Clinical Efficacy of Nimodipine Combined with High Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients with Subcortical Non-Dementia Vascular Cognitive Impairment

HUANG Fang; DING Ling; CHEN Xu

doi:10.14009/j.issn.1672-2124.2021.02.007

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Clinical Efficacy of Nimodipine Combined with High Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients with Subcortical Non-Dementia Vascular Cognitive Impairment

更新时间：2022-10-08

- Clinical Efficacy of Nimodipine Combined with High Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients with Subcortical Non-Dementia Vascular Cognitive Impairment
- Vol. 21, Issue 2, Pages: 155-159(2021)
- 作者机构：
  
  长沙市第三医院神经内科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2021.02.007
  CLC： R749.13
- Published：2021，
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[1]黄芳,丁玲,陈旭.尼莫地平联合高频重复经颅磁刺激治疗皮层下非痴呆型血管性认知障碍的临床疗效研究[J].中国医院用药评价与分析,2021,21(02):155-159.

HUANG Fang, DING Ling, CHEN Xu. Clinical Efficacy of Nimodipine Combined with High Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients with Subcortical Non-Dementia Vascular Cognitive Impairment. [J]. 21(2):155-159(2021)
[1]黄芳,丁玲,陈旭.尼莫地平联合高频重复经颅磁刺激治疗皮层下非痴呆型血管性认知障碍的临床疗效研究[J].中国医院用药评价与分析,2021,21(02):155-159. DOI： 10.14009/j.issn.1672-2124.2021.02.007.

HUANG Fang, DING Ling, CHEN Xu. Clinical Efficacy of Nimodipine Combined with High Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients with Subcortical Non-Dementia Vascular Cognitive Impairment. [J]. 21(2):155-159(2021) DOI： 10.14009/j.issn.1672-2124.2021.02.007.

摘要

目的:探讨尼莫地平联合高频重复经颅磁刺激（repetitive transcranial magnetic stimulation

r TMS）治疗皮层下非痴呆型血管性认知障碍的临床效果。方法:选取2018年6月至2019年6月于长沙市第三医院接受治疗的皮层下非痴呆型血管性认知障碍患者116例

采用随机数字表法分为r TMS治疗组、联合治疗组

每组58例。r TMS治疗组患者进行r TMS治疗

联合治疗组患者在r TMS治疗基础上联合应用尼莫地平。观察两组患者的蒙特利尔认知量表（Montreal cognitive assessment

MoCA）评分、Barthel评分、汉密尔顿焦虑量表（Hamilton anxiety scale

HAMA）及汉密尔顿抑郁量表（Hamilton depression scale

HAMD）评分;比较两组患者的血清S100β蛋白、神经元特异性烯醇化酶（NSE）、胰岛素样生长因子1（IGF-1）、肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）、白细胞介素6（IL-6）、谷胱甘肽过氧化物酶（GSH-Px）、过氧化脂（LPO）及丙二醛（MDA）水平的差异;观察两组患者的临床疗效。结果:治疗后

联合治疗组患者的MoCA评分、Barthel评分均明显高于r TMS治疗组;联合治疗组患者的血清S100β蛋白、NSE水平明显低于r TMS治疗组

IGF-1水平明显高于r TMS治疗组

上述差异均有统计学意义（P<0.05）。治疗后

联合治疗组患者的血清TNF-α、IL-1β及IL-6水平明显低于r TMS治疗组;联合治疗组患者的GSH-Px水平明显高于r TMS治疗组

LPO、MDA水平明显低于r TMS治疗组

上述差异均有统计学意义（P<0.05）。治疗后

与r TMS治疗组比较

联合治疗组患者的HAMA评分、HAMD评分明显更低

差异均有统计学意义（P<0.05）。联合治疗组患者的总有效率高达89.66%（52/58）

明显高于r TMS治疗组的75.86%（44/58）

差异有统计学意义（P<0.05）。结论:采用尼莫地平联合r TMS对皮层下非痴呆型血管性认知障碍患者进行治疗

能够提高患者的认知功能、日常生活能力

调控血清S100β蛋白、NSE及IGF-1水平

减轻脑组织炎症反应

提高抗氧化能力

改善患者抑郁、焦虑情绪

治疗效果显著。

Abstract

OBJECTIVE: To probe into the treatment effects of nimodipine combined with high frequency repetitive transcranial magnetic stimulation（ r TMS） in the treatment of patients with subcortical non-dementia vascular cognitive impairment. METHODS: Totally 116 patients with subcortical non-dementia vascular cognitive impairment admitted into the Third Hospital of Changsha from Jun. 2018 to Jun. 2019 were extracted to be divided into the r TMS treatment group and the combination treatment group via the random number table

with 58 cases in each group. The r TMS treatment group was treated with r TMS

while the combination treatment group received nimodipine on the basis of r TMS. Montreal cognitive assessment（ MoCA） score

Barthel score

Hamilton anxiety scale（ HAMA） and Hamilton depression scale（ HAMD） score of two groups were observed. The serum S100β protein

neuron specific enolase（ NSE）

insulin-like growth factor 1（ IGF-1）

tumor necrosis factor α（ TNF-α）

interleukin-1β（ IL-1β）

interleukin-6（ IL-6）

glutathione peroxidase（ GSH-Px）

lipid peroxide（ LPO） and malondialdehyde（ MDA） of two groups were compared. The clinical efficacy of two groups was analyzed. RESULTS: After treatment

MoCA score and Barthel score of patients in the combination treatment group were significantly higher than those in the r TMS treatment group; the serum levels of S100β protein and NSE in the combination treatment group were significantly lower than those in the r TMS treatment group

and the level of IGF-1 was significantly higher than that in the r TMS treatment group

with statistically significant difference（ P < 0. 05）. After treatment

the serum levels of TNF-α

IL-1β and IL-6 in the combination treatment group were significantly lower than those in the r TMS group; the levels of GSH-Px in the combination treatment group were significantly higher than those in the r TMS group

while the levels of LPO and MDA in the combination treatment group were significantly lower than those in the r TMS treatment group

with statistically significant difference（ P<0. 05）. Compared with the r TMS treatment group after treatment

HAMA score and HAMD score of the combination treatment group decreased significantly

and the differences were statistically significant（ P<0. 05）. The total effective rate of the combination treatment group was 89. 66%（ 52/58）

significantly higher than75. 86%（ 44/58） of the r TMS treatment group

the difference was statistically significant（ P < 0. 05）.CONCLUSIONS: The efficacy of nimodipine combined with r TMS in the treatment of patients with subcortical nondementia vascular cognitive impairment is significant

which can improve the cognitive function and daily life ability of patients

regulate the level of serum S100β

NSE and IGF-1

reduce the inflammatory response of brain tissues

improve the antioxidant capacity and the depression and anxiety of patients.

关键词

高频重复经颅磁刺激尼莫地平非痴呆型血管性认知障碍认知功能

Keywords

High frequency repetitive transcranial magnetic stimulationNimodipineNon-dementia vascular cognitive impairmentCognitive function

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