【摘要】：目的:觀察補腎益智湯聯(lián)合丁基苯酞治療老年血管性癡呆的臨床療效及對血液流變學(xué)、自由基損傷的影響。方法:將醫(yī)院2013年1月—2015年1月收治的70例血管性癡呆患者按隨機數(shù)字表分為研究組和對照組各35例,對照組患者單純口服丁基苯肽0.2 g/次,3次/d,研究組在對照組的基礎(chǔ)上再口服自擬補腎益智湯,3個月為1個療程,治療2個療程,治療前、治療后3個月、治療后6個月進(jìn)行簡易精神狀態(tài)檢查(MMSE-R)、韋氏記憶量表(WMS)、癡呆程度量表(CDR)、日常生活自理能力量表(ADL)評估及中醫(yī)證候評分,治療前、治療后6個月空腹抽血進(jìn)行血液流變學(xué)指標(biāo)[全血高切黏度(HS)、全血低切黏度(LS)、血漿黏度(PV)、紅細(xì)胞沉降率(ESR)]及超氧化物歧化酶(SOD)活性、丙二醛(MDA)檢測,治療結(jié)束后進(jìn)行臨床療效評估。結(jié)果:研究組和對照組治療后3個月、治療后6個月的MMSE-R、WMS明顯升高(P0.05),CDR、ADL明顯降低(P0.05);組間比較,研究組治療后6個月的MMSE-R、WMS明顯高于對照組(P0.05),CDR、ADL明顯低于對照組(P0.05)。研究組治療后善忘、善誤、神情恍惚、善恐易怒、頭暈、耳鳴、失眠較治療前明顯改善(P0.05),且善忘、善誤、神情恍惚、頭暈、耳鳴、失眠的改善效果優(yōu)于對照組(P0.05)。組內(nèi)比較,研究組和對照組治療后HS、LS、PV、ESR較治療前明顯降低(P0.05);組間比較,研究組治療后HS、LS、PV、ESR明顯低于對照組(P0.05)。研究組和對照組治療后SOD明顯高于治療前(P0.05),MDA明顯低于治療前(P0.05);組間比較,研究組治療后SOD明顯高于對照組(P0.05),MDA明顯低于對照組(P0.05)。研究組總有效率為77.14%,明顯高于對照組48.57%(χ2=6.668,P0.05)。結(jié)論:自擬補腎益智湯聯(lián)合丁基苯酞能夠協(xié)同減輕自由基損傷,改善微循環(huán),從而改善行為能力、認(rèn)知功能、中醫(yī)證候,值得臨床推廣使用。
[Abstract]:Objective: to observe the clinical effect of Bushen Yizhi decoction combined with Ding Ji phthalide in the treatment of senile vascular dementia and its effect on hemorheology and free radical injury. Methods: from January 2013 to January 2015, 70 patients with vascular dementia were randomly divided into study group (n = 35) and control group (n = 35). The patients in the control group were treated with Ding Ji phenylpeptide 0.2g / d for three times a day. The study group took the self-made Bushen Yizhi decoction again on the basis of the control group, 3 months as a course of treatment, 2 courses of treatment, 3 months before and 3 months after treatment. Six months after treatment, mini-mental state examination (MMSE-R), Wechsler memory scale (WMS), dementia degree scale (CDR), self-care ability in daily life (ADL) and TCM syndrome score were evaluated. The indexes of hemorheology [whole blood high shear viscosity (HS), whole blood low shear viscosity (LS), plasma viscosity (PV), erythrocyte sedimentation rate (ESR)], superoxide dismutase (SOD) activity and malondialdehyde (MDA) activity were measured 6 months after treatment. Clinical efficacy was evaluated after treatment. Results: after 3 months of treatment and 6 months after treatment, the MMSE-RN WMS in the study group and the control group were significantly increased (P0.05), and the levels of MMSE-RN WMS in the study group were significantly higher than those in the control group (P0.05) at 6 months after treatment (P0.05), and those in the study group were significantly lower than those in the control group (P0.05). After treatment, the study group was better than the control group (P0.05) in the improvement of good memory, good mistake, trance, fear easily irritability, dizziness, tinnitus and insomnia (P0.05), and the improvement effect of good memory, good mistake, trance, dizziness, tinnitus and insomnia was better than that of the control group (P0.05). Compared with the control group, the ESR of the study group and the control group was significantly lower than that of the control group after treatment (P0.05), and the ESR of the study group after treatment was significantly lower than that of the control group (P0.05). After treatment, SOD in study group and control group was significantly higher than that before treatment (P0.05) and MDA in study group was significantly lower than that before treatment (P0.05); after treatment, SOD in study group was significantly higher than that in control group (P0.05) and MDA in control group was significantly lower than that in control group (P0.05). The total effective rate of the study group was 77.14, which was significantly higher than that of the control group (48.57%, 蠂 2 6.668 P 0.05). Conclusion: Bushen Yizhi decoction combined with Ding Ji phthalide can reduce free radical damage, improve microcirculation, and improve behavioral ability, cognitive function and TCM syndromes, which is worth popularizing in clinic.
【作者單位】： 萊蕪市人民醫(yī)院神經(jīng)內(nèi)科;
【基金】：萊蕪市科學(xué)技術(shù)局項目([2013]第111號,[2014]第086號)
【分類號】：R749.13

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