蒋颖

[摘要] 目的 觀察丁苯酞软胶囊联合阿托伐他汀钙片治疗血管性痴呆（VD）患者的临床效果。 方法 收集2014年8月～2016年8月广西中医药大学第一附属医院收治的80例VD患者，采用随机化信封法将患者分为对照组（40例）和观察组（40例）。对照组给予口服丁苯酞软胶囊治疗，观察组在对照组治疗的基础上联合给予阿托伐他汀钙片治疗。每组患者均连续治疗2个月，观察并记录两组患者治疗后临床疗效，日常生活能力量表（ADL）和简易智能精神状态检查量表（MMSE）变化情况；比较两组患者治疗前后血脂水平及超氧化物歧化酶（SOD）活性水平，记录两组患者的不良反应。 结果 治疗后，观察组总有效率显著高于对照组，差异有统计学意义（P < 0.05）。治疗后，两组患者MMSE评分均高于治疗前，观察组MMSE评分显著高于对照组，差异有统计学意义（P < 0.05）；治疗后，两组患者ADL评分均低于治疗前，观察组ADL评分明显低于对照组，差异有统计学意义（P < 0.05）。与治疗前比较，两组患者治疗后胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C ）水平均有显著改善，观察组上述各血脂指标改善明显优于对照组，差异有统计学意义（P < 0.05）；治疗后，对照组患者高密度脂蛋白胆固醇（HDL-C）水平较治疗前无显著变化，差异无统计学意义（P > 0.05），观察组HDL-C水平高于治疗前，且观察组治疗后HDL-C水平显著高于对照组，差异有统计学意义（P < 0.05）。治疗后，两组患者SOD活性均高于治疗前，观察组SOD活性显著高于对照组，差异有统计学意义（P < 0.05）。治疗后，两组患者均未出现严重不良反应。 结论 丁苯酞软胶囊联合阿托伐他汀钙片临床疗效明显，能明显改善VD患者血脂水平，提高超氧化物歧化酶活性水平，保护脑神经细胞免受缺血损害，从而能有效改善VD患者的痴呆症状和精神状态，提高患者的生活质量。

[关键词] 血管性痴呆；丁苯酞软胶囊；阿托伐他汀钙片；认知功能

[中图分类号] R749.13 [文献标识码] A [文章编号] 1673-7210（2018）05（b）-0042-05

Clinical effects of Butylphthalide Soft Capsules combined with Atorvastatin Calcium Tablets in treatment of patients with vascular dementia

JIANG Ying

Cadre Ward of Geriatrics Department， the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine， Guangxi Zhuang Autonomous Region， Nanning 530000， China

[Abstract] Objective To observe the effect of Butylphthalide Soft Capsules combined with Atorvastatin Calcium tablets in treatment of patients with vascular dementia. Methods From August 2014 to August 2016， in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine， 80 vascular dementia （VD） patient were selected and divided into observation group （40 cases） and control group （40 cases） according to randomization envelope method. The control group was treated with oral Butylphthalide Soft Capsules Tablets therapy，and the observation group were treated with Atorvastatin Calcium Tablets on the basis of the control group. The patients in the each group were treated for 2 months，the clinical curative effect of two groups after treatment were observed and recorded. The related scale of mini-mental state examination （MMSE） and activities of daily living （ADL） were compared between the two groups of observed before and after treatment. Blood lipid levels and superoxide dismutase （SOD） activity levels were compared the two groups before and after treatment. Results After the treatment， the total effective rate of the observation group was significantly higher than the control group， the differences were statistically significant （P < 0.05）. After the treatment， the scores of MMSE in two groups were higher than before treatment， and the scores of MMSE in the observation group were significantly higher than the control group， the differences were statistically significant （P < 0.05）； the ADL scores in two groups were lower than before treatment， the ADL scores in the observation group was significantly lower than the control group， the differences were statistically significant （P < 0.05）. Compared with before the treatment， the TC， TG and LDL-C levels after the treatment significantly improved， and these in the observation group was significantly better than the control group， the differences were statistically significant （P < 0.05）； compared with before the treatment， there was no significant difference of HDL-C levels in the control group after the treatment， the difference was not statistically significant （P > 0.05）， the HDL-C level in the observation group after the treatment was significantly higher， and this was significantly higher than the control group， the differences were statistically significant （P < 0.05）. After the treatment， the activity of SOD in the two groups was higher than that before the treatment， and the activity of SOD in observation group was significantly higher than in the control group， the differences were statistically significant （P < 0.05）. There was no obvious adverse reactions observed after treatment in two groups. Conclusion Butylphthalide Soft Capsules combined with Atorvastatin Calcium Tablets has significant clinica effect in VD patients，which can significantly improve the blood lipid level， increase the activity of SOD， and effectively improve VD symptoms in patients with dementia and mental state， improve the quality of life of patients.

[Key words] Vascular dementia； Butylphthalide Soft Capsules； Atorvastatin Calcium Tablets； Cognitive function

血管性痴呆（vascular dementia，VD）是一组由脑血管疾病导致的智能及认知功能障碍综合征，是老年性痴呆的常见病因之一。随着人口老龄化日益严重，老年VD疾病的绝对及相对发病率均明显升高[1]。目前，临床上尚无较理想的特效药物用于治疗VD，而国内外研究显示，在不增加药物不良反应风险前提下，联合用药可通过多靶点、多途径、多环节综合治疗VD的临床疗效显著优于单一用药[2-3]。他汀类药物能有效阻断β-淀粉样蛋白形成，降低载脂蛋白E分泌水平，进而降低痴呆的发生率[4]。丁苯酞是一种多靶点作用的抗脑血管缺血药物，具有对缺血性神经元损伤的保护作用[5]。……