目的：观察银杏叶胶囊联合认知训练对稳定期慢性阻塞性肺疾病（ chronic obstructive pulmonary disease，COPD）患者认知功能障碍的影响，并初步探讨其作用机制。方法60例稳定期COPD患者随机分为常规治疗组（ A组），银杏叶胶囊治疗组（B组），认知训练组（C组）和银杏叶胶囊联合认知训练组（D组），各15例，观察3个月，各组患者治疗前后简易智能精神状态检查量表（ Mini⁃Mental State Exam，MMSE）和蒙特利尔认知评估量表（ Montreal cognitive assessment，MoCA）评分进行比较分析，并采用酶联免疫吸附实验（ ELISA）检测治疗前后患者外周静脉血清S100B水平。结果与各组治疗前相比，B组、C组及D组治疗后的MMSE和MoCA评分有提高，外周静脉血清S100B水平降低，但以D组各指标差异有统计学意义（均P＜0．05）。结论银杏叶联合认知治疗能够有效改善COPD患者的认知功能，可能与降低患者血清中S100B水平有关。%Objective To investigate the effects of Ginkgo biloba capsules and cognitive training on cognitive dysfunction in patients with stable chronic obstructive pulmonary disease. Methods Sixty cases of patients with stable COPD were randomly divided into four groups:Regular treatment group ( A) , Ginkgo biloba capsules treatment group ( B) , Cognitive training group ( C) and Gink⁃go biloba capsules + cognitive training group ( D ) . All groups received regular medicine therapy. The Mini⁃Mental State Exam ( MMSE) and Montreal cognitive assessment ( MoCA) assessment were performed before and after the training program. Serum level of S100B was also evaluated in each subject. Results After 3 months treatment, the score of MMSE and MoCA associated with a sub⁃stantive risk of cognitive impairment elevated and the serum level of S100B decreased in B, C and D group. While there was signifi⁃cantly difference of MMSE, MoCA scores and S100B level in D group ( P<0.05) . Conclusion COPD is a major risk factor for cogni⁃tive impairment. Ginkgo biloba capsules therapy combined with cognitive training is protective for cognitive impairment in patients with COPD, which may be associated with decreasing the serum levels of S100B.
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