石杉碱甲联合丁苯酞治疗脑梗死后轻度认知障碍的临床疗效及对血清Hcy、hs-CRP的影响
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摘要
目的探讨石杉碱甲联合丁苯酞治疗脑梗死后轻度认知障碍的临床效果。方法 120例脑梗死后轻度认知障碍患者分为对照组和观察组各60例,对照组在常规治疗的基础上口服石杉碱甲片,观察组在对照组基础上静脉滴注丁苯酞氯化钠注射液,2周为1个疗程;连续治疗2个疗程后,比较两组患者治疗前后NIHSS评分、MoCA评分、Barthel指数、血清中Hcy、hs-CRP水平,比较两组患者的临床疗效及不良反应发生情况。结果治疗后,两组的NIHSS评分、MoCA评分、Barthel指数及血清Hcy、hs-CRP均较治疗前显著改善,且观察组较对照组改善更明显,差异有统计学意义(P<0.05)。观察组治疗后的总有效率(91.7%)显著高于对照组(81.7%),差异有统计学意义(χ~2=4.421,P<0.05);两组不良反应发生率差异无统计学意义(χ~2=0.072,P>0.05)。结论石杉碱甲联合丁苯酞治疗脑梗死后轻度认知障碍具有较好的临床疗效,且用药安全性高。
Objective To evaluate the clinical efficacy of huperzine A combined with butylphthalide in the treatment of mild cognitive impairment induced by cerebral infarction. Methods Firstly, 120 patients with mild cognitive impairment resulting from cerebral infarction were divided into a control group(n=60) and an experimental group(n=60). Next, the control group were treated with huperzine A tablets in addition to conventional treatment while the exprimental group were administered with intravenous infusion of sodium butylphthalide in addition to medication as given to the control. Both groups were subjected to two courses of medication, each lasting 2 weeks. After two courses of medication, the NIHSS score, MoCA score, Barthel index, serum Hcy and hs-CRP levels of the two groups as observed before and after treatment as well as the clinical efficacy and adverse reactions of the two groups were compared. Results The NIHSS score, MoCA score, Barthel index, serum Hcy and hs-CRP in the two groups as observed after treatment significantly bettered, with those of the experimental group being better than those of the control. The differences were statistically significant(P<0.05). The total effective rate(91.7%) in the experimental group was significantly higher than that in the control group(81.7%). The difference was statistically significant(χ~2=4.421,P<0.05). No significant difference was found between the two groups in the incidence of adverse reactions(χ~2=0.072, P>0.05). Conclusions Huperzine A combined with butylphthalide as a medication for the treatment of mild cognitive impairment after cerebral infarction can result in good clinical efficacy and high safety.
Objective To evaluate the clinical efficacy of huperzine A combined with butylphthalide in the treatment of mild cognitive impairment induced by cerebral infarction. Methods Firstly, 120 patients with mild cognitive impairment resulting from cerebral infarction were divided into a control group(n=60) and an experimental group(n=60). Next, the control group were treated with huperzine A tablets in addition to conventional treatment while the exprimental group were administered with intravenous infusion of sodium butylphthalide in addition to medication as given to the control. Both groups were subjected to two courses of medication, each lasting 2 weeks. After two courses of medication, the NIHSS score, MoCA score, Barthel index, serum Hcy and hs-CRP levels of the two groups as observed before and after treatment as well as the clinical efficacy and adverse reactions of the two groups were compared. Results The NIHSS score, MoCA score, Barthel index, serum Hcy and hs-CRP in the two groups as observed after treatment significantly bettered, with those of the experimental group being better than those of the control. The differences were statistically significant(P<0.05). The total effective rate(91.7%) in the experimental group was significantly higher than that in the control group(81.7%). The difference was statistically significant(χ~2=4.421,P<0.05). No significant difference was found between the two groups in the incidence of adverse reactions(χ~2=0.072, P>0.05). Conclusions Huperzine A combined with butylphthalide as a medication for the treatment of mild cognitive impairment after cerebral infarction can result in good clinical efficacy and high safety.
引文
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[6] 黄坡,李博,郭玉红,等.石杉碱甲治疗轻度认知障碍患者有效性与安全性的系统评价与 Meta 分析[J].中国中药杂志,2019,65(3):582-588.
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[11] 张丽娟.石杉碱甲片对脑梗死后血管性认知功能障碍患者的临床研究[J].中西医结合心脑血管病杂志,2013,11(1):43-44.
[12] Tabira T,Kawamura N.A Study of a supplement containing huperzine A and curcumin in dementia patients and individuals with mild cognitive impairment [J].J Alzheimers Dis,2018,63(1):75-78.
[13] Perng CH,Chang YC,Tzang RF.The treatment of cognitive dysfunction in dementia:a multiple treatments meta-analysis[J].Psychopharmacology (Berl),2018,235(5):1571-1580.
[14] 劳嘉良,张凝远.疏血通联合丁苯酞治疗老年急性大面积脑梗死的临床观察[J].中国药房,2015,26(32):4577-4579.
[15] Stancel N,Chen CC,Ke LY,et al.Interplay between CRP,atherogenic LDL,and LOX-1 and its potential role in the pathogenesis of atherosclerosis[J].Clin Chem,2016,62(2):320-327.
