發(fā)布時(shí)間：2019-05-31 18:50

【摘要】：隨著社會(huì)經(jīng)濟(jì)、文明、科技的進(jìn)步和蓬勃發(fā)展，人類的壽命不斷增長，我國進(jìn)入了老齡化社會(huì)。腦血管病和認(rèn)知障礙均為中老年人群的高發(fā)疾病，血管性因素可引發(fā)認(rèn)知功能障礙，其發(fā)病率逐年上升。血管性認(rèn)知障礙（vascular cognitiveimpairment,VCI）在認(rèn)知疾病中占有相當(dāng)大的比例，嚴(yán)重影響到了中老年人群的健康和生活質(zhì)量，給社會(huì)和家庭帶來了沉重的經(jīng)濟(jì)和精神負(fù)擔(dān)，已經(jīng)引起了醫(yī)學(xué)界的極大關(guān)注。因此，對于VCI的早期診斷、藥物篩選及時(shí)阻止病情進(jìn)一步發(fā)展具有重要意義。 目的：本研究旨在觀察養(yǎng)血清腦顆粒對VCI患者神經(jīng)心理學(xué)量表評分的影響。 方法：病例來源選取2010年6月至2012年1月在大連市中心醫(yī)院神經(jīng)內(nèi)科住院治療的VCI患者42例。按照入組的標(biāo)準(zhǔn)條件，符合條件的患者簽署知情同意書后給予入組。 1.對患者的一般資料、神經(jīng)系統(tǒng)檢查、既往史、個(gè)人史、家族史及其用藥情況進(jìn)行記錄。實(shí)驗(yàn)室檢查包括：血常規(guī)、尿常規(guī)、生化常規(guī)（離子、肝功、腎功、血脂、血糖）、凝血常規(guī)及血液流變學(xué)檢查。影像學(xué)檢查包括：頭顱CT或頭顱MRI、心電圖及頸動(dòng)脈超聲的檢查。神經(jīng)心理學(xué)量表測評包括：MMSE、MoCa、ADL、CDR、HAMD。 2.從入組第1天起，開始服藥。方法：給予養(yǎng)血清腦顆粒（天津天士力集團(tuán)股份有限公司）口服，4g/次，3次/天，療程為12周。 3.在服藥期間進(jìn)行電話監(jiān)督患者服藥情況（購買藥物均在大連市中心醫(yī)院神經(jīng)內(nèi)科專家診并進(jìn)行記錄）。 4.服藥12周后，患者來院專家門診隨診，記錄患者神經(jīng)系統(tǒng)檢查、不良事件及其用藥情況。復(fù)查實(shí)驗(yàn)室檢查包括：血常規(guī)、尿常規(guī)、生化常規(guī)（離子、肝功、腎功、血脂、血糖）、凝血常規(guī)及血液流變學(xué)檢查。復(fù)查影像學(xué)檢查包括：心電圖及頸動(dòng)脈超聲的檢查。神經(jīng)心理學(xué)量表測評包括：MMSE、MoCa、ADL。 5.記錄24周后終點(diǎn)事件。 統(tǒng)計(jì)學(xué)處理：采用SPSS11.5軟件包對資料進(jìn)行統(tǒng)計(jì)分析，計(jì)數(shù)資料用頻數(shù)（百分比）或平均數(shù)±標(biāo)準(zhǔn)差（x±s）表示，參數(shù)分析采用配對t檢驗(yàn)，規(guī)定p＜0.05有統(tǒng)計(jì)學(xué)意義，p＜0.01有顯著統(tǒng)計(jì)學(xué)意義。 結(jié)果： 入組的42例患者服藥前MMSE評分為22.66±2.63，服藥后MMSE評分為22.92±2.70，前后對比，有差異，具有統(tǒng)計(jì)學(xué)意義（p＜0.05）；服藥前MoCA評分為20.04±2.79，服藥后MoCA評分為20.42±2.50，前后對比，有差異，具有統(tǒng)計(jì)學(xué)意義（p＜0.05）；服藥前ADL評分為18.98±1.74，服藥后ADL評分為17.90±1.79，前后對比，差異顯著，具有顯著統(tǒng)計(jì)學(xué)意義（p＜0.01）。 入組的42例患者服藥前血液流變學(xué)與服藥后對比，有差異，具有統(tǒng)計(jì)學(xué)意義（p＜0.05）。 入組的42例患者服藥前收縮壓155.13±20.37，服藥后151.22±17.52，前后對比，差異顯著，但高血壓患者均給予相應(yīng)降壓藥物治療，，無統(tǒng)計(jì)學(xué)意義（p＞0.05）。 入組的42例患者服藥前頸動(dòng)脈內(nèi)膜增厚及斑塊情況與服藥后對比，無明顯差異，無統(tǒng)計(jì)學(xué)意義（p＞0.05）。 臨床觀察結(jié)果顯示服藥后對肝功能、腎功能、血常規(guī)、尿常規(guī)、凝血常規(guī)、心電圖無明顯影響。治療過程中有2例患者在服藥第1天時(shí)出現(xiàn)惡心、腹瀉；有1例患者在服藥第3天時(shí)出現(xiàn)輕度皮膚瘙癢，但都未予治療癥狀自行緩解，說明養(yǎng)血清腦顆粒無明顯不良反應(yīng)。 結(jié)論： 1.中成藥養(yǎng)血清腦顆粒能改善血管性認(rèn)知障礙患者神經(jīng)心理學(xué)量表評分，可能對延緩血管性認(rèn)知障礙的發(fā)展具有一定的治療作用。 2.養(yǎng)血清腦顆粒治療血管性認(rèn)知障礙安全、有效。 3.本實(shí)驗(yàn)研究樣本量較少，需要進(jìn)一步擴(kuò)大樣本量以更準(zhǔn)確地評估養(yǎng)血清顆粒的療效。
[Abstract]:With the progress and vigorous development of social economy, civilization and science and technology, the life of mankind has increased, and our country has entered an aging society. Cerebrovascular disease and cognitive disorder are the high-incidence diseases of the middle-aged and the elderly, and the vascular factors can cause cognitive dysfunction, and the incidence of the disease is increasing year by year. Vascular cognitive disorder (VCI) has a large proportion