加减薯蓣丸对非痴呆型血管性认知障碍患者认知功能的1H-MRS初步分析

摘要

Objective To explore the therapeutic effect evaluation of proton magnetic resonance spectroscopy (1H-MRS) in patients with vascular cognitive impairment no dementia (VCIND) with dioscorea modified pill.Methods A total of 100 patients with VCIND were randomly assigned into the dioscorea modified pill group (n =50) and the aricept group (n =50).And 50 healthy volunteers were recruited as normal group.Each patient was examined with 1H-MRS and scored with mini-mental state examination (MMSE) and clinical dementia rating (CDR) scale pre-and post-treatment.Results After therapy,the NAA/Cr ratios and the itemized scores of cognitive scale compared with that of pre-therapy had significantly difference (P ＜0.05) in the dioscorea modified pill group(MMSE(26.5 ±2.0),CDR(0.14 ± 0.23))vs(MMSE(25.1 ±2.3),CDR(0.5)).But no difference existed in the aricept group (P ＞0.05).Conclusion 1H-MRS may objectively reflect cognitive dysfunction in VCIND patients.And it has important values in the therapeutic effect evaluation of VCIND with dioscorea modified pill.%目的 探讨磁共振质子波谱成像(1 H-MRS)对中药加减薯蓣丸治疗非痴呆型血管性认知障碍(VCIND)的疗效评价功能.方法 收集2010年9月至2012年4月武汉大学人民医院的VCIND患者100例,男女比例1∶1,平均年龄63.2岁.将入选的100例VCIND患者随机分成50例中药、西药治疗两组,50例健康人作为健康对照组.治疗前后对所有被试行1 H-MRS检测及简易智力状态量表(MMSE)检查和临床痴呆程度量表(CDR)评分.结果 治疗后,中药治疗组N-乙酰天冬氨酸/肌酸复合物比值及认知量表评分[MMSE(26.5±2.0)分,CDR(0.14±0.23)分]较治疗前[MMSE(25.1±2.3)分,CDR(0.5)分]差异有统计学意义(P＜0.05),西药治疗组与治疗前差异无统计学意义(P＞0.05).结论 1H-MRS能客观反映VCIND患者认知功能改变,对中药加减薯蓣丸治疗VCIND患者之效果有良好的评价作用.