Tiaobu Xinshen Recipe (调补心肾方) Improved Mild Cognitive Impairment of Alzheimer's Disease Patients with Xin (Heart) and Shen (Kidney) Deficiency

Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer's disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.     

双侧丘脑底核脑深部电刺激治疗中晚期帕金森病的疗效

目的 研究双侧丘脑底核(STN)脑深部电刺激(DBS)对中晚期帕金森病(PD)患者的疗效.方法 对2006年8月至2010年1月在中山大学附属第一医院接受双侧STN DBS治疗的中晚期PD患者于术前、术后分别应用统一帕金森病评分量表(UPDRS)、Hoehn&Yahr(H&Y)分级、帕金森病生活质量问卷(PDQ-39)、简易智能状态检查(MMSE)、帕金森病睡眠评估量表中文版(PDSS-CV)、匹兹堡睡眠质量指数(PSQI)及汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)等评价其临床情况;同时记录各时间点抗PD药物的剂量及DBS相关参数.结果 10例患者术后随访满1年,开机未服药及开机服药状态与术前未服药状态相比UPDRS-Ⅲ运动评分、震颤、强直、迟缓及中轴症状得分均显著降低,其中以震颤改善率最高(52.1%与77.7%),与术前服药状态相比差异无统计学意义.觉醒状态"关"期时间由术前6.3 h/d缩短至1.8 h/d(P=0.008),术后H&Y分级及PDQ-39降低,差异均有统计学意义.非运动症状评分无明显变化.术后1年抗PD药物较术前显著减少49.2%.结论 双侧STN DBS术对中晚期PD患者的运动症状疗效肯定,能有效减少抗帕金森病药物用量,提高患者生活质量.手术具有安全性高、并发症较少且可调控的优点.

Abstract：

Objective To study the effects of deep brain stimulation (DBS) of bilateral subthalamic nucleus (STN) on the motor and non-motor symptoms in moderate or advanced Parkinson's disease (PD) patients. Methods From August 2006 to January 2010, 21 consecutive PD patients with refractory motor fluctuations or dyskinesia underwent operations at our hospital. All patients were evaluated by unified Parkinson's disease rating scale (UPDRS), Hoehn & Yahr (H&Y) stage, Parkinson's disease questionnaire (PDQ-39), mini mental state examination (MMSE), Parkinson's disease sleep scale-Chinese vision( PDSS-CV), Pittsburgh sleep quality index ( PSQI), Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA). And the daily dosage of dopaminergic agents was recorded at 1week pre-operation and 3, 6 and 12 months post-operation. Results Ten patients finished a 12-month follow-up. Their motor functions showed significant improvement. And the scores of UPDRS-motor, tremor,rigidity, bradykinesia and axial symptoms reduced significantly in the on-stimulation-off-medication condition and the on-stimulation-on-medication condition vs the on-medication condition pre-operation. And the improvement of tremor was the most pronounced ( 52. 1% and 77.7% respectively ) . The H&Y stage decreased significantly from 3.2 ± 0. 7 to 2. 5 ± 0. 4 post-operation. The activities of daily living improved while PDQ-39 declined significantly from 56 ±9 pre-operation to 32 ± 13 at 12 months follow-up. The score changes of MMSE, PDSS-CV, PSQI, HAMA and HAMD were statistically insignificant. The levo-dopa equivalent dose of 1-year post-operation decreased significantly by 49.2% versus that of pre-operation ( P ＜0.05). Conclusion Bilateral STN-DBS can significant ameliorate the motor symptoms of moderate or advanced PD patients, reduce the dosage of anti-PD medications and improve the quality of life. This procedure has the advantages of a greater safety, minor side effects and an easy controllability.     

