逍遥丸与艾司西酞普兰治疗血管性痴呆伴发抑郁的疗效对比分析
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摘要
目的:分析比较逍遥丸与艾司西酞普兰治疗血管性痴(vascular dementia,VD)呆伴发抑郁的临床疗效。方法:选取VD伴发抑郁患者100例,随机分为对照组和观察组,每组各50例。两组均给予奥拉西坦注射液+多奈哌齐片的血管性痴呆治疗,对照组患者在此基础上给予口服草酸艾司西酞普兰片,10 mg/次,1次/d,根据个人反应可逐渐增加至20 mg/d观察组患者给予逍遥丸治疗,8丸/次,3次/d;两组均以2周为1个疗程,治疗4疗程。测定治疗前后两组患者血清中BNDF、S100B蛋白、NE、DA、5-HT及Hcy的水平;观察两组治疗前后CSDD、MMSE、CDR及ADL评分,对比治疗后的临床疗效及不良反应。结果:治疗4周及治疗8周后CSDD各项评分及总分均较治疗前明显降低(P<0.05),但两组间比较没有统计学意义(P>0.05)。治疗后两组患者的MMES评分明显升高,与治疗前比较差异有统计学意义(P<0.05),但治疗后两组各评分比较没有统计学意义(P>0.05);两组治疗前后CDR评分均没有显著变化,比较没有统计学意义(P>0.05)。治疗4周及8周后两组患者ADL评分均显著降低,虽然观察组的ADL评分较对照组略高,但比较并没有明显差异(P>0.05)。治疗后两组患者的BNDF、NE、DA及5-HT水平均较治疗前显著升高(P<0.05),S100B及Hcy水平显著降低(P<0.05),对照组的5-HT升高幅度较观察组更为明显(P<0.05),而治疗后两组的BNDF、NE、DA、S100B及Hcy比较没有显著差异(P>0.05)。观察组的治疗临床总有效率为90.0%;对照组的临床总有效率为88.0%,两组比较没有统计学意义(P>0.05);治疗过程中观察组患者不良反应总发生率为8.0%;对照组患者不良反应总发生率为32.0%,两组比较有统计学意义(P<0.05)。结论:逍遥丸治疗血管性痴呆伴发抑郁的临床疗效与艾司西酞普兰基本一致,不良反应少于艾司西酞普兰,值得临床推广应用。
Objective:To comparatively analyze the clinical efficacy of Xiaoyao Pill and escitalopram in the treatment of vascular dementia(VD) patients with depression.Methods:Totally 100 VD patients with depression were randomly divided into control group(n=50) and observation group(n=50).Both groups were treated with Donepezil Tablets and olaxetam injection, while patients in the control group were treated with oral oxalcitalopram oxalate 10 mg/time once a day.According to the individual reaction, the patients in the observation group could be treated with Xiaoyao Pills 3 times a day,20 mg/day, and the two groups were treated for 2 weeks as a course of treatment and 4 courses totally. We determined serum BNDFN S100 B protein, Neda-5-HT and Hcy in two groups before and after treatment. The levels of CDR and ADL were observed before and after treatment, and the clinical efficacy and adverse reactions were compared.Results: After 4 and 8 weeks treatment, the scores and total scores of CSDD were significantly lower than those before treatment(P<0.05), but there was no significant difference between the two groups(P>0.05).After treatment, the MMES score of the two groups was significantly higher than that before treatment(P<0.05), but there was no significant difference between the two groups after treatment(P>0.05), and there was no significant difference between the two groups' CDR score(P<0.05). There was no statistical significance(P>0.05).After 4 and 8 weeks of treatment, the ADL scores of the two groups were significantly decreased. Although the ADL score of the observation group was slightly higher than that of the control group, there was no significant difference between the two groups(P>0.05). There was no significant difference between the two groups(P>0.05). The total effective rate was 90.0% in the observation group.The total effective rate of the control group was 88.0 % and there was no significant difference between the two groups(P>0.05).The overall incidence of adverse reactions was 8.0% in the observation group.Conclusion:The clinical curative effect of Xiaoyao Pill on vascular dementia complicated with depression is consistent with that of escitalopram. The adverse reaction is less than that of escitalopram. It is worthy of clinical application.
