蝉衣竺贝散联合盐酸多奈哌齐对脑卒中后认知功能障碍的临床疗效  

Clinical Effect of Chanyi Zhubei Powder Combined with Donepezil Hydrochloride Tablets on Cognitive Impairment after Stroke

作　　者：邵国强[1] 孙怡婕[1] 许海柱[1] 陈建华 Shao Guoqiang;Sun Yije;Xu Haizhu;Chen Jianhua(Huadong Hospital Afiliated to Fudan University,Shanghai 200040;Shanghai TCM Integrated Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200082)

机构地区：[1]复旦大学附属华东医院,上海200040 [2]上海中医药大学附属上海市中西医结合医院,上海200082

出　　处：《国际老年医学杂志》2023年第1期28-31,共4页International Journal of Geriatrics

基　　金：上海市科委2019年度医学中医引导科技支撑项目(19401931500)。

摘　　要：目的观察蝉衣竺贝散联合盐酸多奈哌齐对脑卒中后认知功能障碍(PSCI)的临床疗效。方法选取2019年1月~2021年1月复旦大学附属华东医院中医科病房和门诊收治的100例PSCI患者作为研究对象,采用随机数字表法分为两组,各50例。多奈哌齐组给予口服多奈哌齐,中药制剂组在口服多奈哌齐基础上联合蝉衣竺贝散(放入胶囊中或鼻饲)。统计两组疗效和不良反应,评价两组中医症状积分、认知功能评分、精神方面评分及生活能力评分的变化。结果中药制剂组的总有效率高于多奈哌齐组,差异有统计学意义(P<0.05)。治疗6个月后,中药制剂组和多奈哌齐组的中医症状积分、临床痴呆评定量表(CDR)评分、神经精神量表(NPI)评分、修正的Rankin量表(mRS)评分低于治疗前(P<0.05),简易智力状态检查量表(MMSE)评分、蒙特利尔认知量表(MoCA)评分、日常生活能力量表(ADL)评分高于治疗前(P<0.05),治疗6个月后中药制剂组的CDR、NPI、mRS评分均低于多奈哌齐组(P<0.05),MMSE、MoCA、ADL评分均高于多奈哌齐组(P<0.05)。两组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论在提高PSCI患者日常生活能力、改善认知功能方面,蝉衣竺贝散联合盐酸多奈哌齐治疗均优于盐酸多奈哌齐单独用药,且患者耐受性好。Objective To observe the clinical effect of Chanyi zhubei powder combined with Donepezil hydrochloride on post-stroke cognitive impairment(PSCI).Methods One hundred patients with PSCI admitted to Huadong Hospital Affiliated to Fudan University from January 2019 to January 2021 were selected as the research objects.They were randomly divided into two groups,50 patients in each group.Donepezil group was given oral Donepezil,and the Chinese medicine preparation group was given oral Donepezil plus Chanyi zhubei powder(put into capsule or nasal feeding).The efficacy and adverse reactions were recorded.The Traditional Chinese Medicine(TCM)symptom score,cognitive function score,mental score and life ability score were compared between the two groups.Results The overall response rate in the Chinese medicine preparation group was higher than that in the Donepezil group,with a statistically significant difference(P<0.05).After 6 months of treatment,the TCM symptom score,Clinical Dementia Rating(CDR)score,Neuropsychiatric Inventroy(NPI)score,and modified Rankin Scale(mRS)score in both groups were lower than before treatment(P<0.05),while Mini-Mental State Examination(MMSE)score,Montreal Cognitive Assessment(MoCA)score,and Activities of Daily Living Scale(ADL)score were higher than before treatment(P<0.05).After 6 months of treatment,the scores of CDR,NPI and mRS in the Chinese medicine preparation group were lower than those in the Donepezil group(P<0.05),while the scores of MMSE,MoCA and ADL were higher than those in the Donepezil group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion The combination of Chanyi zhubei powder and Donepezil hydrochloride in the treatment of PSCI is superior to Donepezil hydrochloride alone in improving the ability of daily life and cognitive function,and the patient’s tolerance is good.

关 键 词：蝉衣竺贝散 盐酸多奈哌齐 脑卒中 认知障碍 耐受性 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]