The Efficacy Of Butyphthalide Combined With Piracetam In The Treatment Of Cognitive Impairment After Cerebral Infarction

BackgroundMore and more people pay attention to cognitive impairment,its existence is always associated with impaired daily functioning and increased dependency,regardless of its severity.It is well known that some diseases can lead to cognitive impairment,for example Alzheimer’s disease,Louie body dementia,vascular dementia and so on.But the etiology and pathogenesis of these diseases are not clearly,so the diagnosis and classification have not yet unified.But it has been clear that cerebrovascular risk factors and cerebrovascular damage are closely related with cognitive impairment.Therefore,intervention in cerebrovascular disease and its risk factors,such as hypertension,diabetes,hyperlipidemia,to improve cognitive impairment symptoms,and it can prevent the occurrence of dementia,but there is no recognized effective treatment for vascular cognitive impairment.However,the knowledge of neuropathology,imaging technology and the development of new drugs will improve our understanding of the mechanism of vascular cognitive impairment,and gradually improve its diagnostic criteria and treatment plans.Finally,we hope to have diagnosis,individualized treatment and scientific management in patients with vascular cognitive impairment at an early stage.ObjectiveTo observe the efficacy of Butyphthalide combined with Piracetam in the treatment of cognitive impairment after Cerebral Infarction.MethodsTotally 146 cases of patients,who was diagnosed with cognitive impairment after cerebral infarction were randomly divided into control group(n = 36),piracetam group(n = 36),butyphthalide group(n = 37),and combination group(n = 37).The control group was given aspirin antiplatelet,atorvastatin calcium lipid lowering,and control of blood pressure,glucose and other routine treatment.Piaracetam group was given conventional therapy and piaracetam treatment,butyphthalide group was given conventional therapy and butyphthalide treatment,the combined treatment group was treated with the conventional therapy and piaracetam combined with butyphthalide.The four groups were treated regularly for 3 months.All of the patients was assessed the National Institute of Health stroke scale(NIHSS),mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA)at pretherapy and 3 month after treatment,and record the changing trends.In addition,the adverse drug reactions were observed and compared in the three groups.Results(1)There was no difference in basic clinical data among the four groups(P>0.05).(2)After treatment,the effective rate of the combined treatment group was 91.89%,which was higher than that of the butyphthalide group(72.98%),the Piracetam group(63.89%),and the control group(47.22%)(P<0.05).The effective rate of butyphthalide group was significantly higher than that of control group(P<0.05),the effective rate of butyphthalide group was higher than that of piracetam group(P>0.05)and the effective rate of piracetam group was higher than that of control group.(3)Compared with before treatment,the NIHSS scores of the four groups decreased after 3 months of treatment(all P<0.05).The NIHSS scores,the subtractive scores and the reduction rates of the four groups were compared respectively after treatment,which indicated that the downturn of the combined treatment group was was more significant than that in butyphthalide group,the piracetam group and the control group.The downturn of butyphthalide group was more significant than the piracetam group and the control group(P<0.05).The downturn in piracetam group was more significant than that in control group(P<0.05).(4)After 3 months of treatment,the scores of MMSE and MoCA in the control group were not significantly changed(P>0.05),but the scores of MMSE and MoCA in the piracetam group,butyphthalide group and combined treatment group were increased(P<0.05).The MMSE and MoCA scores,the subtractive scores and the reduction rates of the four groups were compared respectively after treatment,which indicated that rising trend of the combined treatment group were higher than the butyphthalide group,piracetam group and the control goup.The rising trend of the butyphthalide group was not difference with the piracetam group(P<0.05);and the rising trend of the butyphthalide group was more significant than the control group(P<0.05).The rising of the Piracetam group was more significant than that in the control group(P<0.05).(5)The incidence of adverse reactions in the four groups was not statistically significant(P>0.05).ConclusionsPiracetam combined with butyphthalide can significantly improve the neurological impairment and cognitive impairment in patients,which was cognitive impairment after cerebral infarction.The incidence of adverse reactions was not increased.