Objective:To comparatively analyze the clinical efficacy of Xiaoyao Pill and escitalopram in the treatment of vascular dementia(VD) patients with depression.Methods:Totally 100 VD patients with depression were randomly divided into control group(n=50) and observation group(n=50).Both groups were treated with Donepezil Tablets and olaxetam injection, while patients in the control group were treated with oral oxalcitalopram oxalate 10 mg/time once a day.According to the individual reaction, the patients in the observation group could be treated with Xiaoyao Pills 3 times a day,20 mg/day, and the two groups were treated for 2 weeks as a course of treatment and 4 courses totally. We determined serum BNDFN S100 B protein, Neda-5-HT and Hcy in two groups before and after treatment. The levels of CDR and ADL were observed before and after treatment, and the clinical efficacy and adverse reactions were compared.Results: After 4 and 8 weeks treatment, the scores and total scores of CSDD were significantly lower than those before treatment(P<0.05), but there was no significant difference between the two groups(P>0.05).After treatment, the MMES score of the two groups was significantly higher than that before treatment(P<0.05), but there was no significant difference between the two groups after treatment(P>0.05), and there was no significant difference between the two groups' CDR score(P<0.05). There was no statistical significance(P>0.05).After 4 and 8 weeks of treatment, the ADL scores of the two groups were significantly decreased. Although the ADL score of the observation group was slightly higher than that of the control group, there was no significant difference between the two groups(P>0.05). There was no significant difference between the two groups(P>0.05). The total effective rate was 90.0% in the observation group.The total effective rate of the control group was 88.0 % and there was no significant difference between the two groups(P>0.05).The overall incidence of adverse reactions was 8.0% in the observation group.Conclusion:The clinical curative effect of Xiaoyao Pill on vascular dementia complicated with depression is consistent with that of escitalopram. The adverse reaction is less than that of escitalopram. It is worthy of clinical application.
引文
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[7] 王晓滨,郭琴琴,许贵军,等.坤宁安对去卵巢抑郁模型大鼠海马神经元凋亡的影响[J].中医药学报,2017,45(2):43-45.
[8] 谷晓林,刘琳,亓晓丽. 补肾益智汤联合丁基苯酞对老年血管性痴呆血液流变学及自由基损伤的影响[J]. 中华中医药学刊,2017,35(12):3217-3220.
[9] 庞啸虎,吴秀玮,许庆,等. 血管性痴呆患者认知功能障碍采用舒血宁与吡拉西坦治疗对其MMSE及ADL评分的影响[J]. 临床医学研究与实践,2017,2(35):32-33.
[10] 郝剑辉,杜秀生,张怡. 甜梦口服液联合草酸艾司西酞普兰治疗抑郁症的疗效观察[J]. 现代药物与临床,2016,31(11):1818-1821.
[11] 谢均,范振国,晏玉奎.艾司西酞普兰联合乌灵胶囊治疗脑梗死恢复期合并抑郁临床研究[J].中华中医药学刊,2018,36(1):254-256.
[12] 潘中瑛,高炎超. 小柴胡汤加减联合艾司西酞普兰治疗老年抑郁症疗效观察[J]. 四川中医,2017,35(7):187-189.
[13] 贾璐,蒙华庆,徐中林,等. 艾司西酞普兰治疗老年慢性心力衰竭伴抑郁症对患者认知功能和心功能的影响[J]. 重庆医学,2017,46(19):2652-2658.
[14] 张孟,隋晓琳,张春燕. 地黄导痰汤制剂对血管性痴呆患者脑血流及炎性细胞因子的影响[J]. 现代中西医结合杂志,2018,27(5):473-479.
[15] 胡伍毅,练春玲,李志辉,等. 加味指迷汤合子午流注开穴疗法治疗血管性痴呆临床观察[J]. 中国民族民间医药,2017,26(24):103-105.
[16] 段海水,吕贝,赵玉林,等.舒肝解郁胶囊联合安非他酮治疗老年抑郁症的疗效观察[J].现代药物与临床,2017,32(2):289-292.
[17] 潘中瑛,赵婧,陈静珊.柴胡疏肝散联合帕罗西汀对抑郁症患者血清5-HT的影响及其安全性分析[J].中医药信息,2018,35(1):54-57.
[18] 李涛,胡晓科,范超望,等. 首发性抑郁症患者血清GFAP、NSE、Hcy水平与认知功能的关系[J]. 检验医学与临床,2017,14(24):3601-3604.
[19] 刘锦灿,刘健. 补肾益髓汤对不同MTHFR基因型血管性痴呆患者Hcy及临床症状的影响[J]. 广州中医药大学学报,2018,35(2):205-209.
[20] 陶瑞. 佐匹克隆联合黛力新对卒中后抑郁患者细胞因子及神经递质的影响[J]. 海南医学院学报,2018,24(4):476-479.
[21] 薛剑,李冀.百合地黄汤对抑郁模型大鼠行为及海马内单胺类神经递质和单胺氧化酶含量的影响[J].中医药学报,2018,46(1):109-111.