in cognitive disorders, which seriously affects the health and quality of life of the middle-aged and elderly people, and has brought heavy economic and mental burdens to the society and the family, which has caused great attention to the medical community. Therefore, it is of great significance for the early diagnosis of VCI and the timely prevention of the further development of the disease. Objective: The purpose of this study was to observe the effect of serum brain granule on the score of neuropsychological scale in VCI patients. Response: The source of the case was selected from June 2010 to January 2012 in the patients with VCI in the Department of Neurology of the Central Hospital of Dalian. 42. In accordance with the criteria for enrollment, the eligible patients were given the informed consent Pre-entry group.1. General data, nervous system examination, past history, personal history, family history, and medication status of the patient The condition is recorded. The laboratory tests include: blood routine, urine routine, biochemical routine (ion, liver function, kidney function, blood fat, blood sugar), blood coagulation and blood routine and blood Rheology examination. Imaging examination includes: head CT or head MRI, electrocardiogram and carotid artery Ultrasonic examination. The evaluation of the neuropsychological scale includes: MMSE, MoCa, ADL, CDR HAMD.2. From Group 1 Tianqi, beginning to take the medicine. Method: give the blood serum brain granule (Tianjin Tianshi Power Group Co., Ltd.) for oral, 4g/ time,3 times/ day 3. The course of treatment was 12 weeks.3. During the course of taking the medicine, the patient took the medicine (the purchase of the drug was in the Department of Neurology of the Central Hospital of Dalian) 4. After 12 weeks of taking the medicine, the patient came to the expert clinic to follow up, and the nervous system of the patient was recorded. Adverse events and their medication conditions. Review of laboratory tests included: blood routine, routine urine, routine biochemical (ion, liver function, kidney function, blood lipid, blood sugar), and coagulation. Blood routine and hemorheology examination. The examination of the imaging examination includes the following: Examination of electrogram and carotid ultrasound. The neuropsychological scale assessment includes: MM SE,MoCa,ADL. 5. The end-point events were recorded after 24 weeks. Statistical processing: The data was statistically analyzed using the SPSS11.5 software package, and the frequency (percentage) or the average standard deviation (x-s) of the count data was expressed. The parameter analysis used the paired t-test, which stipulated that p <0.05 was of statistical significance. ,p錛

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