目的 探讨养血清脑颗粒联合奥拉西坦胶囊治疗血管性认知障碍的临床疗效。方法 选取华北石油管理局总医院2014年1月-2015年10月就诊的血管性认知障碍患者76例,随机数字表格法将患者分为对照组和治疗组,每组各38例。对照组患者口服奥拉西坦胶囊0.8 g/次,3次/d。治疗组在对照组治疗基础上口服养血清脑颗粒4 g/次,3次/d。两组患者均连续治疗3个月。观察两组的临床疗效,并比较两组治疗前后认知功能、局部脑血流量、睡眠障碍和事件相关电位P300。结果 治疗后,对照组和治疗组总有效率分别为68.4%、94.7%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者简易精神智能量表(MMSE)评分明显上升,血管性痴呆评估量表-认知分量表(VaDAS-cog)评分明显下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组匹兹堡睡眠质量指数量表(PSQI)评分明显下降,同组治疗前后差异具有统计学意义(P<0.05);治疗组局部脑血流量、PSQI评分的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者事件相关单位P300潜伏期显著下降,波幅明显上升,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些观察指标的幅度明显大于对照组,两组比较差异有统计学意义(P<0.05)。结论 养血清脑颗粒联合奥拉西坦胶囊治疗血管性认知障碍具有较好的临床疗效,能够改善患者认知功能障碍,促进局部脑血流量增多,改善睡眠障碍和相关事件电位P300,具有一定的临床推广应用价值。

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.