【摘要】 目的:甲磺酸双氢麦角碱是经典的治疗痴呆的西药,首灵健脑胶囊是以制首乌为主药的纯中药制剂,对比两药对老年期痴呆患者智力状态及血脂和血液流变学指标的影响。方法:选择2003-04/2004-10湛江市第二中医医院收治的老年期痴呆患者50例,按随机数字表分为2组:①首灵健脑胶囊组30例,口服首灵健脑胶囊,为医院协定处方(由制首乌、赤灵芝、参三七、广郁金等组成,每粒0.3g,含生药3g),3粒/次,3次/d。②对照组20例,给予甲磺酸双氢麦角碱片,1mg/次,3次/d。两组均连续治疗2个月,治疗前后应用简易智力状态量表(共30项,每项回答正确得1分,总分30分,文盲17分,受教育年限≤6年20分,受教育年限≥7年24分为痴呆)和长谷川痴呆量表(共11项,满分32.5分,<21.5分为可疑痴呆)评估智力障碍程度;采用中医症状积分量表(共8项,满分40分,每项5分,1分为症状偶尔出现,5分为症状持续存在,患者主动叙述)评估中医症候;同时采血测定血脂和血液流变学各指标。结果:按意向处理分析,50例患者均进入结果分析。①简易智力状态量表评分:治疗后首灵健脑胶囊组评分有优于对照组的趋势,但无统计学差异(28.01±2.56,25.67±3.29,P>0.05),均较治疗前升高(P<0.05)。②长谷川痴呆量表评分:治疗后首灵健脑胶囊组与对照组比较无差异(26.50±1.10,25.00±1.38,P>0.05),均较治疗前升高(P<0.01)。③中医症状积分量表得分:首灵健脑胶囊组除反应迟钝和语言不利2项外,其他6项得分均较治疗前显著降低(P<0.01),对照组只有失眠健忘和胸闷肢麻2项得分较治疗前显著降低(P<0.01),其他6项与治疗前比无差异(P>0.05)。④血脂和血液流变学测定结果:首灵健脑胶囊组治疗后三酰甘油、低密度脂蛋白胆固醇、全血黏度低切、血浆黏度和红细胞压积均较治疗前显著降低(P<0.05),而对照组除全血黏度低切降低外,其他指标与治疗前比无差异(P>0.05)。结论:首灵健脑胶囊具有益气补肾填精、活血化瘀开窍的功能,能有效降低血脂,改善血液流变性,能明显改善老年期痴呆患者的认知功能和中医症状,促进患者智能恢复,疗效优于甲磺酸双氢麦角碱片。更多还原

【Abstract】 AIM: Co-dergocrine mesyiate tablet is a typical western medicine for the treatment of dementia, and Shouling Jiannao capsule is a pure agent of Chinese herb taking fleece-flower root as the ingredient. This paper compares the effects of these two medicine on the mental status and the indexes of blood lipid and hemorheology in elderly patients with dementia. METHODS:Fifty elderly patients with dementia, who were treated in Zhanjiang Second Hospital of Traditional Chinese Medicine between April 2003 and October 2004, were divided into two groups according to the method of random number table: ① Shouling Jiannao capsule group (n=30): The patients were treated with the hospital set prescription of Shouling Jiannao capsule (consisted of fleece-flower root, red mythic fungus, shensanqi, guangyujin, 0.3 g for each capsule, containing 3 g crude drug), 3 capsules for each time, 3 times a day; ② Control group (n=20): The patients were treated with co-dergocrine mesyiate tablets, 1 mg for each time, 3 times a day. All the patients were treated for 2 months. Before and after treatment, the severity of dysnoesia was assessed with mini-mental state examination (totally 30 items, right answer for each item was 1 point, total score was 30 points, 17 points for illiterate, 20 points for educational background of ≤ 6 years and 24 points for educational background of ≥ 7 years were taken as dementia) and Hasegawa dementia scale (including 11 items, the total score was 32.5 points, < 21.5 points was suspected as dementia); The traditional Chinese medicine symptoms were evaluated with the traditional Chinese medicine symptom integral scale (consisted of 8 items, total score was 40 points, 5 points for each item: 1 point as occasional appearance of symptoms, 5 points as continuous existence of symptoms; the patients stated actively); Blood samples were drawn to detected the indexes of blood lipid and hemorheology. RESULTS: According to intention-to-treat analysis, all the 50 patients were involved in the analysis of results. ① Score of mini-mental state examination: The score after treatment in the Shouling Jiannao capsule group was superior to that in the control group but insignificantly (28.01±2.56, 25.67±3.29, P > 0.05), it was increased as compared with that before treatment (P < 0.05). ② Score of Hasegawa dementia scale: The score after treatment was not different between the Shouling Jiannao capsule group and the control group (26.50±1.10, 25.00±1.38, P > 0.05), both were increased as compared with those before treatment (P < 0.01). ③ Score of traditional Chinese medicine symptom integral scale: In the Shouling Jiannao capsule group, except dullness and language disorder, the scores of the other 6 items after treatment were significantly decreased as compared with those before treatment (P < 0.01); Only the scores of insomnia and amnesia, chest distress and limb numbness in the control group were significantly decreased as compared with those before treatment (P < 0.01), and there were no changes in the other 6 items (P > 0.05). ④ Detection of blood lipid and hemorheology: In the Shouling Jiannao capsule group, triglyceride, low density lipoprotein cholesterol, whole blood low shearing viscosity, plasma viscosity and haematocrit after treatment were all significantly decreased as compared with those before treatment (P < 0.05); In the control group, except whole blood low shearing viscosity, all the other indexes had no differences as compared with those before treatment (P > 0.05). CONCLUSION:Shouling Jiannao capsule has the functions of supplementing kidney and essence, activating blood and eliminating stasis, it can effectively decrease blood lipid, ameliorate hemorheology; It also can ameliorate the cognitive function and traditional Chinese medicine symptoms of elderly patients with dementia, and accelerate the intellectual recovery of the patients, its curative effect is superior to that of co-dergocrine mesyiate tablet.更多还原