[16] Liu Y,Wang J,Zhang L,et al.Relationship between C-reactive protein and stroke:a large prospective community based study[J].PLos One,2014,9(9):107-117.
[17] Johnsen E,Fathian F,Kroken RA,et al.The serum level of C-reactive protein (CRP) is associated with cognitive performance in acute phase psychosis[J].BMC Psychiatry,2016,14(16):60.
[18] 潘庭荣,黄梅,潘丹丹,等.脑卒中患者Hcy、GFAP、BDNF和hs-CRP水平与血管性认知障碍相关性研究[J].东南大学学报:医学版,2018,37 (4):648-652.
[19] 曹月,常明秀,王锐,等.硫腺苷同型半胱氨酸-可能是一种新的脑血管疾病危险因素[J].中风与神经疾病杂志,2013,30(11):1054-1056.
[20] Fu HJ,Zhao LB,Xue JJ,et al.Elevated serum homocysteine (Hcy) levels may contribute to the pathogenesis of cerebral infarction[J].J Mol Neurosci,2015,56(3):553-561.
[21] 张木兰,章可谓,陈晓波.血浆同型半胱氨酸与急性脑梗死的临床分析[J].健康研究,2014,34(1):40-42.
[2] 韩立志,宋治洁,龚煌,等.舒血宁治疗脑梗死后认知障碍的临床研究[J].中国医药指南,2013,11(14):399-400.
[3] 由佳玉,李兴强,孙晓红.血管性轻度认知障碍的研究进展[J].山东医药,2018,58(10):92-95.
[4] 吴彩堂,张媛.新发脑梗死后患者抑郁与认知损害程度的关系研究[J].中国全科医学,2017,20(7):237-238.
[5] 高磊,张宪忠,刘相静,等.复方苁蓉益智胶囊治疗中风后轻度认知障碍的临床研究[J].世界中西医结合杂志,2015,10(1):65-71.
[6] 黄坡,李博,郭玉红,等.石杉碱甲治疗轻度认知障碍患者有效性与安全性的系统评价与 Meta 分析[J].中国中药杂志,2019,65(3):582-588.
[7] 张静.丁苯酞软胶囊和尼莫地平片治疗轻度血管源性认知功能障碍的疗效比较[J].中国实用神经疾病杂志,2017,20(2):108-109.
[8] Behrman S,Valkanova V,Allan CL.Diagnosing and managing mild cognitive impairment[J].Practitioner,2017,261(1804):17-20.
[9] 栾丽芹.急性脑梗死后认知功能障碍的相关危险因素分析[J].中国实用神经疾病杂志,2015,18(3):45-47.
[10] Liu J,Xing Y,Gao Y,et al.Changes in serum interleukin 33 levels in patients with acute cerebral infarction[J].Journal of clinical neuroscience:official journal of the Neurosurgical Society of Australasia,2014,21(2):298-300.
[11] 张丽娟.石杉碱甲片对脑梗死后血管性认知功能障碍患者的临床研究[J].中西医结合心脑血管病杂志,2013,11(1):43-44.
[12] Tabira T,Kawamura N.A Study of a supplement containing huperzine A and curcumin in dementia patients and individuals with mild cognitive impairment [J].J Alzheimers Dis,2018,63(1):75-78.
[13] Perng CH,Chang YC,Tzang RF.The treatment of cognitive dysfunction in dementia:a multiple treatments meta-analysis[J].Psychopharmacology (Berl),2018,235(5):1571-1580.
[14] 劳嘉良,张凝远.疏血通联合丁苯酞治疗老年急性大面积脑梗死的临床观察[J].中国药房,2015,26(32):4577-4579.
[15] Stancel N,Chen CC,Ke LY,et al.Interplay between CRP,atherogenic LDL,and LOX-1 and its potential role in the pathogenesis of atherosclerosis[J].Clin Chem,2016,62(2):320-327.
[16] Liu Y,Wang J,Zhang L,et al.Relationship between C-reactive protein and stroke:a large prospective community based study[J].PLos One,2014,9(9):107-117.
[17] Johnsen E,Fathian F,Kroken RA,et al.The serum level of C-reactive protein (CRP) is associated with cognitive performance in acute phase psychosis[J].BMC Psychiatry,2016,14(16):60.
[18] 潘庭荣,黄梅,潘丹丹,等.脑卒中患者Hcy、GFAP、BDNF和hs-CRP水平与血管性认知障碍相关性研究[J].东南大学学报:医学版,2018,37 (4):648-652.
[19] 曹月,常明秀,王锐,等.硫腺苷同型半胱氨酸-可能是一种新的脑血管疾病危险因素[J].中风与神经疾病杂志,2013,30(11):1054-1056.
[20] Fu HJ,Zhao LB,Xue JJ,et al.Elevated serum homocysteine (Hcy) levels may contribute to the pathogenesis of cerebral infarction[J].J Mol Neurosci,2015,56(3):553-561.
[21] 张木兰,章可谓,陈晓波.血浆同型半胱氨酸与急性脑梗死的临床分析[J].健康研究,2014,34(1):40-42.