中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2014年
5期
331-334
,共4页
高磊%焦静%王美姣%隋晓琳%张宪忠
高磊%焦靜%王美姣%隋曉琳%張憲忠
고뢰%초정%왕미교%수효림%장헌충
芪参通络增智汤%缺血性中风急性期%认知障碍%简易智力状态检查量表%蒙特利尔认知量表%事件相关电位P300
芪參通絡增智湯%缺血性中風急性期%認知障礙%簡易智力狀態檢查量錶%矇特利爾認知量錶%事件相關電位P300
기삼통락증지탕%결혈성중풍급성기%인지장애%간역지력상태검사량표%몽특리이인지량표%사건상관전위P300
Qishen Tongluo Zengzhi decoction%Acute phase of ischemic stroke%Cognitive impairment%Mini-Mental State Examination%Montreal Cognitive Assessment%Event-related potentials P300
目的：观察芪参通增智络汤对缺血性中风急性期患者认知障碍的影响。方法采用前瞻性随机临床对照研究，选择山东中医药大学附属日照市中医医院神经内科、康复科收治的130例气虚血瘀兼痰湿停滞型缺血性中风急性期认知障碍患者，按随机数字表法分为治疗组和对照组，每组65例。两组均给予内科常规治疗，治疗组在常规治疗基础上加服芪参通络增智汤〔组成：黄芪30 g，太子参30 g，三七10 g，鸡血藤25 g，水蛭粉（冲服）3 g，地龙10 g，赤芍12 g，当归12 g，桃仁10 g，红花10 g，川牛膝12 g，漏芦10 g，泽泻6 g，石菖蒲9 g，远志9 g，香附10 g，豨莶草15 g〕每日1剂；对照组在常规治疗基础上静脉滴注奥拉西坦注射液4.0 g，每日1次。两组总疗程均为21 d。采用简易智力状态检查量表（MMSE）、蒙特利尔认知量表（MoCA）评分评定两组患者治疗前后的认知功能，记录P300波潜伏期、波幅。结果最终治疗组纳入62例，对照组纳入63例。两组治疗前MMSE评分、MoCA评分、P300波潜伏期和波幅比较差异均无统计学意义（均P＞0.05）。两组治疗后MMSE评分、MoCA评分和P300波幅均较治疗前升高，P300波潜伏期较治疗前缩短，且以治疗组变化更显著〔MMSE评分（分）：25.33±2.32比21.68±2.29，MoCA评分（分）：26.61±3.06比22.40±2.93，P300波潜伏期（ms）：349.62±20.01比371.87±19.63，P300波波幅（μV）：8.70±2.92比5.72±2.33，均P＜0.01〕。结论芪参通络增智汤能有效干预缺血性中风急性期患者的认知障碍，改善其认知功能。
目的：觀察芪參通增智絡湯對缺血性中風急性期患者認知障礙的影響。方法採用前瞻性隨機臨床對照研究，選擇山東中醫藥大學附屬日照市中醫醫院神經內科、康複科收治的130例氣虛血瘀兼痰濕停滯型缺血性中風急性期認知障礙患者，按隨機數字錶法分為治療組和對照組，每組65例。兩組均給予內科常規治療，治療組在常規治療基礎上加服芪參通絡增智湯〔組成：黃芪30 g，太子參30 g，三七10 g，鷄血籐25 g，水蛭粉（遲服）3 g，地龍10 g，赤芍12 g，噹歸12 g，桃仁10 g，紅花10 g，川牛膝12 g，漏蘆10 g，澤瀉6 g，石菖蒲9 g，遠誌9 g，香附10 g，豨薟草15 g〕每日1劑；對照組在常規治療基礎上靜脈滴註奧拉西坦註射液4.0 g，每日1次。兩組總療程均為21 d。採用簡易智力狀態檢查量錶（MMSE）、矇特利爾認知量錶（MoCA）評分評定兩組患者治療前後的認知功能，記錄P300波潛伏期、波幅。結果最終治療組納入62例，對照組納入63例。兩組治療前MMSE評分、MoCA評分、P300波潛伏期和波幅比較差異均無統計學意義（均P＞0.05）。兩組治療後MMSE評分、MoCA評分和P300波幅均較治療前升高，P300波潛伏期較治療前縮短，且以治療組變化更顯著〔MMSE評分（分）：25.33±2.32比21.68±2.29，MoCA評分（分）：26.61±3.06比22.40±2.93，P300波潛伏期（ms）：349.62±20.01比371.87±19.63，P300波波幅（μV）：8.70±2.92比5.72±2.33，均P＜0.01〕。結論芪參通絡增智湯能有效榦預缺血性中風急性期患者的認知障礙，改善其認知功能。
목적：관찰기삼통증지락탕대결혈성중풍급성기환자인지장애적영향。방법채용전첨성수궤림상대조연구，선택산동중의약대학부속일조시중의의원신경내과、강복과수치적130례기허혈어겸담습정체형결혈성중풍급성기인지장애환자，안수궤수자표법분위치료조화대조조，매조65례。량조균급여내과상규치료，치료조재상규치료기출상가복기삼통락증지탕〔조성：황기30 g，태자삼30 g，삼칠10 g，계혈등25 g，수질분（충복）3 g，지룡10 g，적작12 g，당귀12 g，도인10 g，홍화10 g，천우슬12 g，루호10 g，택사6 g，석창포9 g，원지9 g，향부10 g，희렴초15 g〕매일1제；대조조재상규치료기출상정맥적주오랍서탄주사액4.0 g，매일1차。량조총료정균위21 d。채용간역지력상태검사량표（MMSE）、몽특리이인지량표（MoCA）평분평정량조환자치료전후적인지공능，기록P300파잠복기、파폭。결과최종치료조납입62례，대조조납입63례。량조치료전MMSE평분、MoCA평분、P300파잠복기화파폭비교차이균무통계학의의（균P＞0.05）。량조치료후MMSE평분、MoCA평분화P300파폭균교치료전승고，P300파잠복기교치료전축단，차이치료조변화경현저〔MMSE평분（분）：25.33±2.32비21.68±2.29，MoCA평분（분）：26.61±3.06비22.40±2.93，P300파잠복기（ms）：349.62±20.01비371.87±19.63，P300파파폭（μV）：8.70±2.92비5.72±2.33，균P＜0.01〕。결론기삼통락증지탕능유효간예결혈성중풍급성기환자적인지장애，개선기인지공능。
