盐酸多奈哌齐与尼莫地平治疗血管性痴呆的疗效比较

Comparison of Clinical Efficacy of Donepezil Hydrochloride vs. Nimodipine in the Treatment of Vascular Dementia

目的:对比观察盐酸多奈哌齐与尼莫地平治疗血管性痴呆(VD)的疗效。方法:选择2007年1月～2009年1月的82例VD患者,将其随机分为盐酸多奈哌齐组与尼莫地平组,每组41例,对比观察2组的临床疗效及对认知能力、痴呆程度和日常生活能力的影响。结果:盐酸多奈哌齐组治疗的显效率、总有效率均明显高于尼莫地平组(P<0.05);盐酸多奈哌齐组治疗后4周、12周简易精神状态量表(MMSE)评分、临床痴呆量表(CDR)评分及日常生活活动能力量表(ADL)评分均较治疗前明显改善,差异有统计学意义(P<0.05)。尼莫地平组治疗后4周、12周MMSE评分与治疗前比较,差异有统计学意义(P>0.05);CDR评分仅在治疗后12周明显下降(P<0.05),治疗后4周CDR评分与治疗前比较,差异无统计学意义(P>0.05);ADL评分治疗后4周、12周与治疗前比较,差异均无统计学意义(P>0.05)。盐酸多奈哌齐组治疗后4周、12周MMSE评分、CDR评分和ADL评分均优于同期尼莫地平组,2组比较差异有统计学意义(P<0.05)。结论:在治疗VD方面,盐酸多奈哌齐治疗VD优于尼莫地平,并且较尼莫地平更能改善患者的认知功能、痴呆程度和日常生活活动能力。

OBJECTIVE：To compare and observe clinical efficacy of donepezil hydrochloride vs.nimodipine in the treatment of vascular dementia（VD）.METHODS：From Jan.2007 to Jan.2009,82 VD patients were randomly divided into donepezil hydrochloride group（41 cases）and nimodipine group（41 cases）.The clinical efficacy,the degree of dementia and daily living activity were observed and compared among 2 groups.RESULTS：The effective rate and total effective rate in donepezil hydrochloride group were both significantly higher than those in nimodipine group（P〈0.05）.The MMSE scores,CDR scores and ADL scores in donepezil hydrochloride group were significantly decreased 4 weeks and 12 weeks after treatment,there was statistical significance（P〈0.05）.4 weeks and 12 weeks after treatment,MMSE score in nimodipine group was significantly different from before treatment,there was statistical significance（P〈0.05）.CDR scores in nimodipine group were significantly decreased 12 weeks after treatment（P〈0.05）and had no significant difference 4 weeks after treatment（P〈0.05）.ADL scores had no significant difference 4 weeks and 12 weeks after treatmen（tP〈0.05）.The MMSE scores,CDR scores and ADL scores in donepezil hydrochloride group were significantly better than in nimodipine group 4 weeks and 12 weeks after treatment,there was statistical significance（P 0.05）.CONCLUSION：Donepezil hydrochloride is better than nimodipine in the treatment of VD and can improve perceptibility,the degree of dementia and daily living activity of VD patients.