摘要
目的比较丹参酮ⅡA与长春西汀治疗血管性认知障碍(VCI)的临床疗效和安全性。方法采用前瞻性研究方法,收集2008年5月—2013年5月在本院门诊和老年病中心就诊的VCI患者216例,采用区组随机化分组方法分为丹参酮组〔106例,包括64例非痴呆性血管认知障碍(VCIND)和42例血管性痴呆(VD)〕和长春西汀组〔110例,包括66例VCIND和44例VD〕。两组均在治疗原发病和口服吡拉西坦片、银杏叶片的基础上,丹参酮组给予丹参酮ⅡA 40 mg加入5%葡萄糖注射液250 ml中静脉滴注,长春西汀组给予长春西汀注射液40 mg加入5%葡萄糖注射液250 ml中静脉滴注,均1次/d,14 d为1个疗程,共治疗2个疗程。以蒙特利尔认知评估量表(MoCA)、日常生活能力量表(ADL)、神经精神问卷(NPI)评分作为评价指标,比较两组患者在治疗6个月后认知能力、日常生活能力和精神状况的改善情况。结果治疗前两组无论是VCIND患者还是VD患者,MoCA、ADL、NPI评分比较,差异均无统计学意义(P>0.05)。治疗6个月后,长春西汀组VCIND患者MoCA评分高于丹参酮组VCIND患者,而ADL、NPI评分则低于丹参酮组VCIND患者(P<0.05);长春西汀组VD患者仅ADL评分低于丹参酮组VD患者(P<0.05)。治疗后丹参酮组和长春西汀组不良反应发生率〔6.6%(7/106)与5.5%(6/110)〕间无差异(P>0.05)。结论长春西汀和丹参酮ⅡA治疗血管性认知障碍均安全有效,但长春西汀的临床疗效优于丹参酮ⅡA。
Objective To compare the curative effects and safety between Tanshinone ⅡA and Vinpocetine in the treatment of vascular cognitive impairment（VCI）.Methods Using prospective study method,a total of 216 cases with VCI who went to outpatient and department of geriatrics in our hospital from May 2008 to May 2013,were randomly divided into Tanshinone group（n = 106） and Vinpocetine group（n = 110）.Tanshinone group included 64 cases with vascular cognitive impairment no dementia（VCIND） and 42 cases with vascular dementia（VD）,Vinpocetine group included 66 cases with VCIND and 44 cases with VD.On the basis of the treatment of primary diseases and the use of piracetam and Ginkgo biloba tablets in the two groups,the Tanshinone group were administrated intravenously with 40 mg of Tanshinone ⅡA in 250 ml of 5% glucose injection once a day with two treatment courses（each course with a span of 14 days）,while the Vinpocetine group were administrated intravenously with 40 mg of Vinpocetine in 250 ml of 5% glucose injection once a day with two treatment courses（each course with a span of 14 days）.The improvement of recognition ability,activities of daily living,mental state of the two groups were evaluated by Montreal cognitive assessment scale（MoCA）,activity of daily living（ADL） and neuropsychiatric inventory（NPI）.The scores were compared between the groups before the treatment and after the treatment for 6 months respectively.Results Before treatment,there was no statistically significant difference in the MoCA,ADL,NPI scores between VCIND patients and VD patients in the two groups（P 〉0.05）.6 months after treatment,the scores of MoCA of the VCIND patients in Vinpocetine group were significantly higher than those of the VCIND patients in Tanshinone group,but the scores of ADL and NPI of the VCIND patients in Vinpocetine group were significantly lower than those of the VCIND patients in Tanshinone group（P〈0.05）.The scores of ADL of the VD patients in the Vinpocetine group were significantly lower than those of the VD patients in Tanshinone group（P〈0.05）.After treatment,there was no statistically significant difference in the incidence of adverse reactions between Tanshinone group and Vinpocetine group 〔6.6%（7 /106） vs.5.5%（6 /110）,P〉 0.05〕.Conclusion Both Vinpocetine and Tanshinone ⅡA are safe and effective in treatment of vascular cognitive impairment,but the clinical efficacy of vinpocetine is better than that of Tanshinone ⅡA.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第15期1787-1790,共4页
Chinese General Practice
关键词
丹参酮
长春西汀
认知障碍
痴呆
治疗结果
Tanshinone
Vinpocetine
Cognitive disorders
Dementia
Treatment outcome
