摘要
目的:观察尼莫地平联合甲磺酸二氢麦角碱对血管性痴呆患者认知及非认知功能的改善及其应用的安全性。方法:选择2002-01/2004-05解放军第四军医大学西京医院收治的血管性痴呆患者80例,采用随机法分为两组。单用尼莫地平为对照组(n=40,口服尼莫地平片30mg,3次/d),尼莫地平联合甲磺酸二氢麦角碱为治疗组(n=40,口服尼莫地平片30mg,3次/d,甲磺酸二氢麦角碱2.5mg,2次/d),分别在入组前、治疗后45d和90d进行效果评定。①采用简易智能量表(总分30分)和长谷川痴呆量表(总分30分)评定认知功能。②采用日常生活能力量表(总分100分,分值越高,改善效果越好)、社会功能活动调查表(≤5分为正常,分值越低,改善效果越好)评定非认知功能。③采用简易智能量表评定智能改善效果(显效:治疗前后评分提高≥6分;有效:评分提高≥4分;无效:评分提高<4分)。④同时记录药物的副作用。结果:按实际处理分析,治疗组38例(95%)与对照组37例(93%)进入结果分析。①治疗前及治疗后45d:两组间各量表分值差异无显著性(P>0.05)。②治疗90d后两组认知功能评分比较:治疗组显著高于对照组犤简易智能量表评分(24,2±5.5,18.2±4.9);长谷川痴呆量表评分(23.8±6.2,18.9±4.2)(P<0.05)犦。③治疗90d后两组非认知功能评分比较:治疗组日常生活能力量表评分显著高于对照组(76.8±14.7,61.7±12.9)(P<0.05);治疗组社会功能活动调查表评分显著低于对照组(6.2±3.1,8.6±2.9)(P<0.05)。④治疗90d后两组智能改善效果比较:治疗组显著高于对照组(81.6%,59.5%)(P<0.05)。⑤两组治疗期间无明显的不良反应。结论:尼莫地平与甲磺酸二氢麦角碱的联合治疗血管性痴呆,与单独应用尼莫地平相比,可明显改善认知功能,提高日常生活能力,且具有良好的安全性,可作为血管性痴呆的一种治疗方案。
AIM： To observe the effects and security of dihydroergotamine mesilate plus nimodipine in ameliorating the cognitive and non-cognitive functions of patients with vascular dementia.METHODS： Eighty patients with vascular dementia, who were treated in the Xijing Hospital, Fourth Military Medical University of Chinese PLA from January 2002 to May 2004, were randomly divided into control group （n=40,only treated with oral nimodipine 30mg, 3 times per day） and treatment group （n=40, treated with oral nimodipine 30 mg, 3 times per day and dihydroergotamine mesilate 2.5mg, twice a day）, the efficacies were evaluated before treatment, 45 and 90 days after treatment. ① Cognitive function was assessed with mini mental state examination （total score was 30 points） and Hasegawa＇s dementia scale （total score was 30 points）; ② Non-cognitive function was assessed with activity of daily living scale （total score was 100 points; The higher the score, the between the amelioration） and social function activity inventory （≤ 5 points as normal; The lower the score, the better the amelioration）; ③ The amelioration of intelligence was evaluated with mini mental state examination （The score before and after treatment improved by ≥ 6 points as significant effect; ≥ 4 as effective; 〈 4 points as invalid）. ④ The side effects of the drugs were recorded at the same time.RESULTS： According to actual treatment, 38 cases （95%） in the treatment group and 37 cases （93%） in the control group were involved in the analysis of results. ① There were no significant differences in the scores of each scale before treatment and 45 days after treatment between the two groups （P 〉 0.05）. ② Comparison of cognitive function scores 90 days after treatment between the two groups： Thor were significantly higher in the treatment group than in the control group [mini mental state examination：（24.2±5.5, 18.2±4.9）; Hasegawa＇s dementia scale： （23.8±6.2, 18.9±4.2）, P〈 0.05].③ Comparison of non-cognitive function scores 90 days after treatment between the two groups： The score of activity of daily living scale was significantly higher in the treatment group than in the control group （76.8±14.7,61.7±12.9, P 〈 0.05）; The score of social function activity inventory was significantly lower in the treatment group than in the control group （6.2±3.1,8.6±2.9, P 〈 0.05）. ④ Comparison of intellectual amelioration 90 days after treatment between the two groups： It was significantly higher in the treatment group than in the control group （81.6%, 59.5%） （P〈 0.05）. ⑤No obvious adverse reaction was observed during treatment in both groups.CONCLUSION： Compared with application of nimedipine only, the treatment of dihydroergotamine mesilate plus nimedipine can obviously ameliorate the cognitive function, improve the activities of daily life in patients with vascular dementia with better security, so it can be taken as a therapeutic program for vascular dementia.
出处
《中国临床康复》
CSCD
北大核心
2005年第20期48-49,共2页
Chinese Journal of Clinical Rehabilitation
