石杉碱甲联合心脑舒通治疗对血管性痴呆患者临床疗效及大脑影像学的变化  

Clinical efficacy and brain imaging changes of huperzine A combined with xinnao shutong in the treatment of patients with vascular dementia

作　　者：董芬芬 武岳[1] 刘婷[1] 屈斐 Dong Fen-fen;Wu Yue;Liu Ting;Qu Fei(Department of Neurology,Shangluo Central Hospital,Shangluo 726000,China)

机构地区：[1]商洛市中心医院神经内科,商洛726000

出　　处：《中国药物应用与监测》2025年第2期189-193,共5页Chinese Journal of Drug Application and Monitoring

基　　金：陕西省自然科学基础研究计划项目(S2020-JC-YB-1421)。

摘　　要：目的分析石杉碱甲联合心脑舒通治疗血管性痴呆(VD)患者临床疗效、大脑影像学及认知功能的影响。方法2021年3月至2023年6月商洛市中心医院收治的血管性痴呆患者206例,采用根据随机数字表法分为心脑舒通组(n=103)、石杉碱甲联合组(n=103),心脑舒通组予以心脑舒通等血管性痴呆常规治疗,石杉碱甲联合组在心脑舒通组基础上增加石杉碱甲治疗。对比两组临床疗效、大脑影像学变化、认知功能[简易精神状态检查量表(MMSE)]、痴呆程度[长谷川痴呆量表(HDS)]及日常生活能力[日常生活能力量表(ADL)],并对比治疗安全性。结果石杉碱甲联合组的治疗总有效率为93.21%(96/103)高于心脑舒通组的84.47%(87/103)(χ^(2)=3.964,P=0.046);治疗后,石杉碱甲联合组和心脑舒通组大脑影像显示下皮层下动脉梗死、基底节出血、顶叶梗死、颞叶梗死及额叶梗死率(分别是2.91%、4.85%、3.88%、6.80%、5.83%、9.71%、12.62%、11.65%、15.53%、13.59%),低于治疗前(分别是22.33%、30.10%、13.59%、19.42%、14.56%、20.39%、25.24%、15.53%、21.36%、17.48%),且石杉碱甲联合组各部位梗死率均低于心脑舒通组(均P<0.05);治疗后,石杉碱甲联合组和心脑舒通组MMSE、HDS及ADL评分[分别是(24.46±4.13)分、(25.65±3.87)分、(66.94±7.21)分、(20.41±3.87)分、(21.06±3.22)分、(58.41±6.57)分],均高于治疗前[分别是(18.06±3.47)分、(17.88±2.41)分、(47.51±6.02)分、(17.69±3.52)分、(17.52±2.48)分、(46.84±5.87)分],且石杉碱甲联合组评分均高于心脑舒通组(均P<0.05);在不良反应总发生率方面,心脑舒通组为16.50%(17/103),石杉碱甲联合组为19.41%(20/103),两组比较差异无统计学意义(χ^(2)=0.296,P>0.05)。结论石杉碱甲+心脑舒通更有利于改善血管性痴呆患者认知功能、痴呆程度及日常生活能力,脑梗死率影像改变效果更佳,临床效果更为显著,具有安全性。Objective To investigate the efficacy of huperzine A combined with xinnaoshutong in treatmentn of patients with vascular dementia(VD)and its impact on imaging characteristics and cognitive function.Methods A total of 206 patients with VD admitted to Shangluo Central Hospital from March 2021 to June 2023 were divided into the xinnaoshutong group(n=103)and huperperine A combined group(n=103)according to the random number table method.The patients in the xinnaoshutong group were given conventional treatment while those in the huperzine A combined group were treated with huperzine A on the basis of the regimen in the xinnaoshutong group.The clinical efficacy,brain imaging changes,cognitive function(MMSE score),dementia degree(HDS score)and daily living ability(ADL score)were compared between the two groups.The safety of treatment was also compared.Results The total effective rate of the huperperine A combined group was 93.21%(96/103),which was higher than that of the xinnaoshutong group(84.47%(87/103))(χ^(2)=3.964,P=0.046).After treatment,the rates of subcortical artery infarction,basal ganglia hemorrhage,parietal lobe infarction,temporal lobe infarction and frontal lobe infarction were 2.91%,4.85%,3.88%,6.80%,5.83%,9.71%,12.62%,11.65%,15.53%and 13.59%in the huperperine A combined group and xinnaoshutong group,respectively.The infarct rates of the huperzine A combined group and the xinnaoshutong group were lower than those before treatment(22.33%,30.10%,13.59%,19.42%,14.56%,20.39%,25.24%,15.53%,21.36%,17.48%),and the infarction rates of each part of huperzine A combined with Xinnaoshutong group were lower than those before treatment(all P<0.05).The MMSE,HDS and ADL scores of the huperzine A combined group and the xinnaoshutong group were(24.46±4.13)points,(25.65±3.87)points,(66.94±7.21)points,(20.41±3.87)points,(21.06±3.22)points and(58.41±6.57)points respectively.They were higher than those before treatment((18.06±3.47)points,(17.88±2.41) points, (47.51±6.02) points, (17.69±3.52) points, (17.52±2.48) poi

关 键 词：石杉碱甲 心脑舒通 血管性痴呆 影像学变化 认知功能 痴呆程度 日常生活能力 

分 类 号：R743[医药卫生—神经病学与精神病学]