Abstract:

Objective　To investigate the effect of butylphthalide capsules on cognitive functional network connectivity in patients with cognitive dysfunction after cerebral infarction. Methods　A total of 70 patients with cognitive dysfunction after cerebral infarction who received treatment in Tianjin Medical University General Hospital from January 2022 to April 2024 were selected as the research subjects, and were randomly divided into a placebo group and a butylphthalide capsule group, with 35 cases in each group. In the placebo group, there were 19 males and 16 females, aged (54.59±6.22) years, and there were 9 cases of hypertension, 6 cases of hyperlipidemia, 4 cases of diabetes, and 2 cases of coronary heart disease. There were 21 males and 14 females in the butylphthalide capsule group, aged (55.07±6.32) years, and there were 10 cases of hypertension, 7 cases of hyperlipidemia, 5 cases of diabetes, and 1 case of coronary heart disease. The placebo group received oral placebo based on conventional antiplatelet therapy, 0.2 g each time, three times a day; on the basis of conventional antiplatelet therapy, the butylphthalide capsule group was combined with butylphthalide soft capsules, which was taken fasting orally, 0.2 g each time, three times a day. Both groups were treated continuously for 6 months.The observation indicators included disconnection index, functional network connection index, cognitive function score, and quality of life score before treatment and 3 and 6 months after treatment in both groups, as well as incidence of adverse reactions. Independent sample t test and χ² test were used for statistical analysis. Results　Before treatment, there were no statistically significant differences in the disconnection index, functional network connection index, or cognitive function score between the two groups (all P0.05); 3 and 6 months after treatment, the disconnection index of the butylphthalide capsule group was lower than that of the placebo group [(0.18±0.02) points vs. (0.23±0.03) points, (0.15±0.01) points vs. (0.21±0.02) points], the functional network connectivity index of the butylphthalide capsule group was higher than that of the placebo group [(0.69±0.05) points vs. (0.66±0.07) points, (0.75±0.06) points vs. (0.69±0.07) points], and the cognitive function score of the butylphthalide capsule group was higher than that of the placebo group [(23.39±5.14) points vs. (20.97±4.96) points, (26.17±6.89) points vs. (22.31±5.27) points] (all P0.05). Before treatment, there were no statistically significant differences in the quality of life scores between the two groups (all P0.05); after treatment, the quality of life scores of the two groups were increased, and the scores of all dimensions in the butylphthalide capsule group were higher than those in the placebo group (all P0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusions　Butylphthalide capsules effectively enhance the cognitive functional network connectivity in patients with cognitive dysfunction after cerebral infarction and improve their quality of life through multiple pathways, including regulating cerebral blood circulation, antioxidant stress, inhibiting inflammatory reactions, promoting nerve regeneration, and regulating neurotransmitters. Due to their good safety characteristics, they demonstrate broad clinical application potential.

Key words:

Butylphthalide capsules, Cerebral infarction, Cognitive function, Network connectivity, Intervention study

摘要：

目的　探究丁苯酞胶囊对脑梗死后认知功能障碍患者认知功能网络连通性的影响。方法　选取2022年1月至2024年4月在天津医科大学总医院接受治疗的70例脑梗死后认知功能障碍患者作为研究对象，并按随机数字表法分为安慰剂组和丁苯酞胶囊组，每组35例。安慰剂组中男19例，女16例；年龄（54.59±6.22）岁；高血压9例、高脂血症6例、糖尿病4例、冠心病2例。丁苯酞胶囊组中男21例，女14例；年龄（55.07±6.32）岁；高血压10例、高脂血症7例、糖尿病5例、冠心病1例。安慰剂组患者接受常规抗血小板治疗并口服安慰剂，每次0.2 g，每天三次；丁苯酞胶囊组在常规抗血小板治疗基础上联合丁苯酞软胶囊治疗，空腹口服，每次0.2 g，每天三次。两组均连续治疗6个月。观察指标包括两组患者治疗前及治疗后第3、6个月的失连接指数、功能网络连接指数、认知功能评分、生活质量评分及不良反应发生率。采用独立样本t检验、χ²检验进行统计学分析。结果　治疗前，两组患者失连接指数、功能网络连接指数、认知功能评分差异均无统计学意义（均P0.05）；治疗后第3、6个月，丁苯酞胶囊组的失连接指数均低于安慰剂组［（0.18±0.02）分比（0.23±0.03）分，（0.15±0.01）分比（0.21±0.02）分］，功能网络连接指数均高于安慰剂组［（0.69±0.05）分比（0.66±0.07）分，（0.75±0.06）分比（0.69±0.07）分］，认知功能评分均高于安慰剂组［（23.39±5.14）分比（20.97±4.96）分、（26.17±6.89）分比（22.31±5.27）分］（均P0.05）。治疗前，两组患者生活质量各维度评分差异均无统计学意义（均P0.05）；治疗后，两组患者的生活质量评分均有所上升，且丁苯酞胶囊组各维度评分均高于安慰剂组（均P0.05）。两组不良反应发生率差异无统计学意义（P0.05）。结论　丁苯酞胶囊通过多方面作用，包括调节脑血液循环、抗氧化应激、抑制炎症反应、促进神经再生及调节神经递质等，有效强化了脑梗死后认知功能障碍患者的认知功能网络连通性，提升了其生活品质，且有良好的安全性。

关键词:

丁苯酞胶囊, 脑梗死, 认知功能, 网络连通性, 干预研究