灯盏生脉胶囊治疗缺血性卒中后认知障碍的疗效观察

Clinical observation of Dengzhan Shengmai Capsule in the treatment of cognitive impairment after ischemic stroke

关键词:  缺血性卒中  认知障碍  灯盏生脉胶囊  盐酸多奈哌齐

Key words:  ischemic stroke  cognitive impairment  Dengzhan Shengmai Capsule  donepezil hydrochloride tablets

摘要:

[目的] 观察灯盏生脉胶囊联合盐酸多奈哌齐治疗卒中后认知障碍的临床疗效。[方法] 招募缺血性卒中后认知障碍患者100例，按随机数字表法随机分为对照组和试验组，每组50例。收集患者基线资料，包括：人口学资料、临床资料、认知评估、日常生活能力评估、实验室检查结果、头颅磁共振成像（MRI）资料。对照组采用盐酸多奈哌齐治疗，试验组采用灯盏生脉胶囊联合盐酸多奈哌齐的方法进行治疗，并持续3个月。评估两组患者治疗前后总体有效率，并采用蒙特利尔认知评估量表（MoCA）及MoCA指数、改良Barthel指数（MBI）、美国国立卫生研究院卒中量表（NIHSS）、血清同型半胱氨酸（Hcy）、血清超敏C反应蛋白（hs-CRP）以及患处的脑血流量值（rCBF）变化情况，评价2组患者的临床疗效。[结果] 与治疗前相比，2组患者治疗后的MoCA评分、MoCA指数（对照组除外视空间能力指数、定向力指数）、MBI评分及rCBF明显升高（P＜0.05），NIHSS评分、Hcy及试验组hs-CRP水平明显降低（P＜0.05），且试验组在总体有效率、改善MoCA评分、MoCA记忆指数、MoCA注意力指数、MoCA定向力指数、MBI指数、NIHSS评分、rCBF方面明显优于对照组，差异有统计学意义（P＜0.05），同时在降低Hcy水平方面差异也有统计学意义（P＜0.05）。[结论] 灯盏生脉胶囊联合盐酸多奈哌齐能有效改善脑卒中患者的认知功能及神经功能评分，提高患者日常自理能力，较单纯使用盐酸多奈哌齐效果更好，同时联合用药可以提高脑血流量，治疗安全性高，值得临床推广应用。

Abstract:

[Objective] To observe the clinical effect of Dengzhan Shengmai Capsule combined with donepezil hydrochloride in the treatment of cognitive impairment after stroke. [Methods] A total of 100 patients with cognitive impairment after ischemic stroke were recruited，and they were divided into control group and treatment group，with 50 cases in each group. The baseline data of patients were collected，including demographic data，clinical data，cognitive assessment，assessment of daily living ability，laboratory examination results，and brain MRI imaging data. The control group was treated with donepezil hydrochloride，and the treatment group was treated with Dengzhan Shengmai Capsule combined with donepezil hydrochloride，and the treatment lasted for 3 months. The total effective rate of the two groups was evaluated before and after treatment. The clinical efficacy of two groups patients was evaluated by using montreal cognitive assessment scale（MoCA），MoCA index，modified Barthel index（MBI），the United States national institutes of health stroke scale（NIHSS），serum homocysteine（Hcy），serum hypersensitive c-reactive protein（hs-CRP） and the affected part of the value of the cerebral blood flow（CBF）. [Results] Compared with before treatment，the MoCA score，MoCA index（control group except visuospatial ability index，orientation index），MBI scores and rCBF of the two groups after treatment significantly increased（P＜0.05），NIHSS score，Hcy and experimental hs-CRP levels significantly decreased（P＜0.05）. The overall effective rate，improvement of MoCA scores，MoCA memory index，MoCA attention index，MoCA orientation index，MBI index，NIHSS score，and rCBF of the experimental group were better than that in control group，and the difference was statistically significant. Meanwhile，there were also significant differences in the reduction of Hcy level（P＜0.05）. [Conclusion] Dengzhan Shengmai Capsule combined with donepezil hydrochloride can effectively improve the cognitive function and neurological function scores of stroke patients，and improve the daily self-care ability of patients，which is better than donepezil hydrochloride alone. Meanwhile，the combination can improve cerebral blood flow，with high safety，which is worthy of clinical promotion and application.