[22] 石晓雯,周明眉,朱海燕.中药通过色氨酸-犬尿氨酸代谢途径治疗抑郁症的研究进展[J].中医药学报,2017,45(5):98-102.
[2] 王霞. 吡拉西坦联合尼莫地平治疗脑梗死后血管性痴呆临床分析[J].河南医学研究,2018,27(2):277-278.
[3] 曲艳吉,卓琳,王华丽,等. 1980-2011年中国社区55岁及以上人群中血管性痴呆流行病学的Meta分析[J]. 中国卒中杂志,2013,8(7):533-543.
[4] 贺丹,谭军,张杰文. 盐酸美金刚对血管性痴呆患者认知功能、脑血流动力学及氧化应激水平的影响[J]. 中国药房,2018,29(4):534-537.
[5] 赵小亚,朱庆,朱军,等. 艾司西酞普兰联合尼莫地平、多奈哌齐治疗血管性痴呆伴发抑郁的临床效果[J]. 实用临床医药杂志,2016,20(21):21-23.
[6] 张洪财,陈雁雁,王文姌,等.柴胡-白芍药对干预大鼠抑郁症模型的血清代谢组学研究[J].中医药信息,2018,35(1):34-37.
[7] 王晓滨,郭琴琴,许贵军,等.坤宁安对去卵巢抑郁模型大鼠海马神经元凋亡的影响[J].中医药学报,2017,45(2):43-45.
[8] 谷晓林,刘琳,亓晓丽. 补肾益智汤联合丁基苯酞对老年血管性痴呆血液流变学及自由基损伤的影响[J]. 中华中医药学刊,2017,35(12):3217-3220.
[9] 庞啸虎,吴秀玮,许庆,等. 血管性痴呆患者认知功能障碍采用舒血宁与吡拉西坦治疗对其MMSE及ADL评分的影响[J]. 临床医学研究与实践,2017,2(35):32-33.
[10] 郝剑辉,杜秀生,张怡. 甜梦口服液联合草酸艾司西酞普兰治疗抑郁症的疗效观察[J]. 现代药物与临床,2016,31(11):1818-1821.
[11] 谢均,范振国,晏玉奎.艾司西酞普兰联合乌灵胶囊治疗脑梗死恢复期合并抑郁临床研究[J].中华中医药学刊,2018,36(1):254-256.
[12] 潘中瑛,高炎超. 小柴胡汤加减联合艾司西酞普兰治疗老年抑郁症疗效观察[J]. 四川中医,2017,35(7):187-189.
[13] 贾璐,蒙华庆,徐中林,等. 艾司西酞普兰治疗老年慢性心力衰竭伴抑郁症对患者认知功能和心功能的影响[J]. 重庆医学,2017,46(19):2652-2658.
[14] 张孟,隋晓琳,张春燕. 地黄导痰汤制剂对血管性痴呆患者脑血流及炎性细胞因子的影响[J]. 现代中西医结合杂志,2018,27(5):473-479.
[15] 胡伍毅,练春玲,李志辉,等. 加味指迷汤合子午流注开穴疗法治疗血管性痴呆临床观察[J]. 中国民族民间医药,2017,26(24):103-105.
[16] 段海水,吕贝,赵玉林,等.舒肝解郁胶囊联合安非他酮治疗老年抑郁症的疗效观察[J].现代药物与临床,2017,32(2):289-292.
[17] 潘中瑛,赵婧,陈静珊.柴胡疏肝散联合帕罗西汀对抑郁症患者血清5-HT的影响及其安全性分析[J].中医药信息,2018,35(1):54-57.
[18] 李涛,胡晓科,范超望,等. 首发性抑郁症患者血清GFAP、NSE、Hcy水平与认知功能的关系[J]. 检验医学与临床,2017,14(24):3601-3604.
[19] 刘锦灿,刘健. 补肾益髓汤对不同MTHFR基因型血管性痴呆患者Hcy及临床症状的影响[J]. 广州中医药大学学报,2018,35(2):205-209.
[20] 陶瑞. 佐匹克隆联合黛力新对卒中后抑郁患者细胞因子及神经递质的影响[J]. 海南医学院学报,2018,24(4):476-479.
[21] 薛剑,李冀.百合地黄汤对抑郁模型大鼠行为及海马内单胺类神经递质和单胺氧化酶含量的影响[J].中医药学报,2018,46(1):109-111.
[22] 石晓雯,周明眉,朱海燕.中药通过色氨酸-犬尿氨酸代谢途径治疗抑郁症的研究进展[J].中医药学报,2017,45(5):98-102.