Effects of repeated transcranial magnetic stimulation combined with conventional anti-dementia therapy in treatment of elderly patients with vascular dementia
-
摘要: 目的 观察重复经颅磁刺激联合常规抗痴呆治疗在老年血管性痴呆(VD)患者中的应用效果。 方法 选取190例老年VD患者,采用随机数字表法分为研究组与对照组,每组95例。对照组采用常规抗痴呆治疗,研究组在对照组治疗基础上加用重复经颅磁刺激。观察2组临床疗效、不良反应发生率,比较2组治疗前后认知功能[简易精神状态检查量表(MMSE)评分]、痴呆程度[长谷川痴呆量表(HDS)评分]、日常生活能力[日常生活能力量表(ADL)评分]、生活质量[卒中专用生活质量量表(SS-QOL)评分]以及血清肿瘤坏死因子-α(TNF-α)、半胱氨酸蛋白酶-3(Caspase-3)、过氧化脂(LPO)、基质金属蛋白酶-9(MMP-9)、血管紧张素-Ⅰ(Ang-Ⅰ)水平。 结果 研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05); 治疗后,研究组MMSE、HDS、ADL和SS-QOL评分均高于对照组,血清TNF-α、Caspase-3、LPO和MMP-9水平均低于对照组,血清Ang-Ⅰ水平高于对照组,差异有统计学意义(P<0.05); 2组不良反应发生率比较,差异无统计学意义(P>0.05)。 结论 在常规抗痴呆治疗基础上联合应用重复经颅磁刺激,能进一步下调老年VD患者血清Caspase-3、TNF-α、LPO及MMP-9表达,促进Ang-Ⅰ水平升高,改善认知功能,减轻痴呆程度,疗效显著,且安全性良好,可有效改善患者预后。Abstract: Objective To observe the effect of repeated transcranial magnetic stimulation combined with conventional anti-dementia treatment in treatment of elderly patients with vascular dementia(VD). Methods A total of 190 elderly patients with VD were divided into study group and control group according to random number table method, with 95 cases in each group. The control group received conventional anti-dementia treatment, and the study group received repeated transcranial magnetic stimulation on the basis of the control group. The clinical effects and incidence of adverse reactions were observed. Cognitive function by Mini-mental State Examination(MMSE)score, dementia condition by Hasegawa Dementia Rating Scale(HDS)score, daily living ability by Activities of Daily Living(ADL)score, quality of life by Stroke Specific Quality of Life(SS-QOL)score and serum tumor necrosis factor-α(TNF-α), caspase-3, lipid peroxide(LPO), matrix metalloproteinase-9(MMP-9), and angiotensin-Ⅰ(Ang-Ⅰ)levels before and after treatment were compared between the two groups. Results The total effective rate of the study group was higher than that of the control group(P<0.05). The MMSE, HDS, ADL, and SS-QOL scores in the study group were higher than those in the control group after treatment(P<0.05), and serum levels of TNF-α, Caspase-3, LPO and MMP-9 in the study group were lower than those in the control group, and serum Ang-Ⅰ level was higher than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the study group and the control group(P>0.05). Conclusion - Repeated transcranial magnetic stimulation on the basis of conventional anti-dementia treatment can further down-regulate the expression levels of serum Caspase-3, TNF-α, LPO and MMP-9, increase level of Ang-Ⅰ, significantly improve the cognitive function, relieve the degree of dementia and effectively improve the prognosis of elderly VD patients. It has significant effect and higher safety.
-
-
戚慧敏, 张传金, 戚晓青. 尼莫地平联合盐酸多奈哌齐治疗老年痴呆的效果观察[J]. 解放军预防医学杂志, 2019, 37(7): 114-115. 姚爱娜, 杨发明. 盐酸多奈哌齐联合康复训练治疗脑卒中后血管性痴呆临床研究[J]. 实用医技杂志, 2019, 26(5): 596-598. PARK J E. Repetitive transcranial magnetic stimulation for limb-kinetic apraxia in Parkinson's disease[J]. J Clin Neurol, 2018, 14(1): 110-111.
