目的 探讨复方活脑舒胶囊联合尼麦角林治疗老年血管性认知障碍的临床疗效。方法 回顾性分析2017年7月-2019年7月在郑州大学第五附属医院治疗的84例血管性认知障碍老年患者的临床资料,根据用药的差别分为对照组和治疗组,每组各42例。对照组口服尼麦角林片,10 mg/次,3次/d;治疗组在对照组基础上口服复方活脑舒胶囊,1.25 g/次,2次/d。两组患者均经8周治疗。观察两组患者临床疗效,比较治疗前后两组患者临床症状改善时间,MoCA、MMSE和ADL评分,及血清胰岛素样生长因子(IGF-1)、基质金属蛋白酶-9(MMP-9)、脂蛋白相关磷脂酶A2(Lp-PLA2)、视椎蛋白样蛋白1(VILIP-1)和同型半胱氨酸(Hcy)水平。结果 治疗后,治疗组总有效率明显高于对照组(97.62% vs 78.57%,P<0.05)。经治疗,治疗组表情淡漠、计算能力、少语、焦虑改善时间均明显短于对照组(P<0.05)。经治疗,两组相关量表评分明显升高(P<0.05),且以治疗组升高最为明显(P<0.05)。经治疗,两组患者血清IGF-1水平明显升高,而MMP-9、Lp-PLA2、VILIP-1和HCY水平明显降低(P<0.05),且治疗组血清细胞因子水平明显好于对照组(P<0.05)。结论 复方活脑舒胶囊联合尼麦角林片治疗血管性认知障碍老年患者不仅可促进其临床症状改善,还有利于细胞因子及认知功能改善。

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

河南省医学科技攻关计划项目（2018020259）