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尼麦角林治疗多发梗死性痴呆:两种给药方案的双盲、临床、心理测量及脑电图成像研究

[Therapy of multi-infarct dementia with nicergoline: double-blind, clinical, psychometric and EEG imaging studies with 2 dosage schedules].

作者信息

Saletu B, Hochmayer I, Grünberger J, Böhmer F, Paroubek J, Wicke L, Neuhold A

机构信息

Bereich für Pharmakopsychiatrie, Psychiatrischen Universitätsklinik Wien.

出版信息

Wien Med Wochenschr. 1987 Nov 30;137(22):513-24.

PMID:3324497
Abstract

In a double-blind study, clinical, psychometric and neurophysiological changes were investigated in patients with MID treated by two different drug administration schedules of nicergoline (20 mg evenings versus 10 mg b.i.d.). 24 hospitalized patients (4 males, 20 females) with a mean age of 78 years were included according to the criteria of DSM-III, an Ischemic-Score of at least 7 points and a specific computed tomogram (CT). After a placebo-period of 2 weeks all patients were randomly assigned to an 8-weeks-treatment with either 20 mg nicergoline h.s. or 2 x 10 mg b.i.d. The evaluation of the detailed psychopathology by means of SCAG, CGI, NOSIE, Hamilton-Depressions-Scale and Mini-Mental-Status, as well as psychometric investigations by means of the Nuremberg-Aging-Inventory (NAI), thymophysic and psychophysiological measurements showed a significant improvement in both groups as compared with pre-treatment. This improvement was observed slightly earlier in patients with 20 mg h.s. than in those on the b.i.d. schedule. However inter-group-differences reached the level of statistical significance in only 2 variables. Neurophysiological investigations by means of topographic brain-mapping showed interesting relations between functional EEG-images and morphological CT-images. Vigilance-improving patients showed a better therapeutic response than those who did not show neurophysiological changes indicative of improvement in vigilance. Our findings suggest, that a single dose once daily was at least equal to the b.i.d. administration as far as therapeutic efficacy was concerned, even more so in the light of an expected improvement of compliance.

摘要

在一项双盲研究中,对采用两种不同尼麦角林给药方案(每晚20毫克与每日两次每次10毫克)治疗的中度血管性痴呆(MID)患者的临床、心理测量和神经生理变化进行了研究。根据《精神疾病诊断与统计手册》第三版标准、缺血评分至少7分以及特定的计算机断层扫描(CT)结果,纳入了24名住院患者(4名男性,20名女性),平均年龄78岁。经过2周的安慰剂期后,所有患者被随机分配接受为期8周的治疗,治疗方案为每晚服用20毫克尼麦角林或每日两次每次10毫克。通过SCAG、CGI、NOSIE、汉密尔顿抑郁量表和简易精神状态检查表对详细的精神病理学进行评估,以及通过纽伦堡衰老量表(NAI)、胸腺生理和心理生理测量进行心理测量研究,结果显示与治疗前相比,两组患者均有显著改善。在每晚服用20毫克的患者中,这种改善比每日两次给药方案的患者出现得稍早。然而,组间差异仅在2个变量中达到统计学显著水平。通过脑地形图进行的神经生理研究显示,功能性脑电图图像与形态学CT图像之间存在有趣的关系。警觉性改善的患者比未显示出警觉性改善的神经生理变化的患者表现出更好的治疗反应。我们的研究结果表明,就治疗效果而言,每日一次单剂量至少与每日两次给药相当,考虑到预期的依从性改善,更是如此。

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