奥卡西平与通窍活血汤治疗瘀血内阻型血管性痴呆患者激越行为的疗效比较

目的观察奥卡西平与通窍活血汤治疗瘀血内阻型血管性痴呆患者激越行为的疗效。方法将70例伴有激越行为的瘀血内阻型血管性痴呆患者随机分为西药组和中药组,每组35例,分别应用奥卡西平和通窍活血汤治疗。治疗前及治疗2、4、8周末分别采用简易智能状态检查量表（MMSE）、痴呆行为量表（BEHAVE-AD）、日常生活能力量表（ADL）等进行疗效评定,并记录不良反应。结果两组均完成研究,无脱落病例。治疗2周西药组显著进步率高于中药组（P〈0.05）,西药组BEHAVE-AD量表总分及攻击行为因子分低于中药组（P〈0.05）;治疗8周后中药组显著进步率高于西药组（P〈0.05）,中药组BEHAVE-AD量表总分及攻击行为因子分低于西药组（P〈0.05,P〈0.01）;中药组MMSE量表总分高于西药组（P〈0.05）,而ADL量表总分低于西药组（P〈0.05）;治疗期间,中药组＂过度镇静＂及＂认知功能进行性下降＂发生率均低于西药组（P〈0.05）。结论奥卡西平治疗瘀血内阻型血管性痴呆患者激越行为起效快,急性期疗效优于通窍活血汤;而通窍活血汤治疗起效较慢,但疗效相对稳定持久,且有利于改善患者的认知功能,副反应相对较轻。

Treatment of Vascular Dementia Patients with Agitation of Blood Stagnation Syndrome by Oxcarbazepine And Tongqiaohuoxue Decoction Separately: An Efficacy Comparison

Objective To compare the efficacy of oxcarbazepine and Tongqiaohuoxue decoction（TQHXD） in treating vascular dementia（VD） patients with agitation of blood stagnation（BS） syndrome. Methods Seventy VD patients with agitation of BS were randomly assigned to oxcarbazepine group and TQHXD group,35 cases in each group. Empirical Behavioral Rating Scale（BEHAVE-AD）,Mini-mental State Examination（MMSE）,and Activity of Daily Living Scale（ADL） were evaluated before treatment and at the 2nd, 4th and 8th week,respectively. Adverse reactions were recorded. Results All patients completed the trial. At the end of the 2nd week of the treatment,the success rate in oxcarbazepine group was higher than that in TQHXD group（P〈0.05）,and the scores of BEHAVE-AD and aggressive behavior factor in oxcarbazepine group were lower than those in control group（P〈0.05）.At the end of the 8th week of the treatment,the success rate in TQHXD group was higher than that in oxcarbazepine group（P〈0.05）,and the scores of BEHAVE-AD and aggressive behavior factor in TQHXD group were lower than those in TQHXD group（P〈0.05,P〈0.01）. TQHXD group had higher score of MMSE but lower score of ADL compared with oxcarbazepine group did（Ps0.05）. The events of ＂excessive sedation＂ and ＂cognitive function being declining＂ in TQHXD group were less than those in oxcarbazepine group（Ps 0.05）. Conclusion Oxcarbazepine has a rapid reaction to VD patients with agitation of BS and better therapeutic effects at the acute stage,while the effect of TQHXD is sustainable with less adverse events. TQHXD also can improve the VD patients＇ cognitive function.