脑康Ⅱ号联合茴拉西坦治疗脑梗死后非痴呆型血管性认知障碍的效果分析

摘要

目的 观察脑康Ⅱ号对脑梗死后非痴呆型血管性认知障碍患者的临床疗效.方法 前瞻性连续纳入2012年10月至2014年2月首都医科大学宣武医院神经内科门诊确诊的脑梗死后非痴呆型血管性认知障碍患者100例,其中因未按期返回医院完成回访者6例、自动退出者2例,最终92例纳入研究.按随机数字表法分为观察组(48例)和对照组(44例).对照组给予茴拉西坦治疗,观察组在茴拉西坦基础上加用脑康Ⅱ号(制首乌、熟地黄、三七、菖蒲、远志),疗程12周.比较两组治疗前后中医证候积分的差异,比较两组治疗后的中医证候的有效率及认知功能改善率.结果 观察组治疗前后证候积分分别为(28±5)分和(15±4)分,对照组治疗前后证候积分分别为(26±5)分和(18±5)分,治疗前后比较,差异均有统计学意义(t值分别为15.02、14.73,均P<0.05);治疗后组间证候积分的差异无统计学意义(t=-3.08,P>0.05).观察组总有效率[75.0%(36/48)]高于对照组[45.5%(20/44)],组间差异有统计学意义(χ2=7.023,P=0.008).观察组记忆力、定向力、判断力和解决问题能力的改善率[29.2%(14/48)、27.1%(13/48)、31.2%(15/48)]高于对照组[11.4%(5/44)、9.1%(4/44)、13.6%(6/44)],组间差异均有统计学意义(均P<0.05).观察期间,两组患者均未出现不良反应.结论 脑康Ⅱ号联合茴拉西坦治疗脑梗死后非痴呆型血管性认知障碍患者有增效作用.%Objective To observe the clinical efficacy of Naokang Ⅱ in patients with vascular cognitive impairment of none dementia after cerebral infarction.Methods A total of 100 consecutive patients with vascular cognitive impairment of none dementia after cerebral infarction diagnosed at the Neurology Clinic,Beijing Xuanwu Hospital,Capital Medical University from October 2012 to February 2014 were enrolled prospectively.Six of them did not complete a return visit because of not returning to the hospital in time,2 withdrew automatically,and finally,92 patients were enrolled in the study.According to the random number table method,they were divided into either an observation group (n=48) or a control group (n=44).The control group was treated with aniracetam,while the observation group was treated with aniracetam plus Naokang Ⅱ (Radix Polygoni Multiflori Preparata,Radix Rehmanniae Preparata,Radix Notoginseng,Acorus Calamus L.and Radix Polygalae) for 12 weeks.The differences of traditional Chinese medicine syndrome integral before and after treatment in both groups were compared.The effective rate and cognitive function improvement rate of traditional Chinese medicine syndromes before and after treatment in both groups were compared.Results The scores of traditional Chinese medicine syndrome integral before and after treatment in patients of the observation group were 28±5 and 15±4,respectively,those of the control group before and after treatment were 26±5 and 18±5,respectively.There were significant differences before and after treatment (the t values were 15.02 and 14.73,respectively,all P<0.05).There was no significant difference between the two groups after treatment(t=-3.08,P>0.05).The total effective rate in the observation group (75.0% [36/48]) was higher than that in the control group (45.5% [20/44]).There was significant difference between two groups (χ2=7.023,P=0.008).The improvement rates of memory,orientation,judgment,and problem solving skills in the observation group (29.2% [14/48],27.1% [13/48],and 31.2% [15/48]) were higher than those in the control group (11.4% [5/44],9.1% [4/44],and 13.6% [6/44]).There were significant differences between the two groups (all P<0.05).No adverse reactions were observed in the two groups during the observation period.Conclusion Naokang Ⅱ combined with aniracetam for patients with vascular cognitive impairment of none dementia after cerebral infarction had a synergistic effect.