养血清脑颗粒对血管性认知障碍患者神经心理学量表评分的影响

发布时间：2019-05-31 18:50

【摘要】：随着社会经济、文明、科技的进步和蓬勃发展，人类的寿命不断增长，我国进入了老龄化社会。脑血管病和认知障碍均为中老年人群的高发疾病，血管性因素可引发认知功能障碍，其发病率逐年上升。血管性认知障碍（vascular cognitiveimpairment,VCI）在认知疾病中占有相当大的比例，严重影响到了中老年人群的健康和生活质量，给社会和家庭带来了沉重的经济和精神负担，已经引起了医学界的极大关注。因此，对于VCI的早期诊断、药物筛选及时阻止病情进一步发展具有重要意义。 目的：本研究旨在观察养血清脑颗粒对VCI患者神经心理学量表评分的影响。 方法：病例来源选取2010年6月至2012年1月在大连市中心医院神经内科住院治疗的VCI患者42例。按照入组的标准条件，符合条件的患者签署知情同意书后给予入组。 1.对患者的一般资料、神经系统检查、既往史、个人史、家族史及其用药情况进行记录。实验室检查包括：血常规、尿常规、生化常规（离子、肝功、肾功、血脂、血糖）、凝血常规及血液流变学检查。影像学检查包括：头颅CT或头颅MRI、心电图及颈动脉超声的检查。神经心理学量表测评包括：MMSE、MoCa、ADL、CDR、HAMD。 2.从入组第1天起，开始服药。方法：给予养血清脑颗粒（天津天士力集团股份有限公司）口服，4g/次，3次/天，疗程为12周。 3.在服药期间进行电话监督患者服药情况（购买药物均在大连市中心医院神经内科专家诊并进行记录）。 4.服药12周后，患者来院专家门诊随诊，记录患者神经系统检查、不良事件及其用药情况。复查实验室检查包括：血常规、尿常规、生化常规（离子、肝功、肾功、血脂、血糖）、凝血常规及血液流变学检查。复查影像学检查包括：心电图及颈动脉超声的检查。神经心理学量表测评包括：MMSE、MoCa、ADL。 5.记录24周后终点事件。 统计学处理：采用SPSS11.5软件包对资料进行统计分析，计数资料用频数（百分比）或平均数±标准差（x±s）表示，参数分析采用配对t检验，规定p＜0.05有统计学意义，p＜0.01有显著统计学意义。 结果： 入组的42例患者服药前MMSE评分为22.66±2.63，服药后MMSE评分为22.92±2.70，前后对比，有差异，具有统计学意义（p＜0.05）；服药前MoCA评分为20.04±2.79，服药后MoCA评分为20.42±2.50，前后对比，有差异，具有统计学意义（p＜0.05）；服药前ADL评分为18.98±1.74，服药后ADL评分为17.90±1.79，前后对比，差异显著，具有显著统计学意义（p＜0.01）。 入组的42例患者服药前血液流变学与服药后对比，有差异，具有统计学意义（p＜0.05）。 入组的42例患者服药前收缩压155.13±20.37，服药后151.22±17.52，前后对比，差异显著，但高血压患者均给予相应降压药物治疗，，无统计学意义（p＞0.05）。 入组的42例患者服药前颈动脉内膜增厚及斑块情况与服药后对比，无明显差异，无统计学意义（p＞0.05）。 临床观察结果显示服药后对肝功能、肾功能、血常规、尿常规、凝血常规、心电图无明显影响。治疗过程中有2例患者在服药第1天时出现恶心、腹泻；有1例患者在服药第3天时出现轻度皮肤瘙痒，但都未予治疗症状自行缓解，说明养血清脑颗粒无明显不良反应。 结论： 1.中成药养血清脑颗粒能改善血管性认知障碍患者神经心理学量表评分，可能对延缓血管性认知障碍的发展具有一定的治疗作用。 2.养血清脑颗粒治疗血管性认知障碍安全、有效。 3.本实验研究样本量较少，需要进一步扩大样本量以更准确地评估养血清颗粒的疗效。
[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锛

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