哈伯因与茴拉西坦治疗壮族老年期痴呆患者对照研究

A control study of huperzine a vs aniracetam in the treatment of Zhuang nationality senile dementia patient

目的 评价哈伯因与茴拉西坦治疗壮族老年期痴呆患者的临床疗效及安全性.方法 将100例壮族老年期痴呆患者随机分为哈伯因壮族组和茴拉西坦壮族组,每组50例,分别口服哈伯因和茴拉西坦治疗;将100例汉族老年期痴呆患者分为哈伯因汉族组和综合治疗组,每组50例,哈伯因汉族组口服哈伯因治疗,综合治疗组口服哈伯因或茴拉西坦治疗,同时联合肠溶阿斯匹林及其他康复治疗.观察12周.于治疗前及治疗4周、8周、12周末,采用长谷川痴呆量表评定临床疗效,日常生活能力量表评定生活能力状况,副反应量表评定不良反应.结果 治疗后各组长谷川痴呆量表评分均较治疗前显著升高,日常生活能力量表评分均较治疗前显著下降（P＜0.05或0.01）;治疗12周末,综合治疗组长谷川痴呆量表评分较其他各组升高更显著,日常生活能力量表评分较其他各组下降更显著（P＜0.05）.所有对象中血管性痴呆患者有效率为91.3%,阿尔茨海默病患者为63.3%;轻度痴呆患者为82.2%,中度痴呆为53.6%.血管性痴呆患者有效率显著高于阿尔茨海默病患者,轻度痴呆患者有效率显著高于中度痴呆患者（χ^2=19.69、18.16,P＜0.01）.各组不良反应均轻微,发生率差异均无显著性（P＞0.05）.结论 哈伯因与茴拉西坦能有效改善壮族老年期痴呆患者的智力和记忆功能,对血管性痴呆及轻度痴呆患者效果更显著,同时能提高患者的生活能力,治疗安全性高,依从性高;但药物联合康复治疗远期疗效更显著.

Objective To evaluate the efficacy and safety of huperzine a vs aniracetam in the treatment of Zhuang nationality senile dementia patient. Methods One hundred Zhuang nationality senile dementia patients were randomly assigned to huperzine a Zhuang nationality and aniracetam Zhuang nationality group of 50 ones each, they treated with huperzine a or aniracetam; 100 Han nationality senile dementia patients were randomly assigned to huperzine a Han nationality and combined therapy group of 50 ones each, huperzine a Han group took orally huperzine a, and combined therapy group did huperzine a or aniracetam plus enteric coated aspirin and other rehabilitative treatment. They were observed for 12 week. Efficacies were assessed with the Hasegava Dementia Scale （HDS）, living ability status with the Activity of Daily Living Scale （ADL） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 4^th, 8^th and 12^th week. Results After treatment, the HDS scores of all groups heightened more significantly and ADL scores lowered compared with pretreatment （P〈0. 05 or 0.01）; at the end of the 12^th week, the HDS score heightened more significantly and ADI. scores lowered in combined group than in the other groups （P〈0.05）. The effective rate was significantly higher in VD patients than in AD （91.3% vs 63.3%, χ^2=19. 69,P〈0. 01） and in mild dementia patients than in moderate （ 82.2% vs 53.6% χ^2= 18. 16, P〈0. 01）. Adverse reactions of all groups were mild and their inci dences had no significant differences （P〈0.05）. Conclusion Both huperzine a and aniracetam could effectively improve intelligence and memory function of Zhuang nationality senile dementia patient, especially VD and mild dementia patients, increase patients＇ living ability, and has higher safety and better compli ance; the long-term effect of drug combined with rehabilitative treatment is more notable.