盐酸多奈哌齐治疗老年痴呆的疗效研究

Clinical Efficacy of Donepezil in the Treatment of Senile Dementia

目的探讨盐酸多奈哌齐治疗老年痴呆患者的临床疗效。方法选择2009年1月—2010年9月106例本院就诊的老年痴呆患者,随机分为治疗组53例及对照组53例,两组均给予基础治疗,治疗组在此基础上给予盐酸多奈哌齐治疗。选择治疗前、随访3个月时及2年时患者的临床症状、体征及简易精神状况检查表(MMSE)评分、日常生活能力量表(ADL)评分进行分析比较。结果 106例老年痴呆患者中男44例(41.5%),女62例(58.5%);年龄60～90岁,60～75岁82例(77.3%),76～90岁24例(22.7%);大学学历以下73例(68.87%),大学及大学以上学历33例(31.13%);阿尔茨海默病(AD)72例(67.9%),血管性痴呆(VaD)23例(21.7%),其他类型痴呆11例(10.4%)。随访2年期间失访14例,实访92例。治疗前及随访3个月时两组MMSE评分及ADL评分等级比较,差异均无统计学意义(P>0.05);而随访2年时两组MMSE评分及ADL评分等级比较,差异均有统计学意义(P<0.05)。两组均有不良反应发生,给予对症处理后好转,且两组不良反应发生率比较,差异无统计学意义(χ2=1.38,P>0.05)。结论盐酸多奈哌齐治疗老年痴呆安全有效,不良反应较少,值得临床推广应用。

Objective To evaluate the clinical efficacy of Donepezil in the treatment of senile dementia.Methods A total of 106 senile dementia patients admitted to our hospital were randomly divided into treatment group(n=53) and control group(n=53).The two groups were both given primary treatment,and the treatment group was given additional Donepezil treatment.Clinical symptoms,physical signs,MMSE score and ADL score were compared between the two groups before treatment,three months and two years after treatment.Results Among the 106 senile dementia patients,44 cases were male(41.5%) and 62 cases were female(58.5%);the patients were aged from 60 to 90,and 82 cases were from 60 to 75(77.3%) and 24 cases were from 76 to 90(22.7%);73 cases were under college degree(68.87%) and 33 cases were college degree or above(31.13%);72 cases had Alzheimer′s disease(AD)(67.9%),23 cases had vascular dementia(VaD)(21.7%) and 11 cases had other dementia(10.4%).92 cases were followed up and 14 cases lost following up during the two-year follow up.The MMSE score and ADL score before treatment and on three-month following up between the two groups showed no statistically significant difference(P>0.05),but showed statistically significant differences on two-year following up(P<0.05).Both groups had adverse effects and were improved after symptomatic treatment.The incidence of adverse effect between the two groups showed no statistically significant difference(χ2=1.38,P>0.05).Conclusion Donepezil is safe and effective treatment for senile dementia with little adverse reaction.Donepezil may be regarded as one of best treatments for senile dementia.