摘要
目的:观察培元通脑胶囊联合"智三针"治疗卒中后痴呆(PSD)的临床疗效及作用机制。方法:采用SAS软件生成随机数字表法将98例符合要求的患者分为对照组和观察组各49例。两组患者基础治疗口服多奈哌齐片,10 mg/次,1次/d;尼莫地平片,30 mg/次,1次/d,口服。对照组采用"智三针",1次/d,5次/周。观察组针刺同对照组,加服培元通脑胶囊,3粒/次,3次/d。两组疗程均为连续治疗12周。于治疗前、治疗后4,8,12周评价简易精神状态(MMSE)和蒙特利尔认知评估量表(MoCA),评估治疗前后日常生活能力量表(ADL),神经精神症状问卷(NPI)和中医证候,检测治疗前后血清同型半胱氨酸(Hcy),肝细胞生长因子(HGF),氧化低密度脂蛋白(Ox-LDL)和乙酰胆碱酶(Ach E)水平。结果:观察组临床疗效总有效率为93.88%,高于对照组的77.55%(χ~2=5.333,P<0.05);经重复测量的方差分析,治疗后两组患者MoCA评分逐渐升高(F_(对照)=3.947,F_(观察)=5.833,P<0.05);MMSE评分也逐渐升高(F_(对照)=3.876,F_(观察)=6.011,P<0.05),;观察组患者在治疗后8周和12周MMSE评分均高于对照组(P<0.05),12周观察组MoCA评分高于对照组(P<0.05);治疗后观察组MMSE量表的定向力、注意力和计算力、语言3个因子评分均高于对照组(P<0.05);观察组患者的MMSE和MoCA评分治疗前后差值均高于对照组(P<0.05);治疗后观察组患者ADL,NPI-1,NPI-2和中医证候评分均低于对照组(P<0.01);观察组患者Hcy,OxLDL和Ach E水平均低于对照组,HGF水平高于对照组(P<0.01)。结论:培元通脑胶囊内服联合"智三针"治疗PSD能进一步的提高认知能力和行为能力,改善精神行为异常,减轻临床症状,提高临床疗效,并能调节Hcy,Ox-LDL,Ach E和HGF水平。
Objective: To observe the clinical efficacy of Peiyuan Tongnao capsule combined with "Zhisanzhen" for post-stroke dementia( PSD) and investigate its mechanism. Method: Ninety-eight eligible patients were randomly divided into control group( 49 cases) and observation group( 49 cases) by random number table. Both groups received donepezil tablet,10 mg/time,qd,and nimodipine tablet,30 mg/time,qd. Patients in control group additionally took "Zhisanzhen",qd,5 times/week. Based on the treatment in control group,patients in observation group additionally took Peiyuan Tongnao capsule,3 capsules/time,tid. The treatment course was 12 weeks. Before and at the 4th,8th and 12th week after treatment,mini-mental state examination(MMSE),montreal cognitive assessment( MoCA),activity of daily living scale(ADL),neuropsychiatric inventory(NPI) and symptoms of traditional Chinese medicine(TCM) were evaluated. Before and after treatment,levels of serum hyperhomocysteinemia( Hcy),hepatocyte growth factor(HGF),oxidized low density lipoprotein(Ox-LDL) and acetylcholinesterase( Ach E) were detected. Result: The total clinical effective rate was 93. 88% in observation group,better than 77. 55% in control group(χ^2= 5. 333,P <0. 05). Repeat measurement ANOVA after treatment showed that scores of MoCA,MMSE were gradually increased( Fcontrol= 3. 947,Fobservation= 5. 833,P <0. 05 for MoCA. Fcontrol= 3. 876,Fobservation= 6. 011,P< 0. 05 for MMSE). At the 8th and 12th after treatment,scores of MMSE in the observation group were all higher than those in control group( P< 0. 05). At the 12th week after treatment,score of MoCA in observation group was higher than that in control group( P< 0. 05). Scores of directing force,attention,capacity of calculation in observation group were higher than those in control group after treatment( P <0. 05). The changes in scores of MMSE and MoCA in observation group were larger than those in control group after treatment( P< 0. 05). Scores of ADL,NPI-1,NPI-2 and symptom of TCM in observation group were lower tha
作者
蒋翠蕾
赵俊杰
娄飞
周莹
JIANG Cui-lei;ZHAO Jun-jie;LOU Fei;ZHOU Ying(Laiwu Hospital Affiliated to Taishan Medical University,Laiwu 271100,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2019年第9期103-108,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
山东中医药管理局科学技术项目(Z-2015-1-3-58-5)
