标题：丁苯酞胶囊联合银杏叶提取物治疗血管性痴呆的疗效及对患者认知功能和生活质量的影响

      作者：刘七十，李立，吴引萍，贺骞，王西愿    延安大学咸阳医院神经内科，陕西 咸阳 712000

      卷次： 2021年32卷22期

      【摘要】 目的 观察丁苯酞胶囊联合银杏叶提取物治疗血管性痴呆(VD)的临床疗效，并探讨其对患者认知功能和生活质量的影响。方法 选择2017年12月至2019年12月延安大学咸阳医院神经内科收治的92例VD患者纳入研究，采用随机数表法将患者分为对照组和观察组，每组46例，对照组患者给予丁苯酞胶囊治疗，观察组患者则在对照组治疗基础上联合银杏叶提取物治疗，两组均治疗3个月。疗程结束后比较两组患者的治疗效果，以及治疗前和治疗3个月后的认知功能、精神行为症状、日常生活活动能力、血流动力学和血清生化指标。结果 观察组患者的临床治疗总有效率为86.96%，明显高于对照组的67.39%，差异有统计学意义(P<0.05)；治疗后，两组患者的简易精神状态(MMSE)量表、日常生活功能(ADL)量表评分明显高于治疗前，其中观察组患者明显高于对照组，而神经精神科问卷(NPI-Q)评分明显低于治疗前，其中观察组患者明显低于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的大脑前动脉(ACA)、大脑中动脉(MCA)的平均血流速度明显高于治疗前，其中观察组患者明显高于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的血清一氧化氮(NO)、内皮素(ET)、丙二醛(MDA)、细胞间黏附分子(ICAM)-1水平明显低于治疗前，超氧化物歧化酶(SOD)、胰岛素样生长因子(IGF)-1水平明显高于治疗前，其中观察组患者明显高于对照组，差异均有统计学意义(P<0.05)。结论 丁苯酞胶囊联合银杏叶提取物治疗能提高VD的治疗效果，对患者的认知功能障碍、精神行为症状及日常生活活动能力起到一定改善作用，且能明显减轻内皮功能障碍和炎症反应，消除氧自由基，值得临床上推广应用。
      【关键词】 血管性痴呆；丁苯酞胶囊；银杏叶提取物；认知功能；精神行为症状；生活质量；内皮功能障碍；炎症反应
      【中图分类号】 R743 【文献标识码】 A 【文章编号】 1003—6350（2021）22—2894—05

Efficacy of butylphthalide capsule combined with ginkgo biloba extract in the treatment of vascular dementia andits influence on cognitive function and quality of life of patients.
LIU Qi-shi, LI Li, WU Yin-ping, HE Qian, WANGXi-yuan. Department of Neurology, Xianyang Hospital of Yan’an University, Xianyang 712000, Shaanxi, CHINA
【Abstract】 Objective To observe the clinical efficacy of butylphthalide capsule combined with ginkgo bilobaextract in the treatment of vascular dementia (VD) and to explore its influence on cognitive function and quality of lifeof patients. Methods Ninety-two patients with VD admitted to Department of Neurology, Xianyang Hospital of Yan’an University between December 2017 and December 2019 were enrolled and divided into a control group and an obser-vation group according to the random number table method, with 46 patients in each group. The patients in the controlgroup were treated with butylphthalide capsule, and the patients in the observation group were combined with ginkgo bi-loba extract on the basis of treatment in the control group. The two groups were treated for 3 months. The treatment ef-fect after the end of course of treatment, as well as cognitive function, psychobehavioral symptoms, activities of daily liv-ing, hemodynamics and serum biochemical indicators before treatment and after 3 months of treatment were comparedbetween the two groups. Results The total effective rate of clinical treatment of patients in observation group was sig-nificantly higher than that in control group (86.96% vs 67.39%, P<0.05). After treatment, the scores of mini-mental stateexamination (MMSE) scale and activities of daily living (ADL) in the two groups were significantly higher than thosebefore treatment, and the scores of observation group were significantly higher than those of control group, while thescore of neuropsychiatric inventory questionnaire (NPI-Q) in the two groups was significantly lower than that beforetreatment, and the score of observation group was significantly lower than that of control group (P<0.05). After treat-ment, the mean blood flow velocities of anterior cerebral artery (ACA) and middle cerebral artery (MCA) in the twogroups of patients were significantly faster than those before treatment, and the velocities of observation group were sig-nificantly faster than those of control group (P<0.05). The levels of serum nitric oxide (NO), endothelin (ET), malondial-dehyde (MDA), and intercellular adhesion molecule (ICAM)-1 in the two groups of patients were significantly lower af-