多奈哌齐与法舒地尔联合心理疏导对血管性认知障碍患者的负性情绪及对血清炎性因子的影响
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摘要
目的探讨多奈哌齐与法舒地尔联合心理疏导对血管性认知障碍(VCI)患者负性情绪及血清炎性因子水平的影响。方法选取68例VCI患者随机分为观察组与对照组,各34例。对照组应用多奈哌齐治疗和心理疏导,观察组在对照组基础上加用法舒地尔。比较两组治疗前后简易精神状态检查量表(MMSE)、Barthel指数(BI)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分,检测血清超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)和肿瘤坏死因子α(TNF-α)水平。结果观察组治疗后MMSE、BI评分显著高于对照组,HAMA、HAMD评分显著低于对照组(P<0.05);观察组治疗后血清hs-CRP、IL-6及TNF-α水平显著低于对照组(P<0.05)。结论多奈哌齐与法舒地尔联合心理疏导有利于改善VCI患者的认知功能与日常生活活动能力,减轻负性情绪,并可下调促炎因子水平。
Objective To investigate the effects of donepezil and fasudil combined with psychological counseling on negative emotion and serum inflammatory factors in patients with vascular cognitive impairment(VCI).Methods 68 patients with VCI were randomly divided into observation group and control group,34 cases in each group. The control group was treated with donepezil and psychological counseling,and the observation group was given fasudil on the basis of the control group. The Mini-Mental State Examination Scale(MMSE),Barthel Index(BI),Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)before and after treatment were evaluated,the serum levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared. Results The MMSE and BI scores in the observation group were significantly higher than those in the control group,the HAMA and HAMD scores were significantly lower than those in the control group(P<0.05). The serum levels of hs-CRP,IL-6 and TNF-α in the observation group were significantly lower than those in the control group(P<0.05). Conclusion The donepezil and fasudil combined with psychological counseling is beneficial to improve the cognitive function and activities of daily living in patients with VCI,which can reduce the negative emotions,and down-regulate the levels of pro-inflammatory factors.
Objective To investigate the effects of donepezil and fasudil combined with psychological counseling on negative emotion and serum inflammatory factors in patients with vascular cognitive impairment(VCI).Methods 68 patients with VCI were randomly divided into observation group and control group,34 cases in each group. The control group was treated with donepezil and psychological counseling,and the observation group was given fasudil on the basis of the control group. The Mini-Mental State Examination Scale(MMSE),Barthel Index(BI),Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)before and after treatment were evaluated,the serum levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were compared. Results The MMSE and BI scores in the observation group were significantly higher than those in the control group,the HAMA and HAMD scores were significantly lower than those in the control group(P<0.05). The serum levels of hs-CRP,IL-6 and TNF-α in the observation group were significantly lower than those in the control group(P<0.05). Conclusion The donepezil and fasudil combined with psychological counseling is beneficial to improve the cognitive function and activities of daily living in patients with VCI,which can reduce the negative emotions,and down-regulate the levels of pro-inflammatory factors.
引文
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3.尉杰忠,闫玉清,谷青芳,等.法舒地尔通过促进APP/PS1双转基因小鼠神经再生改善认知功能[J].中国病理生理杂志,2018,34(7):1153-1161.
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8.曾唐怡.法舒地尔用于蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)患者中的作用分析[J].中国现代医生,2017,55(20):40-42.
9.邱斌,王洲羿,邢小珍,等.九味镇心颗粒治疗血管性认知障碍伴焦虑症状的疗效观察[J].中西医结合心脑血管病杂志,2015,13(6):733-735.
10.武海燕,马丽,张力,等.内源性甲醛及炎症介质在血管性痴呆中的研究[J].中国卒中杂志,2016,11(11):930-933.
11.侯进义,孙菊光,史江峰,等.吡拉西坦联合盐酸多奈哌齐对血管性认知障碍病人血清TNF-α、IL-6、hs-CRP、Hcy水平的影响[J].中西医结合心脑血管病杂志,2018,16(7):126-130.
2.李海涛,李桂花,朱国峰,等.新疆维汉血管性痴呆患者认知功能与心理状态的相关性研究[J].中国全科医学,2016,19(S1):340-344.
3.尉杰忠,闫玉清,谷青芳,等.法舒地尔通过促进APP/PS1双转基因小鼠神经再生改善认知功能[J].中国病理生理杂志,2018,34(7):1153-1161.
4.中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志,2011,44(2):142-147.
5.储新娟,涂志兰,金芃芃,等.缺血性脑卒中患者血管性认知功能障碍的现状及影响因素分析[J].中国临床医生杂志,2017,45(12):43-44.
6.方珉,刘学源.血管性认知功能障碍及其早期识别与干预的研究进展[J].上海医药,2016,37(15):5-11.
7.卓伟东,李伟仕.阿托伐他汀联合多奈哌齐对血管性认知功能障碍患者脑血管及认知功能的影响研究[J].实用心脑肺血管病杂志,2016,24(8):32-35.
8.曾唐怡.法舒地尔用于蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)患者中的作用分析[J].中国现代医生,2017,55(20):40-42.
9.邱斌,王洲羿,邢小珍,等.九味镇心颗粒治疗血管性认知障碍伴焦虑症状的疗效观察[J].中西医结合心脑血管病杂志,2015,13(6):733-735.
10.武海燕,马丽,张力,等.内源性甲醛及炎症介质在血管性痴呆中的研究[J].中国卒中杂志,2016,11(11):930-933.
11.侯进义,孙菊光,史江峰,等.吡拉西坦联合盐酸多奈哌齐对血管性认知障碍病人血清TNF-α、IL-6、hs-CRP、Hcy水平的影响[J].中西医结合心脑血管病杂志,2018,16(7):126-130.