王东枝

[摘要] 目的 探究丁苯酞联合奥拉西坦治疗轻度血管性认知功能障碍的有效性和安全性。 方法 选取2013年11月～2015年11月河北省衡水市第二人民医院收治的106例轻度血管性认知功能障碍患者为研究对象，采用随机数字表法将其分为对照组和研究组，每组各53例。给予对照组奥拉西坦，在对照组的基础上研究组加用丁苯酞。比较两组患者的临床疗效、治疗前后认知功能评分、日常生活能力评分，以及不良反应发生率。 结果 治疗后两组患者蒙特利尔认知评估量表（MoCA）评分中延迟回忆、注意力、视空间与执行力、定向力、抽象能力、语言能力、命名能力以及总分均显著升高（P < 0.05），研究组显著高于对照组（P < 0.05）；治疗后两组简易精神状态评价量表（MMSE）和日常生活能力量表（ADL）评分均显著升高（P < 0.01），研究组ADL评分显著高于对照组（P < 0.01），两组MMSE评分比较差异无统计学意义（P > 0.05）；治疗后研究组总有效率显著高于对照组（P < 0.05），但不良反应发生率差异无统计学意义（P > 0.05）。 结论 丁苯酞联合奥拉西坦可显著改善轻度血管性认知功能障碍患者的认知功能，提高患者日常生活能力，且不良反应少，具有推广价值。

[关键词] 血管性认知障碍；丁苯酞；奥拉西坦；认知功能

[中图分类号] R749.13 [文献标识码] A [文章编号] 1674-4721（2016）10（b）-0052-04

[Abstract] Objective To discuss the effectiveness and safety of Butylphthalide combined with Oxiracetam in the treatment of mild vascular cognitive impairment. Methods One hundred and six patients with mild vascular cognitive impairment in the Second Peoples Hospital of Hengshui City from November 2013 to November 2015 were selected as the research subjects， who were divided into control group and study group by a random digital table， with 53 cases in each group. The control group was given Oxiracetam， while the study group was given Butylphthalide based on the control group. The clinical therapeutic effect， cognitive function scores before and after treatment and daily life ability scores were compared between the two groups， as well as the incidence rates of adverse reactions. Results The scores of Montreal cognitive assessment （MoCA） such as delaying recall， attention， visual spatial and executive ability， orientation ability， abstract ability， language ability， naming ability and total scores in the two groups after treatment were significantly increased （P < 0.05）， which in the study group were significantly higher than those in the control group （P < 0.05）. The mini mental state assessment （MMSE） and ability of daily living （ADL） scores in the two groups after treatment were significantly increased （P < 0.01）， between which the ADL score in the study group was significantly higher than that in the control group （P < 0.01）， while the difference in the scores of MMSE between the two groups was not statistically significant （P > 0.05）. The total effective rate in the study group after treatment was significantly higher than that in the control group （P < 0.05）， but the difference in the incidence rate of adverse reactions was not statistically significant （P > 0.05）. Conclusion Butylphthalide combined with Oxiracetam can significantly improve the cognitive function of patients with mild vascular cognitive impairment and increase the daily life abilities， with less adverse reactions， which has value of promotion.

[Key words] Vascular cognitive impairment； Butylphthalide； Oxiracetam； Cognitive function

血管性认知功能障碍是指由高血压、糖尿病等脑血管病危险因素以及明显或不明显脑血管病引起的认知损害综合征，即由血管因素导致的不同程度的认知障碍。血管性认知功能障碍患者语言、视觉空间技能、情感、认知等均存在一定损伤，若不进行及时有效的治疗，严重影响患者的生活质量[1]。目前，临床上对于该病主要采用丁苯酞或奥拉西坦治疗，但资料显示[2-3]，单纯采用上述两种药物治疗，治疗时间长，患者恢复慢，临床疗效并不理想。……