丁苯酞治疗老年遗忘型轻度认知功能障碍患者的效果及安全性分析(1)
【摘要】 目的：研究老年遗忘型輕度认知功能障碍(amnestic mild cognitive impairment，aMCI)患者应用丁苯酞治疗的疗效及安全性。方法：入组61例笔者所在医院就诊的老年aMCI患者，随机分为丁苯酞治疗组(31例)和银杏叶片对照组(30例)，前者用丁苯酞口服治疗，后者用银杏叶片口服治疗，治疗3个月后，比较两组患者主观记忆改善情况，比较两组简明精神状态测试量表(MMSE)、听觉词语学习测试的延迟回忆(AVLT-DR)及日常生活能力量表(ADL)得分情况及不良事件发生情况。结果：丁苯酞治疗组有64.52%的主观记忆改善率，治疗后MMSE、ADL评分无明显改变(P>0.05)，但AVLT-DR评分明显升高(t=-4.23，P<0.05)，而银杏叶片对照组仅有16.67%的主观记忆改善率，治疗前后MMSE、AVLT-DR、ADL无明显改变(P>0.05)；在丁苯酞治疗组中有1例、银杏叶片对照组中有2例发生轻度胃部不适感，均自行恢复。结论：丁苯酞能有效改善老年aMCI患者记忆能力，安全性良好，具有临床推广价值。
【关键词】 丁苯酞； 遗忘型轻度认知功能障碍； 银杏叶片
doi：10.14033/j.cnki.cfmr.2018.23.008 文献标识码 B 文章编号 1674-6805(2018)23-00-03
【Abstract】 Objective：To analyze the efficacy and safety of Butylphthalide in elderly patients with amnestic mild cognitive impairment(aMCI).Method：61 elderly aMCI patients with age and education matched from our hospital were included in this study and randomly divided into tow groups.31 patients were included into Butylphthalide treatment group with a Butylphthalide oral therapy and 30 patients were included into Ginkgo Leaf Tablet control group with a Ginkgo Leaf Tablet oral therapy.After three months，the subjective memory improvement and scores of Mini-Mental State Examination(MMSE)，Delayed Recall of Auditory Verbal Learning Test(AVLT-DR) and Activity of Daily Living Scale(ADL) were compared with pre-treatment in each group.We also assessed the rate of adverse events during the treatment in both group.Result：After three months，the performances of patients in Butylphthalide treatment group were significantly improved in AVLT-DR(t=-4.23，P<0.05)，while not significantly changed in MMSE and ADL(P>0.05)，and 64.52% patients showed subjective memory improvement.But in Ginkgo Leaf Tablet control group，the scores of MMSE，AVLT-DR and ADL were all not significantly changed before and after therapy，and only 16.67% patients showed subjective memory improvement.Only one patient in Butylphthalide treatment group and two patients in Ginkgo Leaf Tablet control group had a mild stomach upset，but they all recovered spontaneously.Conclusion：Butylphthalide can effectively improve memory of elderly aMCI patients with a good safety，and is worth of clinical application.
【Key words】 Butylphthalide； Amnestic mild cognitive impairment； Ginkgo Leaf Tablet
First-author’s address：Suzhou Municipal Hospital，Suzhou 215000，China
全球老龄化趋势让认知障碍性疾病成为危害人类健康的严峻问题，一旦发生痴呆将造成患者生活质量的大幅降低，并最终导致死亡。故痴呆前的过渡阶段——轻度认知功能障碍(mild cognitive impairment，MCI)近年来被医学界广泛关注。遗忘性轻度认知功能障碍(aMCI)是MCI最常见的亚型，临床表现为早期的记忆障碍，伴或不伴其余认知域的损害，但不符合痴呆标准[1]。aMCI患者有高风险进展成老年性痴呆(Alzheimer Disease，AD)[2]，故应得到临床重视。而最新研究显示，丁苯酞能改善脑内微循环和能量代谢，可改善学习及记忆损害，且安全性良好[3]，故本研究运用丁苯酞治疗老年aMCI患者，探讨其疗效及安全性。, 百拇医药(常京豪 顾梅)
【关键词】 丁苯酞； 遗忘型轻度认知功能障碍； 银杏叶片
doi：10.14033/j.cnki.cfmr.2018.23.008 文献标识码 B 文章编号 1674-6805(2018)23-00-03
【Abstract】 Objective：To analyze the efficacy and safety of Butylphthalide in elderly patients with amnestic mild cognitive impairment(aMCI).Method：61 elderly aMCI patients with age and education matched from our hospital were included in this study and randomly divided into tow groups.31 patients were included into Butylphthalide treatment group with a Butylphthalide oral therapy and 30 patients were included into Ginkgo Leaf Tablet control group with a Ginkgo Leaf Tablet oral therapy.After three months，the subjective memory improvement and scores of Mini-Mental State Examination(MMSE)，Delayed Recall of Auditory Verbal Learning Test(AVLT-DR) and Activity of Daily Living Scale(ADL) were compared with pre-treatment in each group.We also assessed the rate of adverse events during the treatment in both group.Result：After three months，the performances of patients in Butylphthalide treatment group were significantly improved in AVLT-DR(t=-4.23，P<0.05)，while not significantly changed in MMSE and ADL(P>0.05)，and 64.52% patients showed subjective memory improvement.But in Ginkgo Leaf Tablet control group，the scores of MMSE，AVLT-DR and ADL were all not significantly changed before and after therapy，and only 16.67% patients showed subjective memory improvement.Only one patient in Butylphthalide treatment group and two patients in Ginkgo Leaf Tablet control group had a mild stomach upset，but they all recovered spontaneously.Conclusion：Butylphthalide can effectively improve memory of elderly aMCI patients with a good safety，and is worth of clinical application.
【Key words】 Butylphthalide； Amnestic mild cognitive impairment； Ginkgo Leaf Tablet
First-author’s address：Suzhou Municipal Hospital，Suzhou 215000，China
全球老龄化趋势让认知障碍性疾病成为危害人类健康的严峻问题，一旦发生痴呆将造成患者生活质量的大幅降低，并最终导致死亡。故痴呆前的过渡阶段——轻度认知功能障碍(mild cognitive impairment，MCI)近年来被医学界广泛关注。遗忘性轻度认知功能障碍(aMCI)是MCI最常见的亚型，临床表现为早期的记忆障碍，伴或不伴其余认知域的损害，但不符合痴呆标准[1]。aMCI患者有高风险进展成老年性痴呆(Alzheimer Disease，AD)[2]，故应得到临床重视。而最新研究显示，丁苯酞能改善脑内微循环和能量代谢，可改善学习及记忆损害，且安全性良好[3]，故本研究运用丁苯酞治疗老年aMCI患者，探讨其疗效及安全性。, 百拇医药(常京豪 顾梅)