摘要
背景:脑血管病的危险因素是血管性痴呆的危险因素。瘀阻脑络为血管性痴呆的基本病机,肾气虚弱为血管性痴呆的重要发病基础,活血化瘀、补肾益智为其治疗大法。目的:观察中药康脑灵颗粒剂对血管性痴呆患者的临床疗效。设计:随机对照观察。单位:山东中医药大学附属医院。对象:自 1998-05/2001-10选择山东中医药大学附属医院、淄博市中医院、河北省邯郸市中医院门诊的血管性痴呆患者 60例,随机分成试验组 40例,对照组 20例。方法:试验组:口服康脑灵颗粒(主要成分:银杏叶、仙灵脾、川芎等),1袋 /次,3次/d。对照组:口服脑复康,0.8g/次,3次/d。两组均服药 2个月为 1个疗程。根据治疗前后症状积分值的变化情况及各种量表检查评分情况分为临床控制、显效、有效、无效或加重 4级。临床控制:主要症状基本恢复正常,定向健全,回答问题正确,生活自理,能恢复一般社会活动;显效:主要症状一部分恢复正常,定向基本健全,回答问题基本正确,反应一般,生活可自理;有效:主要症状有所减轻或部分消失,生活基本自理,回答问题基本正确,但反应仍迟钝,智力与人格仍有障碍;无效,主要症状无改变甚至继续发展。以简易精神状态检查表、长谷川智力量表积分值(总分 30分)评定患者的神经心理、认知能力,以社会功能活动调查表(≤5分为正常,分值越低,改善效果越好)检测患者的日常生活能力。主要观察指标:①两组治疗后临床疗效比较。②治疗前后两组间简易精神状态检查表、长谷川智力量表、社会功能活动调查表积分的比较。结果:60例患者均进入结果分析,无脱落者。①两组治疗后临床疗效比较:试验组显效率高于对照组(78%,50%)。②治疗前后两组各量表积分的比较:试验组治疗后的简易精神状态检查表和长谷川智力量表分值均较治疗前升高(17.03±5.58,12.42±3.87;20.36±6.60,14.73±4.68),社会功能活动调查表量表积分值较治疗前降低(10.64±4.58,15.38±3.37)。对照组治疗后的长谷川智力量表分值均较治疗前升高 (16.82±3.95,13.20±3.12),社会功能活动调查表量表积分值较治疗前降低(11.16±1.06,14.10±2.15)。且试验组治疗后的长谷川智力量表积分值较对照组偏高,差异具有显著性意义(P <0.05)。结论:康脑灵颗粒剂和脑复康均有改善血管性痴呆患者智力的作用,而康脑灵颗粒剂临床效果较佳。
BACKGROUND： The dangerous factors of cerebrovascular disease are also those of vascular dementia （VD）. Stasis and retardation of cerebral channels is the basic pathogenesis of VD, kidney-ql deficiency is the important pathogenic foundation of VD and therefore the most effective treatment is to stimulate blood circulation to remove stasis, tonify the kidney and improve intellegence.
OBJECTIVE： To observe the clinical effects of kangnaoling, a granule traditional Chinese medicine, on the patients with VD.
DESIGN： Randomized controlled observation.
SETTING： Affiliated Hospital of Shandong University of Traditional Chinese Medicine
PARTICIPANTS： Totally 60 patients with VD were selected from Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Zibo City Traditional Chinese Medicine Hospital and the Clinic of Handan Traditional Chinese Medicine Hospital in Hebei Province from May 1998 to October 2001. The patients were randomly divided into experimental group （n=40） and control group （n=20）.
METHODS： Experimental group： Kansnaoling granules （chief ingredients： gingko leaf, epimeddium and ehuanxiong rhizome, etc.） were taken orally, 1 pack/time, three times per day. Control group： Naofukang was taken orally, 0.8 g/time, three times per day. The two groups took the medicine both for two months as a course. According to the integral of symptoms and the score in all kinds of scales before and after treatment, the patients were classified into.4 grades： clinically-controlled, remarkable effective, effective and ineffective or worse. Clinically-controlled： The main symptoms in the patients, on the whole, returned to normal. They could well-perform orientation, correctly answer questions, take care of themselves and resume ordinary social activities： remarkable effective： Part of the main symptoms in the patients returned to normal. They could take care of themselves, basi- cally perform orientation, correctly answer questions although their reaction was ordinary. Effective： The main symptoms in the patients were relieved or partly disappeared. Generally, they could take care of themselves, correctly answer questions but their reaction was still slow and had dysfunction in mentality and personality. Ineffective： the main symptoms in the patients were not bettered, even worse. The neuropsychology and cognitive ability of the patients were determined with Mini-Mental State Examination （MMSE） and Hasegawa Dementia Scale （HDS） （total score： 30 points）, and the daily living ability of the patients was detected with Functional Activities Questionnaire （FAQ） （It was defined as normal when the score was ≤5 points, and the lower the score was, the better the effect was）.
MAIN OUTCOME MEASURES： （1） The comparison between the two groups in the clinical effect after treatment. （2） The comparison between the two groups in the score of MMSE,HDS and FAQ before and after treatment.
RESULTS： All the 60 patients were involved in the analysis of results, no one lost. （1） The comparison between the two groups in the clinical effect after treatment： The remarkable effective rate was higher in experimental group than in control group （78%, 50%）. （2） The comparison between the two groups in the score of MMSE, HDS and FAQ before and after treatment： in experimental group, the score of MMSE and HDS was all higher after treatment than before treatment （17.03±5.58, 12.42±3.87; 20.36±6.60, 14.73±4.68） while the score of FAQ was lower after treatment than before treatment （10.64±4.58, 15.38±3.37）. In control group, the score of HDS was higher after treatment than before treatment （16.82±3.95, 13.20±3.12） while the score of FAQ was lower after treatment than before treatment （11.16±1.06, 14.10±2.15）. And the score of HDS was higher in experimental group than in control group after treatment, there was significant difference （P 〈 0.05）.
CONCLUSION： Kangnaoling granules and naofukang all have the effect in improving the intellegence of the patients with VD while kangnaoling granules have better clinical effect.
出处
《中国临床康复》
CSCD
北大核心
2006年第3期161-163,共3页
Chinese Journal of Clinical Rehabilitation
