丁苯酞联合舒血宁对血管性痴呆患者认知功能和日常生活能力的影响

摘要

目的 探讨丁苯酞联合舒血宁对血管性痴呆(VD)患者认知功能和日常生活能力(ADL)的影响.方法 采用前瞻性研究方法,选择2014年7月至2016年11月河北省衡水市哈励逊国际和平医院收治的轻、中度VD患者101例,按随机数字表法将患者分为对照组(49例)和观察组(52例).两组均给予常规基础治疗,对照组在常规治疗基础上加用舒血宁注射液治疗,每日1次,2周为1个疗程,共2个疗程,观察组在对照组基础上联合口服丁苯酞胶囊0.2 g.于治疗前、治疗1个疗程和治疗2个疗程后采用简易精神状态检查表(MMSE)、长谷川痴呆量表(HDS)评定患者的认知功能,采用ADL量表评定患者的ADL,并观察临床疗效和不良反应发生情况.结果 两组治疗后MMSE、HDS、ADL评分均逐渐升高,治疗2个疗程后均达到最高,且观察组上述指标的升高程度均较对照组更显著〔MMSE评分(分):27.92±3.51比23.88±3.31,HDS评分(分):20.13±2.33比17.68±2.42,ADL评分(分):82.14±6.68比68.17±5.79,均P<0.05〕.观察组治疗后总有效率明显高于对照组〔86.5%(45/52)比75.5%(37/49),P<0.05〕,不良反应发生率低于对照组〔1.9%(1/52)比4.1%(2/49)〕,但两组比较差异无统计学意义(P>0.05).结论 丁苯酞胶囊联合舒血宁注射液能明显改善VD患者认知功能和生活质量,临床疗效安全可靠.%Objective To investigate the effects of butylphthalide combined with shuxuening on cognitive function and activity of daily living (ADL) of patients with vascular dementia (VD).Methods A prospective research method was conducted, one hundred and one light and moderate VD patients admitted to Harrison International Peace Hospital from July 2014 to November 2016 were enrolled, and they were divided into a control group (49 cases) and an observation group (52 cases) according to random number tables. The two groups were given routine basic treatment, the control group received Shuxuening injection once a day for 2 courses (2 weeks as a course), while the observation group was additionally treated by butylphthalide capsule 0.2 g on the basis of the control group treatment. Before the treatment and 1 and 2 courses after treatment, the cognitive function was evaluated by mini-mental state examination (MMSE) and Hastgawa Dementia Scale (HDS), ADL was evaluated by ADL scale; the efficacy and adverse reactions were observed.Results The MMSE, HDS and ADL scores were increased gradually after treatment in the two groups, reached the highest degree after 2 courses of treatment, and the degrees of increase in the above indicators in observation group were more significant than those in the control group (MMSE score: 27.92±3.51 vs. 23.88±3.31, HDS score: 20.13±2.33 vs. 17.68±2.42, ADL score: 82.14±6.68 vs. 68.17±5.79, allP < 0.05). The total effective rate of observation group was significantly higher than that in the control group [86.5% (45/52) vs. 75.5% (37/49), P < 0.05], and the incidence of adverse reactions was lower than that in the control group [1.9% (1/52) vs. 4.1% (2/49)], being no significant difference between the two groups in adverse reaction (P > 0.05).Conclusions Polybutylene phthalate capsule combined with shuxuening injection can significantly improve the cognitive function and quality of life of patients with vascular dementia,and the clinical efficacy is safe and reliable.