目的 探討復(fù)方活腦舒膠囊聯(lián)合尼麥角林治療老年血管性認(rèn)知障礙的臨床療效。方法 回顧性分析2017年7月-2019年7月在鄭州大學(xué)第五附屬醫(yī)院治療的84例血管性認(rèn)知障礙老年患者的臨床資料,根據(jù)用藥的差別分為對(duì)照組和治療組,每組各42例。對(duì)照組口服尼麥角林片,10 mg/次,3次/d;治療組在對(duì)照組基礎(chǔ)上口服復(fù)方活腦舒膠囊,1.25 g/次,2次/d。兩組患者均經(jīng)8周治療。觀察兩組患者臨床療效,比較治療前后兩組患者臨床癥狀改善時(shí)間,MoCA、MMSE和ADL評(píng)分,及血清胰島素樣生長因子(IGF-1)、基質(zhì)金屬蛋白酶-9(MMP-9)、脂蛋白相關(guān)磷脂酶A2(Lp-PLA2)、視椎蛋白樣蛋白1(VILIP-1)和同型半胱氨酸(Hcy)水平。結(jié)果 治療后,治療組總有效率明顯高于對(duì)照組(97.62% vs 78.57%,P<0.05)。經(jīng)治療,治療組表情淡漠、計(jì)算能力、少語、焦慮改善時(shí)間均明顯短于對(duì)照組(P<0.05)。經(jīng)治療,兩組相關(guān)量表評(píng)分明顯升高(P<0.05),且以治療組升高最為明顯(P<0.05)。經(jīng)治療,兩組患者血清IGF-1水平明顯升高,而MMP-9、Lp-PLA2、VILIP-1和HCY水平明顯降低(P<0.05),且治療組血清細(xì)胞因子水平明顯好于對(duì)照組(P<0.05)。結(jié)論 復(fù)方活腦舒膠囊聯(lián)合尼麥角林片治療血管性認(rèn)知障礙老年患者不僅可促進(jìn)其臨床癥狀改善,還有利于細(xì)胞因子及認(rèn)知功能改善。

Objective To explore the efficacy of Compound Huonaoshu Capsules combined with nimergoline in treatment of senile vascular cognitive impairment. Methods The clinical data of 84 elderly patients with vascular cognitive impairment treated in the Fifth Affiliated Hospital of Zhengzhou University from July 2017 to July 2019 were analyzed retrospectively and divided into control and treatment group based on different treatments, and each group had 59 cases. Patients in the control group were po administered with Compound Huonaoshu Capsules, 10 mg/time, three times daily. Patients in the treatment group were po administered with Nicergoline Tablets on the basis of the control group, 1.25 g/time, twice daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the scores of MoCA, MMSE, and ADL, and the levels of serum cytokine IGF-1, MMP-9, Lp-PLA2, VILIP-1, and Hcy in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.62% vs 78.57%, P < 0.05). After treatment, expression indifference, calculation ability, verbal deficiency and anxiety improvement time in the treatment group was significantly shorter than the control group (P < 0.05). After treatment, the scores of the related scale were significantly increased in two groups (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the level of serum IGF-1 in two groups were significantly increased, while the levels of MMP-9, Lp-PLA2, VILIP-1, and Hcy were significantly decreased (P < 0.05), and the level of serum cytokines in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion Compound Huonaoshu Capsules combined with nimergoline in treatment of senile vascular cognitive impairment can not only promote the improvement of clinical symptoms, but also benefit the improvement of cytokines and cognitive function.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（2018020259）