COGNITIVE AND EMOTIONAL IMPAIRMENT IN OBSTRUCTIVE SLEEP APNEA SYNDROME

Objective To evaluate the emotional and cognitive status in patients with obstructive sleep apnea syndrome (OSAS),using neuropsychological tests and evoked-related potential (P3).Methods Sixteen patients diagnosed of OSAS were tested by Hamilton rating scale for anxiety (HRSA) and Hamilton rating scale for depression (HRSD). Other three groups, OSAS patient group (n = 21), snoring group (n = 21), and control group (n = 21), were administered polysomnography (PSG), auditory evoked event-related potential (P3), and clinic memory test. The results were analyzed using general linear model (GLM) analysis and Post Hoc test.Results Twelve OSAS patients' scores of HRSA and HRSD were beyond the normal range, 26.42 ± 4.48 and 22.08 ±3.97 respectively. The auditory P3 latency in OSAS group was 363.1 ± 22.9 ms (Fz), 368.57 ± 28.03 ms (Cz), in snoring group 336.57 ± 31.08 ms (Fz), 339.81 ± 31.76 ms (Cz), in control group 340.8 ± 28.7 ms (Fz), 338.29 ± 29.21 ms (Cz).There were significant differences between OSAS group and snoring group, as well as control group (P ＜ 0.05). No significant difference was seen between snoring group and control group. No significant difference was noted in P3 amplitude among three groups. Memory quotient (MQ) reduced in snoring group compared with control group.Conclusions Emotional disturbances are common clinical features in OSAS patients. Abnormal auditory P3 latency indicates the cognitive dysfunction in OSAS patients. Nocturnal hypoxaemia may play an important role on it. Snorers should be monitored because of the tendency to develop cognitive impairment.     

Effect of Ligustrazine on Activity Changes of Angiotensin Ⅱ in Plasma and Cerebrospinal Fluid in Patients with Vascular Dementia

Objective: To study the relationship between the activity changes of angiotensin II (Ang II ) in plasma, cerebrospinal fluid (CSF) and the pathophysiology of vascular dementia (VD) on the one hand and the therapeutic effects of ligustrazine (LIG) on VD and its mechanisms on the other hand. Methods: Case grouping: VD group with 50 cases (26 VD patients treated with LIG and 24 with Ginaton) ; cerebral infarction (CI) group with 62 cases (routine therapy was given) and control group (without organic disease in central nervous system) with 26 cases. Investigation method ? To test cognitive function by Mini-Mental State Examination (MMSE), Functional Activities Questionnaire (FAQ), Hachinski Ischemic Scale (HIS) and P300 peak latency (P300PL) . To measure the concentration of AngII by radioimmunoassay (RIA) technology. Results: As compared with CI recovery phase or with control group, AngII levels in CSF were markedly increased in VD group(P<0. 01), MMSE scores was significantly lowered (P<0. 01), P300PL was     

Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function,Depression,and Anxiety:A Multicenter,Randomized,Controlled Trial

Objective:To compare the clinical effects of interactive dynamic scalp acupuncture(IDSA),simple combination therapy(SCT),and traditional scalp acupuncture(TSA)on cognitive function,depression and anxiety in patients with post-stroke cognitive impairment.Methods:A total of 660 patients with post-stroke cognitive impairment who were admitted to 3 hospitals in Shenzhen City between May 2017 and May 2020 were recruited and randomly assigned to the IDSA(218 cases),SCT(222 cases)and TSA groups(220 cases)according to a random number table.All the patients received conventional drug therapy for cerebral stroke and exercise rehabilitation training.Scalp acupuncture and computer-based cognitive training(CBCT)were performed simultaneously in the IDSA group,but separately in the morning and in the afternoon in the SCT group.The patients in the TSA group underwent scalp acupuncture only.The course of treatment was 8 weeks.Before treatment(M0),1(M1)and 2 months(M2)after treatment,as well as follow-up at 1(M3)and 2 months(M4),the cognitive function of patients was assessed using the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment Scale(MoCA)Scales;depression,anxiety,sleep quality,and self-care ability of patients were assessed using Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Rating Scale(HAMA),Pittsburgh Sleep Quality Index(PSQI),and Modified Barthel Index(MBI),respectively.During this trial,all adverse events(AEs)were accurately recorded.Results:There were no significant differences in the MMSE,MoCA,HAMD,HAMA,PSQI,and MBI scores among the 3 groups at M0(all P>0.05).In the IDSA group,the MMSE,MoCA and MBI scores from M2 to M4 were significantly higher than those in the SCT and TSA groups,while the HAMD,HAMA and PSQI scores were significantly reduced(all P<0.01).The changes of all above scores(M2–M0,M4–M0)were significantly superior to those in the SCT and TSA groups(all P<0.01,except M4–M0 of HAMD).At M2,the severity of MMSE,HAMD,HAMA,PSQI and MBI in the IDSA group was significantly lower than that in the SCT and TSA groups(all P<0.01).There was no serious AE during this trial.Conclusions:IDSA can not only significantly improve cognitive function,but also reduce depression,anxiety,which finally improves the patient's self-care ability.The effect of IDSA was significantly better than SCT and TSA。     

