功能的改善作用.設計:以患者為觀察對象的病例對照研究.單位:河南大學第一附屬醫院神經科.對象:2000-10/2002-03河南大學第一附屬醫院神經內科住院血管性癡呆患者91例,隨機分為治療組48例和對照組43例.榦預:治療組以杏丁註射液20 mL加吡拉西坦8 g分彆加入50 g/L葡萄糖註射液250 mL中靜脈滴註,1次/d,14 d為1箇療程;對照組以吡拉西坦8 g加入50 g/L葡萄糖註射液250 mL靜脈滴註,1次/d,14 d為1箇療程.兩組其他治療藥物無差彆.兩組于治療結束後1箇月以複查簡明智能狀態檢查量錶,長穀川癡呆脩改量錶評估對認知功能的改善,以神經功能缺損評分分析神經功能癥狀的改善.主要觀察指標:①兩組患者簡明智能狀態檢查量錶,長穀川癡呆脩改量錶及神經功能缺損評分.②療效分析.結果:91例患者均進入結果分析.兩組治療前簡明智能狀態檢查量錶和長穀川癡呆脩改量錶評分相比差異均無顯著性意義,治療組治療後簡明智能狀態檢查量錶和長穀川癡呆脩改量錶評分[(23.26±5.12)分和(2.78±3.46)分]與對照組[(19.14±3.21)分和(15.21±2.29)分]比較,差異有顯著性意義(t=4.79,15.44,P＜0.01),治療組治療後神經功能缺損積分13.68±7.83與對照組17.33±8.81比較,差異有顯著性意義,治療組總有效率(總顯效率+進步)為92%,對照組總有效率為56%,兩組相比差異亦有顯著性意義(X2=15.48,P＜0.01).結論:治療組治療後簡明智能狀態檢查量錶評分高于對照組,長穀川癡呆脩改量錶評分低于對照組,說明杏丁聯閤吡拉西坦治療血管性癡呆能顯著改善其認知功能.
배경:목전국내외대치태증치료방법화약물교다.행정화필랍서탄(뇌복강)시일충순배장애개선제화신경세포보호제,가감만뇌조직공능감퇴,대인지공능장애구유개선작용.목적:관찰행정여필랍서탄연합응용치료혈관성치태대인지공능적개선작용.설계:이환자위관찰대상적병례대조연구.단위:하남대학제일부속의원신경과.대상:2000-10/2002-03하남대학제일부속의원신경내과주원혈관성치태환자91례,수궤분위치료조48례화대조조43례.간예:치료조이행정주사액20 mL가필랍서탄8 g분별가입50 g/L포도당주사액250 mL중정맥적주,1차/d,14 d위1개료정;대조조이필랍서탄8 g가입50 g/L포도당주사액250 mL정맥적주,1차/d,14 d위1개료정.량조기타치료약물무차별.량조우치료결속후1개월이복사간명지능상태검사량표,장곡천치태수개량표평고대인지공능적개선,이신경공능결손평분분석신경공능증상적개선.주요관찰지표:①량조환자간명지능상태검사량표,장곡천치태수개량표급신경공능결손평분.②료효분석.결과:91례환자균진입결과분석.량조치료전간명지능상태검사량표화장곡천치태수개량표평분상비차이균무현저성의의,치료조치료후간명지능상태검사량표화장곡천치태수개량표평분[(23.26±5.12)분화(2.78±3.46)분]여대조조[(19.14±3.21)분화(15.21±2.29)분]비교,차이유현저성의의(t=4.79,15.44,P＜0.01),치료조치료후신경공능결손적분13.68±7.83여대조조17.33±8.81비교,차이유현저성의의,치료조총유효솔(총현효솔+진보)위92%,대조조총유효솔위56%,량조상비차이역유현저성의의(X2=15.48,P＜0.01).결론:치료조치료후간명지능상태검사량표평분고우대조조,장곡천치태수개량표평분저우대조조,설명행정연합필랍서탄치료혈관성치태능현저개선기인지공능.
BACKGROUND: At present, there are many drugs and therapeutic methods for dementia at home and abroad. Both xingding and piracetam are the kind of improver for circulatory obstruction and protector for nerve cells and can slow down the functional decline of brain tissue and provide improvement for cognitive deficit.OBJECTIVE: To observe the improvement of allied application of xingding and piracetam on cognitive function in treatment of vascular dementia.DESIGNS: Case-controlled study based on patients.SETTING: Neurological Department in Affiliated Hospital of Henan University. PARTICIPANTS: Totally 91 cases of vascular dementia hospitalized in Neurological Department of First Affiliated Hospital of Henan University from October 2000 to March 2002, which were randomized into treatment group of 48 cases and the control of 43 cases.INTERVENTIONS: In treatment group, xingding injection of 20 mL and piracetam of 8 g were administrated and 50 g/L glucose injection 250 mL was added respectively for intravenous injection, once daily and 14 days made one session. In the control, piracetam of 8 g was prescribed with 50 g/L glucose injection 250 mL added for intravenous injection, once daily and 14 days made one session. There was no any difference in other medication treatment. One month later after treatment of two groups, he patients were re-examined with mini-mental state examination(MMSE) and Hasegawa dementia scale(HDS) was used to assess the cogitative improvement and neurological defect scale(NDF) was used to analysis the improvement of neurological functional symptoms.MAIN OUTCOME MEASURES: ① Scores of MMSE, HDS and NDF in two groups. ② Analysis on therapeutic effects.RESULTS: Totally 91 cases entered the analysis on the results. There was no significant difference in MMSE and HDS before treatment in two groups. In treatment group, after treatment, MMSE and HDS scores were (23.26±5.12) and(2.78±3.46) respectively, indicating significant difference(t=4.79, 15.44, P＜0.01) compared with the control(19.14 ±3.21)and(15.21±2.29) . NDF score was 13.68±7.83 after treatment and the significant difference was presented compared with the control(17.33 ±8.81) . The total effective rate(total remarkable rate + progression) was 92% in the treatment group and was 56% in the control. By the comparison between two groups, the difference was significant(χ2= 15.48, P＜0.01).CONCLUSION: After treatment, MMSE score in treatment group was higher than that in the control and HDS score was lower than that in the control, explaining that xingding allied piracetam significantly improves cogitative function in the treatment of vascular dementia.
