丁苯酞序贯治疗对一氧化碳中毒迟发脑病老年患者认知功能的影响
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摘要
目的观察丁苯酞氯化钠注射液序贯丁苯酞软胶囊对一氧化碳中毒迟发脑病老年患者的认知功能及日常生活能力的改善作用。方法将70例急性一氧化碳中毒迟发脑病的老年患者随机分成对照组(n=35)和治疗组(n=35)。对照组给予常规药物加高压氧治疗,治疗组在对照组治疗的基础上加用丁苯酞氯化钠注射液,25 mg/次,2次/d,连续14d,之后口服丁苯酞软胶囊,0.2 g/次,3/d,连用76 d。分别在入院时、治疗14 d、30 d、90 d进行ADAS-Cog及ADL评分,观察2组治疗前后认知功能和日常生活能力的变化,并进行比较和统计学分析。结果 2组患者症状均有所改善,认知功能及日常生活能力评分较前均有所提高。与对照组比较,治疗组90 d后ADAS-Cog及ADL评分明显改善(P<0.05)。结论丁苯酞序贯治疗可明显改善一氧化碳中毒迟发脑病患者的认知及日常生活能力,长期预后较好。
Objective To observe the effect of sequential therapy with butylphthalide sodium chloride injection and butylphthalide soft capsules in improving the cognitive function and daily life ability of the elderly with delayed encephalopathy caused by carbon monoxide poisoning. Methods 70 elderly with delayed encephalopathy caused by acute carbon monoxide poisoning were randomly divided into 2 groups: control group and treatment group, 35 in each; routine drug treatment was applied to all the elderly in the 2 groups while butylphthalide sodium chloride injection(25 mg once, twice a day for 14 days) followed by oral administration of butylphthalide soft capsules(0.2 g once, 3 times a day for 76 days) was added to the elderly in treatment group; ADAS-cog and ADL survey was performed on the elderly at the time point of at admission, the 14 th, the 30 th and the90 th day after treatment; the changes in cognitive function and daily life ability before and after treatment were observed and statistical comparison was carried out. Results Improvement was found in the elderly in both groups and the scores of cognitive function and daily life ability after treatment were higher than those before treatment(P<0.05); the scores of ADAS-cog and ADL survey at the time point of the 90 th day in treatment group were much more improved than those in control group(P<0.05).Conclusions The sequential therapy with butylphthalide sodium chloride injection and butylphthalide soft capsules is of obvious effect in improving the cognitive function and daily life ability of the elderly with delayed encephalopathy caused by carbon monoxide poisoning and better long-term prognosis.
Objective To observe the effect of sequential therapy with butylphthalide sodium chloride injection and butylphthalide soft capsules in improving the cognitive function and daily life ability of the elderly with delayed encephalopathy caused by carbon monoxide poisoning. Methods 70 elderly with delayed encephalopathy caused by acute carbon monoxide poisoning were randomly divided into 2 groups: control group and treatment group, 35 in each; routine drug treatment was applied to all the elderly in the 2 groups while butylphthalide sodium chloride injection(25 mg once, twice a day for 14 days) followed by oral administration of butylphthalide soft capsules(0.2 g once, 3 times a day for 76 days) was added to the elderly in treatment group; ADAS-cog and ADL survey was performed on the elderly at the time point of at admission, the 14 th, the 30 th and the90 th day after treatment; the changes in cognitive function and daily life ability before and after treatment were observed and statistical comparison was carried out. Results Improvement was found in the elderly in both groups and the scores of cognitive function and daily life ability after treatment were higher than those before treatment(P<0.05); the scores of ADAS-cog and ADL survey at the time point of the 90 th day in treatment group were much more improved than those in control group(P<0.05).Conclusions The sequential therapy with butylphthalide sodium chloride injection and butylphthalide soft capsules is of obvious effect in improving the cognitive function and daily life ability of the elderly with delayed encephalopathy caused by carbon monoxide poisoning and better long-term prognosis.
引文
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[7] Huai Y, Dong Y, Xu J, et al. L-3-n-butylphthalide protects against vascular dementia via activation of the Akt kinase pathway[J].Neural Regen Res, 2013, 8(19):1733-1742.
[8]刘超,杜万红,郑桃林.丁苯酞软胶囊治疗血管性痴呆的临床疗效[J].西南国防医药, 2013, 23(2):144-146.
[9]段智慧,马聪敏,姬亚杰.丁苯酞对急性重度一氧化碳中毒的治疗作用[J].中国实用神经疾病杂志, 2013, 16(13):34-36.
[10]田书娟,鲍军强,解雄伟,等.丁苯酞氯化钠注射液对一氧化碳中毒迟发性脑病患者认知功能的影响[J].中国临床医生杂志, 2016, 44(12):52-54.
[2]纪海茹,孔令伟,孔维,等.丁苯酞预处理对大鼠脑缺血再灌注损伤后脑水肿和血脑屏障的影响[J].中风与神经疾病杂志, 2014, 31(8):698-700.
[3]李宗丽,曾宪珠,刘晓,等.丁苯酞治疗血管性痴呆疗效及安全性的系统性分析[J].中国老年学杂志, 2017, 37(21):5392-5395.
[4] Xiang J, Pan J, Chen F, et al. L-3-n-butylphthalide improves cognitive impairment of APP/PS1 mice by BDNF/TrkB/PI3K/AKT pathway[J]. Int J ClinExp Med, 2014, 7(7):1706-1713.
[5] Kohler J, Riepe MW, Jendroska K, et al. Early diagnosis and treatment of Alzheimer's disease. Implementation in the doctor's office[J]. Fortschr Med Orig, 2002, 120(4):135-141.
[6]顾春婷,吴亦影,施念玮,等.慢性疾病及生活习惯对老年人日常生活能力的影响[J].老年医学与保健, 2018, 24(4):389-392.
[7] Huai Y, Dong Y, Xu J, et al. L-3-n-butylphthalide protects against vascular dementia via activation of the Akt kinase pathway[J].Neural Regen Res, 2013, 8(19):1733-1742.
[8]刘超,杜万红,郑桃林.丁苯酞软胶囊治疗血管性痴呆的临床疗效[J].西南国防医药, 2013, 23(2):144-146.
[9]段智慧,马聪敏,姬亚杰.丁苯酞对急性重度一氧化碳中毒的治疗作用[J].中国实用神经疾病杂志, 2013, 16(13):34-36.
[10]田书娟,鲍军强,解雄伟,等.丁苯酞氯化钠注射液对一氧化碳中毒迟发性脑病患者认知功能的影响[J].中国临床医生杂志, 2016, 44(12):52-54.