Therapeutic Effect of Jinlongshe Granule(金龙蛇颗粒) on Quality of Life of Stage IV Gastric Cancer Patients Using EORTC QLQ-C30:A Double-Blind Placebo-Controlled Clinical Trial

Objective:To evaluate the impact of Jinlongshe Granule(金龙蛇颗粒,JLSG)on quality of life(QOL)of stageⅣgastric cancer patients.Methods:This randomized,double-blind and placebo-controlled clinical trial included 50 patients with advanced gastric cancer.They were equally randomized into a JLSG group and a placebo group.Patients in both groups received routine Chinese herbal decoctions according to Chinese medicine(CM)treatment based on syndrome differentiation.Patients in JLSG group received additional JLSG,and those in the placebo group received an additional placebo.In the JLSG group,19 patients who completed the study were used for analysis.In the placebo group,finally the data of 20 patients who completed the study were used for analysis.The treatment course was at least 3 months,and the follow-up duration was at least 6 months in5 interviews.Repeated measurements of the subscale items and individual items in European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30(EORTC QLQ-C30)obtained at the 5interviews were compared using different patient groups,changes over time and changes within one group over time independently to observe the tendency of changes in the scores,Results:Using time as the variant,there was significant difference in 4 functional scales(physical,role,ernotionai and social,P0.05),3 symptom scales(fatigue,nausea and vomiting and pain,P0.05)and a global health status/QOL scale(P0.05)and 6 single symptoms dyspnoea(P0.05),insomnia(P0.05),appetite loss(P0.05),constipation(P0.05),diarrhea(P0.05)and financial difficulties(P0.05).There was also significant difference in these items between the two groups when the placebo group and group over time were used as variants(P0.05 or P0.01).Conclusion:Additional use of JLSG on the basis of routine CM treatment could improve the somatic function,role function,emotional function,social function,cognitive function and general QOL of patients with advanced gastric cancer,and relieve the symptoms of fatigue,nausea and vomiting,pain,loss of appetite and constipation.     

美金刚治疗帕金森病的临床疗效观察

目的:观察美金刚改善帕金森病患者认知及运动障碍的疗效及安全性。方法:将98例帕金森病患者随机分为三组,对照组常规治疗31例;治疗组1常规治疗+美金刚10mg/d 20例;治疗组2常规治疗+美金刚20mg/d 34例。于4、12、24、36周进行MMSE、UPDRS-Ⅲ及Webster评分的疗效评估。结果:在MMSE评分中,治疗组1在12周后、治疗组2在4周后较治疗前有明显改善(P<0.05),在UPDRS-Ⅲ和Webster评分中,治疗组1在24周后、治疗组2在12周后较治疗前有明显改善(P<0.05);且两组上述评分显著优于对照组(P<0.05)。结论:美金刚能有效改善帕金森病患者认知和运动障碍,延缓病情进展;且用药安全,耐受性好。     

美金刚联合辅酶Q10治疗帕金森病的临床疗效观察

目的:观察美金刚联合辅酶Q10治疗帕金森病的临床疗效及安全性。方法:将110例帕金森病患者按照随机数字表分为四组,分别为对照组:常规治疗31例;治疗1组:常规治疗+美金刚(20mg/d)34例;治疗2组:常规治疗+辅酶Q10(1200mg/d)21例;治疗3组:常规治疗+美金刚(20mg/d)+辅酶Q10(1200mg/d)24例。并于4、12、24、36周进行疗效评估。主要评估指标包括统一帕金森病评分量表第三部分运动评分(UPDRS-Ⅲ)及帕金森病的病情评估量表Webster评分。结果:治疗3组在4周后患者量表评分UPDRS-Ⅲ和Webster评分较治疗前UPDRS-Ⅲ和Webster评分均有明显改善(P相似文献   

Clinical observation on effect of scalp electroacupuncture for mild cognitive impairment

