尼莫地平联合丁苯酞治疗轻中度血管性认知障碍的临床研究  

Clinical trial of nimodipine combine with butylphthalide in the treatment of patients with mild to moderate vascular cognitive impairment

作　　者：周格知[1] 杨帆[1] 童民锋[1] Zhou Gezhi;Yang Fan;Tong Minfeng(Department of Neurosurgery,Jinhua Municipal Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院神经外科,浙江省321000

出　　处：《中国基层医药》2019年第11期1343-1346,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省科技计划项目(2013C33103).

摘　　要：目的观察尼莫地平联合丁苯酞治疗轻中度血管性认知障碍的临床疗效。方法选择金华市中心医院2012年1月至2016年12月收治的轻中度血管性认知障碍患者100例,采用随机数字表法分为对照组50例和观察组50例。对照组予以丁苯酞胶囊口服,200 mg/次,3次/d;观察组在对照组基础上联合尼莫地平治疗(40 mg/次,3次/d,口服)。两组疗程均为24周。根据蒙特利尔认知评估量表(MoCA)评分、日常生活能力量表(ADL)评分以及血清超敏C-反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平,评价临床疗效和不良反应。结果治疗后,观察组MoCA、ADL评分分别为(24.32±2.87)分、(59.22±6.17)分,对照组分别为(22.76±2.67)分、(55.63±6.3)分,两组差异均有统计学意义(t=2.814、2.870,均P<0.05)。对照组总有效率为52.00%(26/50),低于观察组的74.00%(37/50),差异有统计学意义(χ^2=5.191,P<0.05)。治疗后,观察组、对照组hs-CRP分别为(189.51±23.27)mg/L、(211.51±25.51)mg/L,IL-6分别为(76.42±9.86)ng/L、(95.85±10.23)ng/L,TNF-α分别为(0.24±0.08)ng/L、(0.32±0.10)ng/L,两组差异均有统计学意义(t=4.505、9.670、4.417,均P<0.05)。对照组有3例出现恶心呕吐,不良反应率为6.00%;观察组有3例出现恶心呕吐和1例低血压,不良反应率为8.00%,两组不良反应发生率差异无统计学意义(P>0.05)。结论尼莫地平联合丁苯酞可有效治疗轻中度血管性认知障碍,且安全性较高。Objective To evaluate the clinical efficacy and safety of nimodipine combine with butylphthalide in the treatment of patients with mild to moderate vascular cognitive impairment(VCI).Methods From January 2012 to December 2016,100 patients with mild to moderate VCI in Jinhua Municipal Central Hospital were randomly divided into control group(n=50)and treatment group(n=50)according to the random number table method.The control group received butylphthalide capsule,200 mg po tid.The treatment group received nimodipine tablets,40mg po tid,on the basis of the control group.The two groups of patients were treated for 24 weeks.Montreal cognitive assessment(MoCA),activities of daily living(ADL),serum hs-CRP,IL-6,TNF-α,clinical efficacy and adverse drug reactions were compared after treatment.Results After treatment,the scores of MoCA and ADL in the treatment group were(24.32±2.87)points,(59.22±6.17)points,respectively,which were significantly higher than those in the control group[(22.76±2.67)points,(55.63±6.3)points,t=2.814,2.870,all P<0.05].The effective rates in the treatment group and control group were 74.00%(37/50),52.00%(26/50),respectively,and there was statistically significant difference between the two groups(χ^2=5.191,P<0.05).After treatment,the levels of hs-CRP[(189.51±23.27)mg/L vs.(211.51±25.51)mg/L],IL-6[(76.42±9.86)ng/L vs.(95.85±10.23)ng/L],TNF-α[(0.24±0.08)ng/L vs.(0.32±0.10)ng/L]between the treatment group and the control group had statistically significant differences(t=4.505,9.670,4.417,all P<0.05).The adverse drug reactions were nausea and vomiting in 3 cases in the control group(6.00%),nausea and vomiting in 3 cases and hypotension in 1 case in the treatment group(8.00%),and there was no statistically significant difference between the two groups(P>0.05).Conclusion Nimodipine combined with butylphthalide in the treatment of mild to moderate VCI is effective and has high safety.

关 键 词：认知障碍 血管性 药物疗法 联合 C反应蛋白质 细胞介素6 肿瘤坏死因子Α 疗效比较研究 尼莫地平 丁苯酞 

分 类 号：R749.13[医药卫生—神经病学与精神病学]