张金培, 杨屹. 养生益智汤治疗血管性痴呆的效果及对血清TNF-α和Caspase-3水平的影响[J]. 新疆医科大学学报, 2017, 40(8): 1009-1012. 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑小血管病诊治共识[J]. 中华神经科杂志, 2015, 48(10): 838-844. 张东亚, 杨苗苗, 杨改清. 尼麦角林联合盐酸多奈哌齐治疗血管性痴呆的临床疗效观察[J]. 中国实用神经疾病杂志, 2016, 19(21): 104-105. BREDER R, LEITE M A A, PINTO J A JR, et al. Low sensitivity of the mini-mental state examination for cognitive assessment of Brazilian patients with parkinson disease[J]. J Geriatr Psychiatry Neurol, 2017, 30(6): 311-315.
韩倩, 国欣涛, 张环环, 等. 高压氧联合丁苯肽对一氧化碳中毒后脑代谢改善效果观察[J]. 中华劳动卫生职业病杂志, 2017, 35(8): 591-593. 李灵真. 盐酸多奈哌齐治疗轻中度血管性痴呆患者的疗效分析及认知功能和日常生活能力的影响[J]. 临床研究, 2016, 24(10): 202-203. 蒋虹, 郝习君, 陈长香. 运动性引导想象对脑卒中后睡眠障碍和焦虑抑郁的干预效果[J]. 中华行为医学与脑科学杂志, 2019, 28(4): 343-348. LI C Y, ZHANG L, LI J, et al. Effect of endogenous arginine-vasopressin arising from the paraventricular nucleus on learning and memory functions in vascular dementia model rats[J]. Biomed Res Int, 2017, 2017: 3214918.
黄伟强, 李惠, 邹立华, 等. 血管性痴呆患者乙酰胆碱血浆一氧化氮水平及血液流变学指标的研究[J]. 检验医学与临床, 2015, 12(14): 2076-2077. 沈莹, 余鸽, 张海生. 逍遥丸联合盐酸多奈哌齐治疗血管性痴呆伴发抑郁疗效观察[J]. 中华中医药学刊, 2018, 36(7): 1724-1726. 王学红. 奥拉西坦联合重复经颅磁刺激治疗血管性痴呆的疗效观察[J]. 中国实用神经疾病杂志, 2016, 19(7): 57-58. 黄树栋, 岑雄图, 黄光位. 低频重复经颅磁刺激联合多奈哌齐治疗血管性痴呆患者认知功能障碍的观察[J]. 国际医药卫生导报, 2015, 21(5): 661-663. 拜承萍, 铁婷婷. HMGB1、MIF和TNF-α在血管性痴呆患者血清中的表达及价值分析[J]. 国际检验医学杂志, 2019, 40(13): 1615-1618. 赵燕民, 洪丽, 王献, 等. 养生益智汤治疗血管性痴呆临床观察[J]. 新中医, 2018, 50(6): 76-79. 王德秀, 蔡欣, 王钢, 等. 银杏叶提取物对血管性痴呆大鼠学习记忆的影响及海马神经元的保护作用[J]. 中华行为医学与脑科学杂志, 2019, 28(6): 516-521. 孟天娇, 王立波, 陈飞儿, 等. 长春西汀治疗血管性痴呆效果与TNF-α和caspase-3的关系[J]. 中国老年学, 2017, 37(1): 206-207. 王金彩, 吉四辈, 宋志秀, 等. 丁苯酞软胶囊联合重复经颅磁刺激对血管性痴呆患者血清Ang-Ⅰ、MMP-9水平变化的影响[J]. 中国合理用药探索, 2018, 15(6): 70-72. 任雅芳, 付胜奇, 禹萌, 等. 丁苯酞联合rTMS对血管性痴呆患者临床疗效及血清Ang-ⅠMMP-9LPO水平的影响[J]. 临床心身疾病杂志, 2018, 24(6): 25-27 , 62.
张作念, 顾伟, 王志晔, 等. 血管性痴呆患者血清炎症因子和生化指标的检测及临床意义[J]. 河北医学, 2018, 24(3): 517-520. -
期刊类型引用(2)
1. 郭红歌. 人工上油应用于轴节类手术器械的效果分析. 辽宁医学杂志. 2019(02): 101-103 . 百度学术
2. 李秀英, 路珊珊. 一起灭菌后手术器械表面液体珠现象的调查. 中国感染控制杂志. 2019(07): 684-686 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 337
- HTML全文浏览量: 107
- PDF下载量: 19
- 被引次数: 2