OBJECTIVE: To evaluate the therapeutic effect of scalp electroacupuncture for mild cognitive impairment (MCI) in the early stage. METHODS: Two hundred and thirty three MCI patients were randomly divided into three groups: the drug group, the scalp electroacupuncture group, and the syndrome differentiation group. For the scalp electroacupuncture group, the points of Baihui (DU 20), Sishecong (EX-HN1), Fengchi (GB 20), and Shenting (DU 24) were selected. For the syndrome differentiation group, specific acupoints were added on the basis of syndrome differentiation and according to the scale for the differentiation of syndromes in vascular dementia (SDSVD) beside the acupoints used in the scalp electroacupuncture group. For the drug group, nimodipine was orally administered. Each patient was treated for two courses, eight weeks. The score differences in minimental state examination (MMSE), picture recognition, and clock drawing test were observed before and after the treatment. RESULTS: After treatment, the score differences in MMSE and clock drawing test were of obvious statistical significance among three groups (P<0.01, P<0.05). The score differences in picture recognition were of extremely statistical significance between the scalp electroacupuncture group and the syndrome differentiation group (P<0.01), while the difference was not found in the drug group (P>0.05). There were statistical significant differences in therapeutic effects between the scalp electroacupuncture group and the drug group, and between the syndrome differentiation group and the drug group (P<0.05), while no statistical difference was found between scalp electroacupuncture group and the syndrome differentiation group (P>0.05). CONCLUSION: All the three therapies may improve the cognitive function of MCI patients. The therapeutic effects in the scalp electroacupuncture and syndrome differentiation groups were basically the same, but superior to nimodipine.     

Clinical Observation and Mechanism Study on Treatment of Senile Dementia with Naohuandan(脑还丹)

Objective: To observe the therapeutic effect and mechanism of Naohuandan (脑还丹, NHD)in treating senile dementia (SD). Methods: Clinical study: Fifty-eight patients with SD, whose diagnosis conforms to the Diagnostic Standard of DSM-Ⅳ issued by American Association of Psychiatry, were enrolled and randomly assigned into two groups. The 30 patients in the treated group were treated with NHD, 4 capsules each time, 3 times daily. The 28 patients in the control group were treated with Piracetam, 1.6 g each time, 3 times daily. The therapeutic course for both groups was 3 months. The therapeutic efficacy was estimated and compared by comprehensive scores of memory and cognition, scores of Mini-mental State Examination (MMSE) and Activities of Daily Living (ADL). Experimental study: Rats were divided into the control group,the model group and the high-dosage and Iow-dosage NHD treated groups. The protective effect of NHD on the per-oxidative damage of hippocampal neurons in β-amyloid protein induced SD model was observed and the related criteria were determined. Results: Clinical study showed that both NHD and Piracetam could improve the clinical symptoms of patients, the two medicines showing insignificant difference in total effective rate. But NHD was better in elevating MMSE score and lowering ADL score in patients than Piracetam ( P＜0.05 and P＜0.01). Experimental study showed that (1) 24 and 72 hrs after modeling, the activity of SOD and GSH were lower and the level of MDA higher in the model group than those in the control group ( P＜0.05or P＜0.01). Compared with the model group at the corresponding time points, in the high-dosage NHD group, SOD and GSH were higher, MDA was lower ( P＜0.05 or P＜0.01); but in the Iow-dosage NHD group, SOD at the 72th hr was higher (P＜0.05) and MDA at 24th and 72th hrs was lower ( P＜0.01). And most of the criteria in the high-dosage NHD group was improved better than that in the Iow-dosage NHD group. ( 2) The survival rates of neurons in various groups were not different significantly (P＞0.05) 24 hrs after modeling, but that in the high-dosage NHD group was significantly higher than that in the model group ( P＜0.01 ) and in the Iow-dosage NHD group 72 hrs after modeling( P＜0.05). Conclusion: NHD is an effective Chinese herbal preparation for treatment of SD, and its mechanism is related with its inhibition on peroxidative injury and protection on neurons.     

