通脑灵颗粒联合多奈哌齐治疗卒中后认知障碍  

Tongnaoling granules combined with donepezil in the treatment of post-stroke cognitive impairment

作　　者：蒋辉[1] 倪杰 郑艳[1] JIANG Hui;NI Jie;ZHENG Yan(Department of Neurology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 210000,China)

机构地区：[1]江苏省中医院神经内科,江苏南京210000 [2]南京市鼓楼医院急诊科,江苏南京210000

出　　处：《中国临床研究》2018年第11期1582-1585,共4页Chinese Journal of Clinical Research

摘　　要：目的观察通脑灵颗粒联合多奈哌齐治疗卒中后认知障碍(PSCI)患者的治疗效果。方法将2015年1月至2017年12月在江苏省中医院接受治疗的80例PSCI患者随机分为对照组和联合治疗组,每组40例。对照组给予多奈哌齐口服治疗,联合治疗组给予通脑灵颗粒和多奈哌齐口服治疗,疗程为6个月。两组患者在治疗前后,采用简易精神状态检查(MMSE)、长谷川痴呆量表(HDS)、韦氏记忆测验(WMS)评分,分别评估患者的认知障碍程度。另外采用酶联免疫吸附试验方法对两组患者在治疗前后进行血浆乙酰胆碱(Ach)、一氧化氮(NO)水平进行检测分析。结果治疗后,两组MMSE、HDS、WMS评分均升高,且联合治疗组高于对照组,差异均有统计学意义(P均<0. 05)。治疗后,两组血浆Ach水平升高,且联合治疗组高于对照组,两组NO水平降低,且联合治疗组低于对照组,差异均有统计学意义(P <0. 05)。两组均无严重不良反应。结论通脑灵颗粒联合多奈哌齐能够更有效的治疗卒中后认知障碍,其机制可能与提高血浆Ach水平和降低血浆NO水平有关。Objective To investigate the clinical effect of Tongnaoling granules combined with donepezil in the treatment of post-stroke cognitive impairment（PSCI）. Methods A total of 80 PSCI patients who received treatment at Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2015 to December 2017 were divided into control group and combined treatment group randomly（n = 40,each）. The control group was given donepezil orally,and the combined treatment group was given Tongnaoling granules and donepezil orally. The course of treatment was 6 months. The minimental state examination（MMSE）,Hasegawa dementia scales（HDS） and Wechsler memory scale（WMS） were used to estimate patients＇ cognitive impairment before and after the treatment. The enzyme-linked immunosorbent assay was used to detect the level of acetylcholine（Ach） and nitric oxide（NO） in plasma before and after the treatment. Results The scores of MMSE,HDS and WMS were significant higher after the treatment in two groups,and they were higher in combined treatment group after the treatment（all P〈0. 05） After the treatment,the plasma Ach level was increased and it was higher in combined treatment group（P〈0. 05）,and the plasma NO level was decreased and it was lower in combined treatment group（P〈0. 05）. There was no serious adverse reaction. Conclusion Tongnaoling granule combined with donepezil can be more effective in the treatment of PSCI and its mechanism may be related to the increase of plasma Ach level and the decrease of plasma NO level.

关 键 词：通脑灵颗粒 多奈哌齐 卒中后认知障碍 乙酰胆碱 一氧化氮 

分 类 号：R743.3[医药卫生—神经病学与精神病学]