Observation Of The Efficacy Of Butylphthalide And Nimodipine In The Treatment Of Vascular Dementia

Objective: Vascular Dementia is the acquired intellectual impairment syndrome caused by ischemic stroke, hemorrhagic stroke,and chronic brain dysfunction. Currently, the incidence and mortaliey of vascular dementia are both increasing. Currently, vascular dementia is the second cause of dementia after Alzheimer’s disease. Studies have shown that vascular dementia is the only preventable type of dementia so far. This study will analyze the impact factors of vascular dementia, to help preventing vascular dementia in clinical. Vascular dementia is reversible treat early. Now, there is no specific treatment to vascular dementia internationally. Previous reports show Butylphthalide and Nimodipine have significant efficacy of vascular dementia, but the report of combianation and alone Butylphthalide is uncommon. Combined use of Nimodiine and Butylphthalide is expected to improve the prognosis of patients with VD. This study will observe the efficacy and safety of butyiphthalide and nimodipine in the treatment of vascular dementia, to help treating vascular dementia in clinical. The main contents are as follows:Methods and Result: 1.In order to analyze factors of vascular dementia, we selected 90 VD patients(reffered to as VD group). The patients included inpatients and outpatients of Affliated Hospital of Hebei University from December 2012 to October 2014. Selected 100non-demented patients with ischemic stroke. The patients included inpatients and outpatients during the same period. Analyze and compare the two groups, like general state(gender,age, education, occupation, smokingand drinking history), medical history(hypertension,diabetes, heart disease, ischemic stroke history), blood tests(cholesterol, uric acid,homocysteine), and neuroimage(number and location of cerebral lesion). We will statistic the data by SPSS 16.0. The results show that: 1. the significant factors of vascular dementia: age, occupation, smoking and drinking history, hypertension, diabetes, history of stroke, hyperlipidemia, hyperuricemia; 2. patients with temporal lobe,basal ganglia, thalamus,corpus callosum, hippocampus ischemic are more susceptible to vascular dementia.2. In order to observe the efficacy and security of Butylphthalide and Nimodipine in the treatment of vascular dementia, 90 vascular dementia patients were selected based on rigid standard. These patients included inpatients and outpatients of Affliated Hospital of HebeiUniversity during December 2012 to October 2014. They were devided into 3 groups randomly and treated with additional Butylphthalide and Nimodipine(Group A),Butylphthalide(Group B), Nimodipine(Group C) besides normal treatment for 12 weeks.These patients are evaluated before and after treating based on Mini-Mental State Examination(MMSE), Montrea Cognitive Assessment(Mo CA) and Activities of Daily Living Scale(ADL). Their blood tests and electrocardiogram will be assayed; additionally, side effects of digestive and nerous system, allergic reactions will be recorded as well. All of above results will be analyzed with the statistical software named SPSS 16.0. The MMSE,Mo CA and ADL Scores of Group A after treatment(23.13±5.768,18.13±5.30,46.13±18.091) are better than scores before treatment(19.33±5.486, 13.67±5.094, 52.6±18.844),differences are statistically signifucant(P<0.05); The scores of Group B after treatment(22.67±4.416, 16.79±4.755, 47.71±17.261) are better than scores before treatment(19.71±4.165, 13.46±4.364, 52.88±16.858), differences are statistically signifucant(P<0.05);The scores of Group C after treatment(20.83 ±4.678, 15.33±4.207, 50.00±17.899) are better than scores before treatment(18.83±4.469, 13.08±3.988, 52.25±17.808), differences are statistically signifucant(P<0.05). Considering the positive effect of MMSE、Mo CA and ADL on vascular dementias, the difference between group A and B is not statistically signifucant(P>0.05);the results of group A are better than the results of group C, difference is statistically signifucant(P<0.05). Additionally, there is one renal dysfunction from group A, one liver dysfunction from group B and C respectively. There are no significant differences in incidence rate of side effect among these groups.conclusions: In conclusion, age, physical labor, smoking history, drinking history,hyperlipidemia, hyperuricemia are factors of vascular dementia; Patients with temporal lobe,basal ganglia, thalamus, corpus callosum, hippocampus ischemic are more susceptible to vascular dementia; It is recommended that the vascular dementias should be treated as soon as possible with Butylphthalide and Nimodipine which is of greatly positive effect on brain function and little untoward effect.