ObjectiveTo observe the effect of Qishen Tongluo Zengzhi decoction on cognitive impairment in patients with acute phase of ischemic stroke.Methods A prospective randomized controlled trial was conducted, and 130 patients with acute phase of ischemic stroke and cognitive impairment accompanied by Qi deficiency and blood stasis and stagnationof phlegm-dampness syndrome admitted into the Neurology and Rehabilitation Departments of Rizhao Hospital of Traditional Chinese Medicine(TCM) Affiliated to Shandong University of TCM were randomly divided into treatment group and control group, 65 cases in each group. In the two groups, conventional internal treatment was given to all patients, and in the treatment group, additionally the Qishen Tongluo Zengzhi decoction was administered orally(composition: astragalus membranaceus 30 g, radix pseudostellariae 30 g, notoginseng 10 g,spatholobus stem 25 g, hirudo 3 g, pberetima 10 g, radix paeoniae rubra 12 g, Chinese angelica 12 g, peach kernel 10 g, carthamus tinctorious 10 g, achyranthes 12 g, radix rhapontici 10 g, rhizoma alismatis 6 g, Acorus gramineus Soland 9 g, polygala root 9 g, rhizoma cyperi 10 g, herba siegesbeckiae 15 g),one dose a day. While in the control group, oxiracetam 4.0 g intravenous drip was given, once a day. The whole course was 21 days in both groups. Before and after treatment, the cognitive function of all the patients in two groups was assessed by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA) scores, and incubation period and amplitude of P300 wave were recorded.Results Finally 62 cases were in treatment group and 63 cases in control group. Before treatment, the comparisons of the MMSE score, MoCA score and P300 latent period and amplitude between the two groups had no statistically significant differences(allP>0.05). After treatment in the two groups, the MMSE score, MoCA score and P300 wave amplitude were elevated, P300 latency period was shortened compared with those before treatment, and the changes were more prominent in treatment group〔score of MMSE: 25.33±2.32 vs. 21.68±2.29, score of MoCA(score): 26.61±3.06 vs. 22.40±2.93, P300 wave incubation period(ms): 349.62±20.01 vs. 371.87±19.63, P300 wave amplitude(μV): 8.70±2.92 vs. 5.72±2.33,allP<0.01〕.ConclusionQishen Tongluo Zengzhi decoctioncan effectively intervene cognitive impairment in patients with acute phase of ischemic stroke, and improve their cognitive function.
