The Clinical Study In Treatment Of Vascular Dementia With Butyl Phthalide And Idebenone

Objective: To observe the combined treatment effect of Butylphthalide &Idebenone in patients with VD(Vascular dementia).Test the change of active BuChE content in patients' serum.Explore the clinic value of combined treatment of Butylphthalide & Idebenone.Method: The 90 patients was from The No.2 hospital of Baoding & The No.1 center hospital of Baoding,neurology department.(55 male,35 Female.Age form 45 to 80,65.3 ±8.5.Course from 1 to 12 monthes).All cases confirmed by DSM-IV & NINDS-AIRE.All patients were randomly divided into three groups.The group 1 used Butylphthalide,0.2g Po Tid,group 2 used Idebenone,30 mg Po Tid,and group 3 used Butylphthalide &Idebenone,with the same dose of the other two groups.All these three groups were given Danhong and kept blood glucose,blood pressure,blood lipid levels noraml.The following data were observed in 4 time points(before treatment,2 weeks,4 weeks,8 week):(1)MMSE,ADL,CDR were used to value the live ability and cognitive impairment.(2)active BuChE content by DTNB were tested;(3)The change of routine blood and urine test,blood glucose,serum lipid and ECG were obtained.(4)The side effect of drugs were observed.SPSS softwere 17.0 was used to analyze the treatment effect of the 3groups including the change of serum BuChE content,and the correlation between serum BuChE and MMSE,ADL,CDR.Results:1 Tthree groups of patients with general information including age,gender,duration and the comparison between basic diseases without statistical significance(P>0.05).2 MMSE,ADL and CDR were used to value the treatment effect of the 3groups in 4 time points(0w,2w,4w,8w).(1)The score of MMSE were increased,ADL and CDR were decreased(P<0.05);(2)Compared with two single drug treatment group,the score of MMSE were increased,ADL and CDR were decreased.Furthermore,after 8w treatment,the score of MMSE were increased 3.04,ADL and CDR were decreased 30.69 and 1.1 each,The difference was significant.(P<0.05);(3)There were no significant difference between two single drug treatment in MMSE,ADL,CDR(P>0.05).3 All three groups were tested the active BuCh E content at 0w,2w,4w,8w.(1)The active BuChE content decreased in 4 time points and the differences were significant compared with pre-treatment.(P<0.05);(2)There was significant difference of active BuChE content between combined treatment group and two single drug treatment group(P<0.05);(3)Active BuChE content was no significant between two single drug treatment group(P> 0.05).4 MMSE was negative correlated with serum active BuChE content(r=-0.5,P<0.05).ADL and CDR were positive correlated with serum active BuChE content(r=-0.56,r=0.64,r=0.67,P<0.05).5 There were no drug side effects during the whole experiment.This indicated that the combined use of Butylphthalide & Idebenone was safe.Conclusion:1 The effect of combined treatment of butylphthalide & idebenone is obviously better than each single drug group.Combined treatment improved the cognitive dysfunction and self-care ability in VD patients significantly.This suggests that combined use of butylphthalide & idebenone provide a more effective treatment for VD patients.2 Comparison of MMSE,ADL & CDR,the best curative effect were showed in 8 weeks after treatment.3 Combined butylphthalide and idebenone reduced the active serum BuChE content was obviously better than that of single drug group,and the active Bu ChE content and the degree of dementia were negatively correlated,indicating that BuChE content is an important biochemical indicators to judgeVD cognitive impairment severity and prognosis effectively.