计算机游戏式认知功能训练联合丁苯酞软胶囊在血管性轻度认知障碍老年人中的应用效果

doi:10.20047/j.issn1673-7210.2023.14.15

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摘要目的评价计算机游戏式认知功能训练联合丁苯酞软胶囊在血管性轻度认知障碍老年人中的应用效果。方法 2019年1月至2020年12月在沈阳市的4所医院（辽宁省金秋医院、辽宁省人民医院、中国医科大学第一附属医院、盛京医院）门诊就诊人群，连续入组66例血管性轻度认知障碍老年人，记录人口学及临床资料。依照随机数字表法分为观察组和对照组，观察组给予计算机自适应游戏式认知训练联合丁苯酞软胶囊口服，对照组给予丁苯酞软胶囊单药治疗，每组各33例。比较两组干预前、干预后即刻及干预结束后1个月总体认知功能（MoCA）、数字广度测验、听觉词汇学习测验（AVLT）、连线测试（STTA-STTB）、Stroop色词测验评分。结果两组数字广度测试顺背及倒背测验时间、组间及交互作用比较，差异有统计学意义（P＜0.05）。进一步两两比较显示：干预后即刻，两组数字广度测试顺背及倒背评分高于干预前，且观察组高于对照组；观察组干预结束后1个月数字广度测验评分高于干预前，且高于对照组，差异有统计学意义（P＜0.05）。两组听觉词汇学习AVLT再认评分时间、组间及交互作用比较，差异有统计学意义（P＜0.05）；两组AVLF即刻记忆总分时间比较，差异有统计学意义（P＜0.05）。进一步两两比较显示：干预后即刻，两组AVLF再认、即刻记忆总分高于干预前；干预结束后1个月，观察组听觉词汇学习AVLT测验评分高于干预前，差异有统计学意义（P＜0.05）。两组连线测试STT-A组间比较，差异有统计学意义（P＜0.05）；两组连线测试STT-B时间、组间及交互作用比较，差异有统计学意义（P＜0.05）。进一步两两比较显示：干预后即刻、干预结束后1个月，观察组STT-A低于对照组同时间点；干预后即刻两组STT-B低于干预前，且观察组低于对照组；干预结束后1个月，观察组STT-B低于干预前，且低于对照组，差异有统计学意义（P＜0.05）。两组StroopA时间及交互作用比较，差异有统计学意义（P＜0.05）；两组StroopB时间、组间及交互作用比较，差异有统计学意义（P＜0.05）。进一步两两比较显示：干预后即刻，两组StroopA低于干预前；干预结束后1个月观察组StroopA低于干预前，且低于对照组，差异有统计学意义（P＜0.05）。干预后即刻，两组StroopB低于于干预前，且观察组低于对照组；干预结束后1个月观察组StroopA低于干预前，且低于对照组，差异有统计学意义（P＜0.05）。两组MoCA总分时间、组间及交互作用比较，差异有统计学意义（P＜0.05）。进一步两两比较显示：干预后即刻、干预结束后1个月观察组总体认知功能MoCA总分高于干预前，且高于对照组，差异有统计学意义（P＜0.05）。结论对血管性轻度认知障碍老年人应用计算机游戏式认知功能训练联合丁苯酞治疗，其效果显著，可有效改善认知功能障碍，提高患者生活质量。

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	张薇　　李艳玲

关键词 ：轻度血管性认知障碍, 丁苯酞, 计算机认知训练, 认知功能评估

Abstract：Objective To evaluate the effect of computer game cognitive function training combined with Butylphthalide soft Capsules in the elderly with vascular mild cognitive impairment. Methods From January 2019 to December 2020, a total of 66 elderly patients with vascular mild cognitive impairment were enrolled in outpatients from four hospitals (Liaoning Jinqiu Hospital, Liaoning Provincial People’s Hospital, the First Affiliated Hospital of China Medical University and Shengjing Hospital) in Shenyang, and demographic and clinical data were recorded. According to the random number table, they were divided into observation group and control group. The observation group was given computer adaptive gaming cognitive training combined with Butylphthalide Soft Capsules, while the control group was given single drug treatment with Butylphthalide soft capsules, with 33 cases in each group. Scores of overall cognitive function (MoCA), number span test, auditory vocabulary learning test (AVLT), connection test (STTA-STTB) and Stroop color word test were compared between the two groups before intervention, immediately after intervention and one month after intervention. Results There were significant differences of the anteriorly and backward scores of digital span test in the time, intergroup, and interaction between the two groups (P＜0.05). Further pair comparison showed that immediately after intervention, the anteriorly and backward scores of digital span test in the two groups were higher than before intervention, while those of the observation group were higher than those of the control group; the number span test score of the observation group was higher than that of the control group one month after intervention, and the differences were statistically significant (P＜0.05). There were statistically significant differences of AVLT recognition in scoring of the anteriorly and backward scores of digital span test time, inter-group and interaction between the two groups (P＜0.05). The total time of AVLF immediate memory between the two groups was statistically significant (P＜0.05). Further pairwise comparison showed that the total scores of AVLF recognition and immediate memory in the two groups were higher immediately after intervention than before intervention; one month after the intervention, the AVLT scores of the observation group were higher than those before the intervention, and the differences were statistically significant (P＜0.05). The comparison of STT-A between the two groups was statistically significant (P＜0.05). Comparison of STT-B in time, intergroup, and interaction between the two groups showed statistically significant differences (P＜0.05). Further pair-to-pair comparison showed that STT-A in the observation group was lower than that in the control group at the same time point immediately after intervention and a month after intervention; immediately after intervention, STT-B in both groups was lower than before intervention, and the observation group was lower than the control group; one month after the intervention, STT-B in the observation group was lower than before intervention, and lower than that in the control group, the differences were statistically significant (P＜0.05). The comparison of StroopA in time and interaction between the two groups were statistically significant (P＜0.05). The comprison of StroopB in time, intergroup and interaction between the two groups were statistically significant (P＜0.05). Further pair comparison showed: immediately after intervention, StroopA in both groups was lower than before intervention; one month after intervention, StroopA in observation group was lower than before intervention, and lower than control group, the differences were statistically significant (P＜0.05). Immediately after intervention, StroopB in the two groups was lower than before intervention, and the observation group was lower than the control group; one month after intervention, StroopA in the observation group was lower than before intervention and lower than the control group, with statistical significance (P＜0.05). There were statistically significant differences of total MoCA in time, intergroup, and interaction between the two groups (P＜0.05). Further pair comparison showed that the total score of MoCA of cognitive function in the observation group was higher than that before intervention and was higher than that in the control group after intervention, and the differences were statistically significant (P＜0.05). Conclusion The application of computer game cognitive function training combined with Butylphthalide Soft Capsules therapy in the elderly with vascular mild cognitive impairment has a significant effect, which can effectively improve the cognitive dysfunction and improve the quality of life of patients.

Key words： Mild vascular cognitive impairment Butylphthalide Soft Capsules Computer cognitive training Cognitive function assessment

基金资助:辽宁省科学技术计划项目（20180550326）。

引用本文:

张薇　　李艳玲. 计算机游戏式认知功能训练联合丁苯酞软胶囊在血管性轻度认知障碍老年人中的应用效果[J]. 中国医药导报, 2023, 20(14): 70-75,85.
ZHANG Wei LI Yaning. Application effect of computer game cognitive function training combined with Butylphthalide Soft Capsules in elderly with vascular mild cognitive impairment. 中国医药导报, 2023, 20(14): 70-75,85.

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https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.14.15 或 https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I14/70

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