帕金森病人血清胱抑素C水平、尿酸变化与病情分期、认知障碍、运动功能的相关性研究

目的探讨帕金森病(PD)病人血清胱抑素C(CysC)、尿酸(UA)水平变化与病情分期、认知障碍、运动功能的相关性。方法纳入PD病人90例作为PD组,选取同期健康体检者82名作为健康组。比较2组血清CysC与UA水平,根据帕金森Hoehn-Yahr(H-Y)分期将PD病人分成H-Y≥3期组(n=36)、H-Y < 3期组(n=54)。根据蒙特利尔认知评估量表(MoCA)将PD病人分成认知障碍组(n=49,MoCA < 26分)、非认知障碍组(n=41,MoCA≥26分)。根据统一帕金森病评估量表第三部分(UPDRS-Ⅲ)评估PD病人运动障碍程度,并分成轻度组(n=26,0~15分)、中度组(n=41,16~40分)、重度组(n=23,41~56分)。比较不同病情分期、认知障碍、运动功能病人的血清CysC与UA水平,经Pearson线性相关分析血清CysC、UA水平与H-Y分期、MoCA评分、UPDRS-Ⅲ评分的相关性。结果PD组血清CysC高于健康组,但血清UA水平低于健康组(P < 0.01)。H-Y≥3期组血清CysC、H-Y分期较H-Y < 3期组增高,血清UA较H-Y < 3期组降低(P < 0.01)。认知障碍组血清CysC较非认知障碍组增高,血清UA、MoCA评分较非认知障碍组降低(P < 0.01)。重度组血清CysC及UPDRS-Ⅲ评分较中、轻度组增高,且中度组高于轻度组,但重度组血清UA较中、轻度组降低,且中度组低于轻度组(P < 0.01)。Pearson线性相关分析结果显示,PD病人血清CysC与H-Y分期、UPDRS-Ⅲ评分呈正相关,与MoCA评分呈负相关(P < 0.05~P < 0.01),而血清UA与H-Y分期、UPDRS-Ⅲ评分呈负相关,与MoCA评分呈正相关(P < 0.05~P < 0.01)。结论PD病人血清CysC水平增高,而血清UA降低,且二者均与病人的病情分期、认知障碍、运动功能存在相关性,临床可将血清CysC、UA作为评估PD进展的指标。     

美金刚联合尼莫地平治疗老年性痴呆的疗效及安全性

目的探讨美金刚联合尼莫地平对老年性痴呆患者认知功能和行为能力的改善作用及安全性。方法将78例老年性痴呆患者随机分为3个组,在治疗前和治疗12周后进行简易精神状态量表（MMSE）、日常生活活动能力量表（ADL）和临床痴呆评定量表（CDR）的评分并比较3组的评分结果。结果单用美金刚治疗组治疗后MMSE评分为（19．0&#177;4．9）分,ADL评分为（30．3&#177;11．3）分,较对照组[分别为（16．8&#177;4．8）分和（33．7&#177;12．0）分]有显著改善,差异有统计学意义（P〈0．05）;联合用药组MMSE评分为（20．8&#177;4．0）分,ADL评分为（27．2&#177;10．7）分,与单用美金刚治疗组比较,差异亦均有统计学意义（P〈0．05）。结论美金刚能有效改善老年性痴呆患者的认知功能及日常生活能力,与尼莫地平联合治疗的效果优于单独使用,且安全性较高。     

帕金森病患者不同脑区白质疏松与认知功能损害的相关性研究

目的 探讨帕金森病(Parkinson's disease,PD)患者不同脑区白质疏松(leukoaraiosis,LA)对认知功能的影响。 方法 收集2015年1月—2017年1月于温州医科大学附属第一医院神经内科住院的PD患者87例,采用MMSE和MoCA量表评估认知功能。运用UPDRS-Ⅲ评价PD患者运动功能,Hoehn-Yahr分期进行病情分级。根据认知评分和诊断标准,将PD患者分为3组:认知功能正常组(PD-NC)、轻度认知功能障碍组(PD-MCI)和痴呆组(PD-D),入组者均行头颅MRI (3.0 T)检查,运用Scheltens量表对侧脑室旁、深部白质评分。 结果 3组间不同部位白质疏松比较,额叶、深部白质、侧脑室旁、LA总分差异有统计学意义(均P<0.05)。顶叶、枕叶、颞叶、基底节、幕下白质疏松评分差异无统计学意义(均P>0.05),PD-MCI组与PD-NC组相比较,额叶LA评分差异有统计学意义。侧脑室旁LA评分PD-D组与其余两组相比较,差异有统计学意义。回归分析结果显示,MMSE与教育程度(P<0.001)、H-Y分期(P=0.008)、深部白质(P<0.001)显著相关,教育程度呈正相关,H-Y分期和深部白质呈负相关。MMSE与深部白质关系最显著(β=-1.034)。 结论 PD认知功能与LA具有相关性,尤其是额叶、深部白质,PD患者MMSE与深部白质关系最为显著。      

