多奈哌齐加综合康复训练治疗颅脑外伤后患者认知功能障碍的研究

The Study of Therapeutic Effects of Donepezil and Comprehensive Rehabilitation on the Cognitive Dysfunction Following Traumatic Brain Injury

目的探讨能有效提高TBI患者认知功能的治疗方案。方法将100例存在认知功能障碍的TBI患者随机均分为A组和B组,A组给予认知功能训练、高压氧、针灸、低频电穴位刺激等综合康复措施,B组在此基础上加施盐酸多奈哌齐片。并通过第2版洛文斯顿作业疗法认知评定成套测验(LOTCA)中文量表评定所有患者治疗前后的认知功能以及功能独立性功能评估(FIM)评定患者日常生活活动能力的综合情况。结果每个组内,治疗后的LOTCA和FIM评分均明显高于治疗前(P<0.05),且以治疗8周后最高;治疗前,两组的同种评分均无异(P>0.05);治疗4周后,B组略高于A组,但LOTCA评分中二者差异无统计学意义(P>0.05);治疗8周后,B组评分明显高于A组,且差异具有统计学意义(P<0.05),但是FIM评分增幅明显较前4周减小(P<0.05)。结论给予TBI患者积极的治疗对认知功能的恢复有较大的潜力,且可通过有效的干预(本研究中加予盐酸多奈哌齐)获得最大限度的功能恢复。

Objective To explore how to improve cognitive function in patients with TBI.Methods 100 patients with cognitive impairment were randomly divieded into the control group A and experimental group B.A group was cared by cognitive training,hyperbaric oxygen,acupuncture,low-frequency electrical acupoint stimulation comprehensive rehabilitation measures.B group was administrated with the routine comprehensive rehabilitation measures and donepezil.All patients were assessed with LOTCA and FIM before,4 weeks and 8 weeks after the treatment.Result Before the treatment,both LOTCA and FIM scores had no difference in two groups（P〈0.05）.After 4 weeks,FIM score of B group was better than that of A group（P〉0.05）.After 8 weeks,both LOTCA and FIM scores improved statistically significant in two groups（P〈0.05）.And the sores of B group were better than those of A group（P〈0.05）.But FIM score increased significantly decreased compared with the former（P〈0.05）.Conclusion TBI patients have a greater potential for recovery on cognitive function by aggressive treatment.And the donepezil can be an effective intervention to maximize functional recovery.