银杏叶提取物片联合重酒石酸卡巴拉汀治疗阿尔茨海默病的临床研究  

Clinical Study of Ginkgo Biloba Extract Tablets Combined with Rivastigmine Hydrogen Tartrate in the Treatment of Alzheimer′s Disease

作　　者：夏静 魏月 舒艳 罗云波[1] 景良 许学杰[1] XIA Jing;WEI Yue;SHU Yan;LUO Yunbo;JING Liang;XU Xuejie(Sichuan Mianyang 404 Hospital,Mianyang 621000,Sichuan,China)

机构地区：[1]四川绵阳四〇四医院,四川绵阳621000

出　　处：《中西医结合心脑血管病杂志》2022年第23期4355-4359,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：四川省医学科研课题计划项目(No.S17059)。

摘　　要：目的探讨银杏叶提取物片联合重酒石酸卡巴拉汀治疗阿尔茨海默病(AD)的临床疗效及其对病人肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响。方法选取2016年9月—2019年9月我院收治的98例老年AD病人,采取简单随机数字表法将其分成观察组与对照组,每组49例,其中,对照组口服重酒石酸卡巴拉汀胶囊治疗,观察组在对照组基础上口服银杏叶提取物片治疗,疗程12周。比较两组临床疗效和安全性,观察两组治疗前后总体认知功能[AD评定量表认知分量表(ADAS-Cog)、简易精神状态量表(MMSE)评分]、精神行为症状[神经精神科问卷(NPI)评分]、日常生活能力[日常生活能力量表(ADL)评分]及血清TNF-α、IL-1β、SOD、MDA水平的变化情况。结果观察组总有效率为91.8%,明显高于对照组的75.5%(P<0.05)。治疗后,两组ADAS-Cog、NPI评分均较治疗前明显降低(P<0.05),MMSE、ADL评分明显增高(P<0.05),且观察组ADAS-Cog、MMSE、NPI和ADL评分改善比对照组均更明显(P<0.05)。治疗后,两组血清TNF-α、IL-1β水平均较治疗前明显降低(P<0.05),且观察组血清TNF-α、IL-1β水平低于对照组(P<0.05)。治疗后,两组血清SOD水平均较治疗前明显升高,MDA含量明显降低(P<0.05);观察组血清SOD水平明显高于对照组,MDA水平明显低于对照组(P<0.05)。观察组不良反应发生率为22.4%,对照组不良反应发生率为18.4%,两组比较差异无统计学意义(P=0.616)。结论银杏叶提取物片联合重酒石酸卡巴拉汀治疗老年AD,可有效改善老年病人的总体认知功能、日常生活能力和精神行为症状,其作用机制可能是通过明显下调体内炎性因子表达水平、减轻氧化应激损伤的途径实现。Objective To investigate the clinical efficacy of ginkgo biloba extract tablets combined with rivastigmine hydrogen tartrate in the treatment of Alzheimer′s disease(AD)and its effects on tumor necrosis factor(TNF)-α,interleukin-1β(IL-1β),superoxide dismutase(SOD),and malondialdehyde(MDA).Methods A total of 98 elderly patients with AD were selected and randomly divided into observation group and control group by simple random number table method,with 49 cases in each group.The control group was treated with rivastigmine hydrogen tartrate capsule,and the observation group was treated with ginkgo biloba extract tablets on the basis of control treatment,the course of treatment was 12 weeks.The clinical efficacy and safety of two groups were compared.The overall cognitive function[Alzheimer′s Disease Assessment Scale-Cognitive section(ADAS-Cog)score,mini mental state examination(MMSE)score],mental behavioral symptoms[neuropsychiatric symptom inventory(NPI)score],daily living ability[activities of daily living(ADL)score],serum TNF-α,IL-1β,SOD,and MDA levels were observed before and after treatment.Results The total effective rate of observation group was 91.8%,which was significantly higher than that of control group 75.5%(P<0.05).After treatment,ADAS-Cog,NPI scores in two groups were significantly lower than those before treatment,while MMSE,ADL scores were significantly higher(P<0.05),and the improvement of ADAS-Cog,MMSE,NPI,and ADL scores in observation group were more obvious than those in control group(P<0.05).After treatment,the levels of serum TNF-αand IL-1βin two groups were significantly decreased compared with that before treatment(P<0.05),and the levels of serum TNF-αand IL-1βin observation group were significantly decreased compared with that in control group(P<0.05),and the level of SOD in serum of both groups was significantly higher than that before treatment,while the content of MDA was decreased significantly(P<0.05).The serum SOD level in observation group was significantly higher than th

关 键 词：阿尔茨海默病 银杏叶提取物片 重酒石酸卡巴拉汀 炎性因子 氧化应激 

分 类 号：R749.16[医药卫生—神经病学与精神病学]