丁苯酞联合重复经颅磁刺激对脑梗死后轻度认知障碍的疗效观察

张淑红; 凌迎春; 罗方; 盛高扬

doi:10.16766/j.cnki.issn.1674-4152.003464

丁苯酞联合重复经颅磁刺激对脑梗死后轻度认知障碍的疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.003464

1.
龙游县人民医院神经内科，浙江衢州 324400
2.
绍兴市第七人民医院检验科，浙江绍兴 312000

基金项目:

浙江省医药卫生科技计划项目 2022KY1309

详细信息

通讯作者:
凌迎春，E-mail：s951269@163.com

中图分类号: R743.33 R749.13
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- 文章访问数: 199
- HTML全文浏览量: 86
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2024-01-03
- 网络出版日期: 2024-05-29

Observation on the therapeutic effect of combined butylphthalide and repeated transcranial magnetic stimulation on mild cognitive impairment after cerebral infarction

1.
Department of Neurology, Longyou People' s Hospital, Quzhou, Zhejiang 324400, China

摘要

摘要: 目的探讨丁苯酞联合重复经颅磁刺激治疗脑梗死后轻度认知障碍患者的有效性与安全性，为临床治疗提供借鉴。方法选取2020年2月—2023年1月龙游县人民医院神经内科收治的190例脑梗死后轻度认知障碍患者，采用随机数表法分为A组(95例)、B组(95例)。A组应用丁苯酞治疗，B组应用丁苯酞联合重复经颅磁刺激治疗。比较2组治疗效果、认知功能、脑血流指标、炎症反应指标以及不良反应发生情况。结果 B组治疗总有效率为90.53%(86/95)，高于A组的71.58%(68/95，P＜0.05)。治疗后，2组患者认知功能均有一定程度的改善，且B组患者蒙特利尔认知量表(MoCA)评分明显高于A组[(26.33±2.50)分vs. (24.21±2.84)分，P＜0.05]。2组患者治疗后血流搏动指数均降低、收缩期血流速度及平均血流速度均升高(P＜0.05)，且B组治疗后脑血流指标均优于A组(P＜0.05)。2组治疗后C反应蛋白、肿瘤坏死因子-α、白介素-1β均降低(P＜0.05)，且B组各指标均低于A组(P＜0.05)。2组患者治疗后不良反应发生率比较差异无统计学意义(P＞0.05)。结论丁苯酞联合重复经颅磁刺激治疗脑梗死后轻度认知障碍疗效显著，可改善患者的认知功能以及脑血流指标，减轻炎症反应，不良反应少，有效性与安全性兼备，可推行。
- 丁苯酞 /
- 重复经颅磁刺激 /
- 脑梗死 /
- 认知障碍 /
- 脑血流 /
- 炎症反应指标
Abstract: Objective This study aims to explore the efficacy and safety of combing butylphthalide with repetitive transcranial magnetic stimulation for treating mild cognitive impairment in patients following cerebral infarction, offering valuable insights for clinical treatment. Methods A total of 190 patients with mild cognitive impairment after cerebral infarction were randomly divided into either Group A (n=95) or Group B (n=95) at Longyou People' s Hospital from February 2020 to January 2023. Group A received butylphthalide treatment, while Group B received a combination of butylphthalide and repetitive transcranial magnetic stimulation. The study aimed to compare the treatment effects, cognitive function, cerebral blood flow indicators, inflammatory reactions indicators, and adverse reactions between the two groups. Results The total effective rate of treatment in Group B (90.53%, 86/95) was significantly higher than in Group A (71.58%, 68/95, P < 0.05). Both groups demonstrated improved cognitive function compared to before treatment, with Group B showing a significantly higher Montreal cognitive assessment (MoCA) score than Group A [(26.33±2.50) points vs. (24.21±2.84) points, P < 0.05]; After treatment, both groups exhibited decreased pulsatile index of blood flow in both groups of patients decreased, and the systolic and average blood flow velocities of blood flow and increased systolic and average blood flow velocities (P < 0.05). However, Group B showed better cerebral blood flow indicators compared to Group A (P < 0.05). Post-treatment C-reactive protein, tumor necrosis factor-α, and interleukin-1β decreased in both groups (P < 0.05), with all indicators in Group B being lower than in Group A (P < 0.05). There were no significant differences in adverse reactions between the two groups (P>0.05). Conclusion The combination of butylphthalide and repetitive transcranial magnetic stimulation demonstrates a significant therapeutic effect on mild cognitive impairment following cerebral infarction. It effectively improves cognitive function, enhances cerebral blood flow indicators, reduces inflammatory reactions, and exhibits minimal adverse reactions. This treatment approach is both effective and safe, warranting its promotion.
- Butylphthalide /
- Repetitive transcranial magnetic stimulation /
- Cerebral infarction /
- Cognitive impairment /
- Cerebral blood flow /
- Inflammatory response indicators

HTML全文

表 1 2组脑梗死后轻度认知障碍患者临床总有效率比较[例(%)]

Table 1. Comparison of clinical total effective rate in 2 between the two groups of patients with mild cognitive impairment after cerebral infarction[cases(%)]

组别	例数	基本控制	显著进步	进步	无变化	恶化	总有效
A组	95	31(32.63)	24(25.26)	13(13.68)	20(21.05)	7(7.37)	68(71.58)
B组	95	44(46.32)	26(27.37)	16(16.84)	6(6.31)	3(3.16)	86(90.53)
注：2组总有效率比较，χ²=11.104，P=0.001。

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表 2 2组脑梗死后轻度认知障碍患者治疗前后认知功能比较(x±s，分)

Table 2. Comparison of cognitive function in 2 between the two groups of patients with mild cognitive impairment after cerebral infarction before and after treatment(x±s, points)

组别	例数	治疗前	治疗后
A组	95	19.06±1.73	24.21±2.84^b
B组	95	19.17±1.62	26.33±2.50^b
统计量		0.452^a	4.463^c
P值		0.652	＜0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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表 3 2组脑梗死后轻度认知障碍患者治疗前后脑血流指标比较(x±s)

Table 3. Comparison of cerebral blood flow indexes in 2 between the two groups of patients with mild cognitive impairment after cerebral infarction before and after treatment(x±s)

组别	例数	血流搏动指数		收缩期血流速度(cm/s)		平均血流速度(cm/s)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	95	0.86±0.07	0.83±0.04^b	69.25±1.02	70.30±1.45^b	48.60±1.42	52.22±1.53^b
B组	95	0.87±0.06	0.79±0.03^b	69.23±1.04	73.08±1.53^b	48.58±1.44	54.36±1.61^b
统计量		1.057^a	5.266^c	0.134^a	7.892^c	0.096^a	6.309^c
P值		0.292	＜0.001	0.894	＜0.001	0.923	＜0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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表 4 2组脑梗死后轻度认知障碍患者治疗前后炎症反应指标比较(x±s)

Table 4. Comparison of inflammatory response indexes in 2 between the two groups of patients with mild cognitive impairment after cerebral infarction before and after treatment(x±s)

组别	例数	C反应蛋白(mg/L)		肿瘤坏死因子-α(pg/mL)		白介素-1β(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	95	10.65±2.35	6.76±1.18^b	35.76±3.53	21.76±2.57^b	28.50±2.44	20.36±2.06^b
B组	95	10.71±2.38	4.61±1.03^b	35.84±3.50	16.32±2.30^b	28.55±2.41	15.83±1.77^b
统计量		0.175^a	7.830^c	0.157^a	8.021^c	0.142^a	8.425^c
P值		0.861	＜0.001	0.876	＜0.001	0.887	＜0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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