世界中医药

基金项目:上海市中西医结合科研专项计划资助项目（编号:2009ZXY003）;上海市中西医结合治疗脑梗死重点病种建设项目（编号:zxbz2012-20）;上海市浦东新区名中医及名中医工作室计划资助项目（编号:PDZYXK-3-2014008）;上海市浦东新区中医神经内科特色专科计划资助项目（编号：PDZYXK-1-2014004）;上海市浦东新区优秀青年医学人才培养项目（编号:PWZ-2010）;上海市浦东新区名中医继承人培养建设项目（编号:PDZYXK-6-2014038）;上海市浦东新区名中医继承人培养建设项目（编号:PDZYXK-6-2014019）

作者	单位
王厹东1,2，黄海军2，赵虹3，顾晓丽4，沈丽萍1，王萍1，顾竞1,2，陈雪莲1，沈利荣1，邬渊敏2	1 上海市浦东新区中医医院中西医结合脑病科,上海,201200 2 上海市浦东新区中医医院中西医结合神经电生理研究室,上海,201200 3 上海中医药大学附属岳阳中西医结合医院神经科,上海,200437 4 上海市静安中心医院影像科,上海,200040

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中文摘要:

目的:运用灯盏生脉胶囊治疗血管性认知功能障碍,以改良Rankin评分量表、汉密尔顿抑郁量表（HAMD）和简易智能量表（MMSE）,并以P300指标进行评估,探讨灯盏生脉胶囊治疗血管性认知功能障碍的机制。方法:选取2010年10月至2014年3月浦东新区中医医院神经内科收治的69例灯盏生脉胶囊治疗血管性认知功能障碍69例疗效,并进行改良Rankin评分量表、HAMD和MMSE评分,并运用不良反应量表（TESS）进行安全性评估。采用oddball刺激序列检测P300,靶刺激叠加200~500次,分析时间1 000 ms。结果:治疗结束后,2组改良Rankin评分（2.121±1.139和3.273±1.008）、HAMD评分（21.424±3.725和26.939±5.321）和MMSE评分（26.242±2.411和23.212±1.816）,2组差异均有统计学意义（P<0.001）。P300之潜伏期在观察组（338.111±17.159）较对照组（387.091±11.983）明显好转,差异有统计学意义（P<0.001）,P300之波幅在观察组（5.888±1.958）较对照组（3.358±0.928）明显好转,差异有统计学意义（P<0.001）。TESS评分显示治疗无明显不良反应,比较差异无统计学意义（P>0.05）。结论:灯盏生脉胶囊治疗血管性认知功能障碍安全有效,P300潜伏期和波幅可以评估灯盏生脉胶囊治疗血管性认知功能障碍抑郁和认知功能障碍的疗效,是一个较敏感而客观的指标。

English Summary:

To explore the mechanism of Deng Zhan Sheng Mai capsual treating vascular cognitive impairment(VCI), Modified Rankin Scale(mRS), Hamilton depression scale(HAMD), mini mental state examination(MMSE) as well as the indicator of P300 were used to evaluate the treatment. Methods:A total of 69 patients with Vascular Cognitive Impairment（VCI in neurology deepartment of Pudong New Area Hospital of Traditional Chinese Medicine from October 2010 to March 2014. All patients were assessed with Modified Rankin Scale(mRS), Hamilton depression scale(HAMD), and mini mental state examination(MMSE). And treatment emergent symptom scale (TESS) was adopted to evaluate the security. Oddball stimulus sequence P300 detection was taken, and superimposed target stimulation repeated for 200~500 times. The nanlysis time lasted for 1 000 ms. Results:After the treatment, two sets of data, mRS(2.121±1.139 and 3.273±1.008), HAMD(21.424±3.725 and 26.939±5.321) and MMSE(26.242±2.411and23.212±1.816), were significantly different(P<0.001). The incubtion period and amplitude of P300 in observation group improve markedly compaired with that of control group(P<0.001). Besides, there was no obvious adverees reaction in the treatment according to TESS, comparing the two groups, there was no statistically significant(P>0.05).Conclusion:The results suggest that the P300 can be the reliable evaluative means for vascular cognitive impairment and cognition disorder. In addition, DZSM is safe and effective in curing VCI.

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