珍枣胶囊治疗静止性脑梗死
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摘要
目的分析静止性脑梗死患者失眠的特征及与认知障碍的相关性,探讨珍枣胶囊治疗静止性脑梗死患者失眠、改善认知功能的疗效。方法利用匹兹堡睡眠质量指数量表(PSQI)对120例静止性脑梗死患者进行睡眠质量评估,将患者分为失眠组和非失眠组,对2组患者进行简易智能精神状态量表(MMSE)评估,比较2组患者认知障碍的发生率。对辨证为阴虚火旺证的失眠组患者进行4周的珍枣胶囊治疗,比较治疗前后PSQI、MMSE评分情况。结果纳入研究的脑梗死患者中,79例(65.83%)发生失眠,失眠的形式以潜伏期延长、维持障碍、质量下降为主。失眠组MMSE评分明显高于非失眠组,认知功能障碍发生率高于非失眠组。阴虚火旺证的失眠患者经珍枣胶囊治疗后,PSQI评分较治疗前显著降低,MMSE评分较治疗前明显提高。结论失眠在静止性脑梗死患者中的发生率较高,并且与认知障碍有一定的相关性,早期给予珍枣胶囊干预治疗,可改善患者的睡眠质量,减轻认知障碍症状。
Objective To analyze the correlation of insomnia and cognitive impairment after silent cerebral infarction, and to explore the ef fect of Zhenzao Capsule on insomnia and cognitive improvement in patients with static cerebral infarction. Methods A total of 120 patients with silent cerebral infarction were randomly selected and all patients were assessed for sleep quality with the Pittsburgh Sleep Quality Index(PSQI). The patients were divided into insomnia group and non-insomnia group. Both groups were assessed by simple intelligent mental state examination(MMSE), and the incidence of cognitive impairment was compared between the two groups. The insomnia patients with syndrome of exuberant fire due to yin deficiency were treated with Zhenzao Capsule for 4 weeks, and the scores of PSQI and MMSE before and after treatment were compared. Results Insomnia occurred in 79 patients(65.83%).The main causes of insomnia were difficulty in falling asleep, early awakening, and difficulty in maintaining sleep.The MMSE score of insomnia group was significantly higher than non-insomnia group, the incidence of cognitive dysfunction was higher than non-insomnia group. The PSQI score of insomnia patients treated with Zhenzao Capsule was significantly lower than that before treatment, and the MMSE score was significantly higher than that before treatment. Conclusion The incidence of insomnia is higher in patients with static cerebral infarction, and has a certain correlation with cognitive dysfunction. Early treatment with Zhenzao Capsule can improve the quality of sleep and reduce the symptoms of cognitive dysfunction.
Objective To analyze the correlation of insomnia and cognitive impairment after silent cerebral infarction, and to explore the ef fect of Zhenzao Capsule on insomnia and cognitive improvement in patients with static cerebral infarction. Methods A total of 120 patients with silent cerebral infarction were randomly selected and all patients were assessed for sleep quality with the Pittsburgh Sleep Quality Index(PSQI). The patients were divided into insomnia group and non-insomnia group. Both groups were assessed by simple intelligent mental state examination(MMSE), and the incidence of cognitive impairment was compared between the two groups. The insomnia patients with syndrome of exuberant fire due to yin deficiency were treated with Zhenzao Capsule for 4 weeks, and the scores of PSQI and MMSE before and after treatment were compared. Results Insomnia occurred in 79 patients(65.83%).The main causes of insomnia were difficulty in falling asleep, early awakening, and difficulty in maintaining sleep.The MMSE score of insomnia group was significantly higher than non-insomnia group, the incidence of cognitive dysfunction was higher than non-insomnia group. The PSQI score of insomnia patients treated with Zhenzao Capsule was significantly lower than that before treatment, and the MMSE score was significantly higher than that before treatment. Conclusion The incidence of insomnia is higher in patients with static cerebral infarction, and has a certain correlation with cognitive dysfunction. Early treatment with Zhenzao Capsule can improve the quality of sleep and reduce the symptoms of cognitive dysfunction.
引文
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[11]骆守真,王晓勇.珍枣胶囊治疗阴虚火旺型失眠临床观察[J].河北中医,2018,40(7):1014-1017.
[2]DEVORE E E,GRODSTEIN F,SCHERNHAMMER ES.Sleep duration in relation to cognitive function among older adults:a systematic review of observational studies[J].Neuroepidemiology,2016,46(1):57-78.
[3]王新德.各类脑血管疾病诊断要点(1986年中华医学会第二次全国脑血管病学术会议第三次修订)[J].中华神经精神科杂志,1998,21(1):60.
[4]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:168-173.
[5]中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(7):534-540.
[6]YAO H,ARAKI Y,TAKASHIMA Y,et al.Chronic kidney disease and subclinical brain infarction increase the risk of vascular cognitive impairment:the sefuri study[J].J Stroke Cerebrovasc Dis,2017,26(2):420.
[7]GUPTA A,GIAMBRONE AE,GIALDINI G,et al.Silent Brain Infarction and Risk of Future Stroke:ASystematic Review and Meta-Analysis[J].Stroke,2016,47(3):719-725.
[8]HU M,ZHANG P,LI C,et al.Sleep disturbance in mild cognitive impairment:a systematic review of objective measures[J].Neurol Sci,2017,38(8):1363-1371.
[9]CROSS N E,CARRIER J,POSTUMA R B,et al.Association between insomnia disorder and cognitive function in middleaged and older adults:a cross-sectional analysis of the Canadian Longitudinal Study on Aging[J].Sleep,2019,zsz114.
[10]韩旭,李七一,郭宏敏,等.珍枣胶囊对老年阴虚火旺失眠患者5-HT、DA含量的影响[J].南京中医药大学学报,2013,29(5):429-431.
[11]骆守真,王晓勇.珍枣胶囊治疗阴虚火旺型失眠临床观察[J].河北中医,2018,40(7):1014-1017.