阿托伐他汀钙对血管性认知障碍合并高脂血症患者的血脂及认知功能的影响

目的 观察阿托伐他汀钙对血管性认知障碍合并高脂血症患者的降血脂效果和对认知障碍进展的影响.方法 选择60例血管性认知障碍合并高脂血症患者随机分为研究组和对照组,各30例.对照组给予常规治疗,研究组在对照组治疗的基础上每晚加服阿托伐他汀钙20 mg.比较两组治疗前及治疗后24周的血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及简易智能状态量表(mini-Mental State Examination,MMSE)、画钟测验量表(clock drawing task,CDT)和日常生活自理量表(activities of daily living,ADL)评分的分值,以MMSE、CDT和ADL评分为主要评价指标.结果 治疗后研究组患者的血清TC、TG、LDL-C水平低于对照组,血清HDL-C水平高于对照组,差异均有统计学意义(P＜0.05);研究组患者的MMSE、CDT及ADL评分与对照组比较,差异亦均有统计学意义(P＜0.05).研究组患者上述各指标治疗前后比较差异均有统计学意义(P＜0.05);而对照组患者上述各指标治疗前后比较差异均无统计学意义(P＞0.05).结论 阿托伐他汀钙降血脂同时能延缓血管性认知障碍的进展.     

帕金森病与血管性帕金森综合征嗅觉功能改变的研究

目的：研究帕金森病(PD)与血管性帕金森综合征(VP)的嗅觉功能改变及其影响因素,探讨Sniffin' Sticks方法(SST)嗅觉功能检查在PD诊断和鉴别诊断中的应用价值。方法选取2015年3~12月在南通大学第二附属医院就诊的PD、VP患者及性别、年龄匹配的同期体检正常对照者（HC组）各40例。采用SST检查方法分别评价PD、VP、HC三组受检者的嗅觉阈值(OT)、嗅觉辨别阈值(OD)、嗅觉识别阈值(OI)及三项得分之和(TDI)总分,比较三组受检者间嗅觉功能的差异,并评估其嗅觉功能与年龄、性别、简易精神状态量表（MMSE）、病程、H-Y分级、统一帕金森病评定量表(UPDRS-Ⅲ)等变量的相关性。应用受试者工作特征曲线(ROC)评价TDI在PD诊断中的价值。结果 PD、VP、HC三组受检者间基线资料比较差异均无统计学意义(P>0.05);PD组嗅觉障碍发生率为92.5%,显著高于VP组(37.5%)及HC组(35.0%),差异有统计学意义(P<0.05);PD、VP、HC三组受检者的TDI总分分别为(20.07±4.45)分、(30.53±5.90)分和(31.00±4.99)分,PD组TDI总分明显低于HC组和VP组(P<0.05),而VP组与HC组间比较差异无统计学意义(P>0.05);HC组TDI总分与年龄呈负相关(r=-0.987,P<0.05),与MMSE呈正相关(r=0.866,P<0.05);PD组TDI总分与病程呈负相关(r=-0.484,P<0.05),与MMSE呈正相关(r=0.618,P<0.05),与性别、年龄、H-Y分级及UPDRS-Ⅲ评分无关;VP组TDI总分与年龄、病程、H-Y分级均呈负相关(分别为r=-0.989,P<0.05;r=-0.770,P<0.05;r=-0.353,P<0.05),与MMSE呈正相关(r=0.838,P<0.05),与性别、UPDRS-Ⅲ评分无关;区分PD组和HC组时TDI总分曲线下面积(AUC)为0.944,临界值为23.313,灵敏度为82.5%,特异度为97.5%;区分PD组和VP组时,TDI总分AUC为0.911,临界值为23.563,灵敏度为87.5%,特异度为82.5%。结论 SST嗅觉检测方法临床应用简单、结果可靠、可操作性强;PD存在较为显著的嗅觉障碍,VP嗅觉功能与HC比较无显著差异;使用SST能够为PD的诊断和鉴别诊断提供重要的参考信息。     

美金刚治疗帕金森病痴呆的临床观察

目的:观察美金刚治疗帕金森病痴呆的疗效及安全性。方法:将52例帕金森病痴呆患者随机分为治疗组32例,对照组20例。治疗组使用美金刚5mg,对照组行常规治疗,并进行4、12、24周临床简易精神状态量表(MMSE)评价认知功能,UPDRSⅢ评定患者开期的运动功能观察。结果:治疗组治疗4周后,MMSE评分无明显改善,12、24周后MMSE改善明显,差异有统计学意义(P<0.01)。UPDRSⅢ评分:治疗组4、12周后有一定程度改善(P<0.01),而24周后改善不明显。对照组治疗4、12周后MMSE、UPDRSⅢ均无明显改善,而24周后有一定程度改善(P<0.01)。两组均无明显不良反应。结论:美金刚可改善帕金森病患者认知功能,具有安全性,且对运动障碍的改善有一定帮助。     

