尼麦角林与茴拉西坦治疗血管性痴呆临床研究

目的：探讨尼麦角林（Nicergoline）与茴拉西坦（Aniracetam）联合治疗轻中度血管性痴呆的疗效。方法：选取符合美国精神障碍诊断与统计手册DSM—Ⅲ诊断标准的血管性痴呆患者86例。随机分为尼麦角林组29例（尼麦角林30mg，poqd）；茴拉西坦组28例（茴拉西坦每次200mg，pobid）；联合治疗组29例（尼麦角林30mg，pobid及茴拉西坦200mg，pobid）。疗程均为12周。以简易精神状态检查（MMSE）、韦克斯勒记忆量表（WMS）、临床综合调查表（CGI）和日常生活能力量表（ADL）为评价指标，评价3组患者的疗效。结果：经12周治疗干预后，联合治疗组MMSE、WMS、SI及ADL较治疗前明显改善，P〈0．01。尼麦角林组上述四项指标亦改善明显，P〈0．05。而茴拉西坦组仅MMSE和ADL评分较前改善，P〈0．05。联合治疗组与尼麦角林组和茴拉西坦组比较，上述指标改善更明显，P〈0．05。而尼麦角林组与茴拉西坦组比较，仅MMSE有统计学差异意义显著，余P〉0．05。3组均无明显药物相关的不良反应。结论：尼麦角林联合茴拉西坦能更好地改善血管性痴呆患者的认知功能，无不良反应。

Clinical Investigation of Efficacy and Safety of Nicergoline and Aniracetam in the Treatment of Vascular Dementia

Objective： To study the efficacy and safety of nicergoline and aniracetam in the treatment of vascular dementia patients with mild and moderate cognitive impairment. Method： All the 86 subjects meeting the DSM-criteria for vascular dementia were divided into three groups randomly： nicergoline group （n = 29, nicergoline 30 mg·d^-1 ）, aniracetam group （ n = 28, aniracetam 200 mg, twice a day） and combined treatment group （ n = 29, nicergoline 30 mg·d^-1 and aniracetam 200mg, twice a day）. The treatment course was 12 weeks. MMSE, WMS, CGI and ADL were used 0as assessing items. Result： After 12 weeks＇intervention, MMSE, WMS, SI and ADL in the combined treatment group significantly improved compared with its prior treatment, P 〈0.01, and the above four data obviously improved in the nicergoline group too, but only MMSE and ADL improved in the aniracetam group, P 〈 0.05. Compared with those in the nicergoline group and the aniracetam group, the above data improved significantly in the combined treatment group. But only MMSE improved in the nicergoline group, compared with those in the aniracetam group. No significant side-effects were observed in the 3 groups. Conclusion： Nicergoline combined with aniracetam should be a nice choice in improving cognitive functions in vascular dementia patients.