目的 探討?zhàn)B血清腦顆粒聯(lián)合奧拉西坦膠囊治療血管性認(rèn)知障礙的臨床療效。方法 選取華北石油管理局總醫(yī)院2014年1月-2015年10月就診的血管性認(rèn)知障礙患者76例,隨機數(shù)字表格法將患者分為對照組和治療組,每組各38例。對照組患者口服奧拉西坦膠囊0.8 g/次,3次/d。治療組在對照組治療基礎(chǔ)上口服養(yǎng)血清腦顆粒4 g/次,3次/d。兩組患者均連續(xù)治療3個月。觀察兩組的臨床療效,并比較兩組治療前后認(rèn)知功能、局部腦血流量、睡眠障礙和事件相關(guān)電位P300。結(jié)果 治療后,對照組和治療組總有效率分別為68.4%、94.7%,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者簡易精神智能量表(MMSE)評分明顯上升,血管性癡呆評估量表-認(rèn)知分量表(VaDAS-cog)評分明顯下降,同組治療前后比較差異具有統(tǒng)計學(xué)意義(P<0.05);治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組匹茲堡睡眠質(zhì)量指數(shù)量表(PSQI)評分明顯下降,同組治療前后差異具有統(tǒng)計學(xué)意義(P<0.05);治療組局部腦血流量、PSQI評分的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者事件相關(guān)單位P300潛伏期顯著下降,波幅明顯上升,同組治療前后比較差異具有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的幅度明顯大于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 養(yǎng)血清腦顆粒聯(lián)合奧拉西坦膠囊治療血管性認(rèn)知障礙具有較好的臨床療效,能夠改善患者認(rèn)知功能障礙,促進局部腦血流量增多,改善睡眠障礙和相關(guān)事件電位P300,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Trastuzumab Injection combined with Docetaxel Injection in treatment of Her-2 positive breast cancer. Methods Patients (86 cases) with breast cancer in Puai Hospital of Central Hospital of Huangshi from February 2011 to February 2015 were selected according to study subjects, were divided into control group and treatment group, and each group had 43 cases. Patients in the control group were iv administered with Docetaxel Injection 75 mg/m², dripped off within 1 h, repeated administration with interval of 21 d, accounted to four times. Patients in the treatment group were iv administered with Trastuzumab Injection on the basis of the control group, diluted with normal saline into 250 mL. Its first dosage was 4 mg/kg, dripped off within 90 min, then maintained at 2 mg/kg, once weekly. After treatment, the objective effective rate and control rate of disease were evaluated, and expression of Her-2, levels of apoptosis associated factors, and incidence of adverse reactions were compared. Results After treatment, the objective effective rate and control rate of disease in the control and treatment groups were 60.5%, 81.4%, and 70.0%, 88.4%, respectively, and there was difference between two groups (P < 0.05). After treatment, the proportion of Her-2 (++), (+++) expressions and levels of Caspase-3, DcR3, and COX-2 in the two groups were significantly decreased, and the differences were statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The main adverse reactions in two groups were gastrointestinal reactions, skin rash, white blood cell reduction, fatigue, and cardiac toxicity, but there were no significant differences between two groups. Conclusion Trastuzumab Injection combined with Docetaxel Injection has clinical curative effect in treatment of Her-2 positive breast cancer, can effectively weaken the expression of HER-2, reduce the levels of apoptosis related factors, decrease the incidence of adverse reactions, which is of great clinical application value.