盐酸美金刚联合多奈哌齐治疗中、重度阿尔茨海默病的临床研究

目的：探讨盐酸美金刚联合多奈哌齐治疗中、重度阿尔茨海默病（AD）的临床疗效及安全性。方法将86例AD 患者随机分为盐酸美金刚联合多奈哌齐组（实验组）和多奈哌齐组（对照组）,在治疗前、治疗后24周末分别利用简易智能状态检查（MMSE）评分量表、AD评估量表-认知部分（ADAS-cog）、日常生活能力（ADL）量表和神经精神症状问卷（NPI）评估。结果实验组和对照组在治疗前后ADAS-cog、ADL和NPI及MMSE差异均有统计学意义（P〈0．01）,实验组的NPI评分变化高于对照组（P〈0．05）。两组不良反应事件发生率差异无统计学意义（P〉0．05）。结论实验组和对照组对AD认知功能均有改善,但前者对NPI的改善更明显,两组治疗均具有良好的安全性。     

血清胱抑素C、尿酸水平与帕金森病伴认知功能障碍的相关性分析

目的探讨帕金森病（PD）病人血清半胱氨酸蛋白酶抑制剂C（胱抑素C）、尿酸水平的变化,并分析血清胱抑素C、尿酸水平与PD伴认知功能障碍的相关性。方法选择60例PD病人为PD组,年龄及性别相匹配的30名健康体检者为对照组。对PD组病人行简易智力状况检查量表（MMSE）评分,根据MMSE评分将PD组分为PD伴认知功能障碍组、PD不伴认知功能障碍组。检测各组血清胱抑素C及尿酸水平。结果PD组血清胱抑素C水平高于对照组（P < 0.05）,血尿酸水平明显低于对照组（P < 0.01）。PD伴认知功能障碍组血清胱抑素C水平明显高于不伴认知功能障碍组（P < 0.01）,血尿酸水平低于不伴认知功能障碍组（P < 0.05）。血清胱抑素C水平与MMSE评分呈负明显相关关系（r=-0.403,P < 0.01）;血清尿酸水平与MMSE评分呈正相关关系（r=0.286,P < 0.05）。结论血清胱抑素C及尿酸水平与PD伴认知功能障碍有关,可作为PD伴认知功能障碍的早期生物学评估指标。     

高同型半胱氨酸血症在帕金森病中的临床意义

目的 探讨帕金森病(PD)患者血同型半胱氨酸(Hcy)水平与运动障碍、认知状态及抑郁的关系.方法 检测56例PD患者的Hcy、叶酸、VitB12水平,高于正常值者(Hcy>14 μmol/L)为研究组,正常值范围内(Hcy≤14 μmol/L)为对照组,应用统一PD评价量表(UPDRS)运动分量表、简易精神状态量表(M...     

尼莫地平联合奥拉西坦治疗脑梗死后认知障碍的疗效观察及对认知功能的影响

目的:尼莫地平联合奥拉西坦治疗脑梗死后认知障碍的疗效观察及对认知功能的影响。方法:将110例脑梗死后认知障碍患者随机分为观察组与对照组,每组各55例,均给予调节血糖、控制血压、抗血小板聚集、他汀调脂稳定斑块、缓解脑水肿、降低颅内压、营养支持等常规治疗。对照组在常规治疗基础上给予奥拉西坦治疗,观察组在对照组基础上加用尼莫地平。检测患者血液粘度,评估患者认知功能与生存质量,统计不良反应发生率。结果:两组治疗后血浆比粘度、纤维蛋白原、红细胞压积较治疗前显著降低(P<0.05)。观察组治疗6个月后简易精神状态评分(MMSE)、蒙特利尔认知评分(MOCA)、生活质量评分(BI)分别为(27.39±4.93)分、(24.70±4.45)分、(83.19±14.98)分显著高于对照组的(24.94±4.49)分、(22.88±4.11)分、(75.63±13.61)分(P<0.05),神经功能缺损评分(NIHSS)为(4.52±0.83)分显著低于对照组的(5.02±0.91)分(P<0.05)。结论:尼莫地平联合奥拉西坦可以改善患者脑循环,促进脑梗死后认知功能障碍患者认知功能恢复。