认知功能训练联合盐酸多奈哌齐治疗脑卒中认知功能障碍的疗效观察

Cognitive function training joint hydrochloride donepezil in the treatment of cerebral stroke cognitive dysfunction

目的探讨认知功能训练联合盐酸多奈哌齐治疗脑卒中认知功能障碍的临床疗效。方法将60例脑卒中发生认知功能障碍的患者随机分为两组，各30例。两组患者均给予相应的改善循环等常规治疗，其中A组患者给予盐酸多奈哌齐治疗，B组患者在A组基础上增加认知功能训练。分别于治疗前及治疗后1个月、3个月，对两组患者行临床痴呆评定量表（CDR）、简易精神状态量表（MMSE）及日常生活活动能力量表（ADL）进行评价和比较。结果两组患者治疗后1个月CDR评分[（2．3±0．5）分、（1．9±0．6）分]及ADL评分[（43．3±12．5）分、（39．6±12．2）分]，均较治疗前[（2．6±0．6）分、（2．6±0．5）分]、[（49．6±11．2）分、（48．3±12．5）分]下降（均P〈0．05），而MMSE评分[（20．6±3．2）分、（21．0±3．5）分]较治疗前[（19．3±3．5）分、（19．6±3．2）分]改善不明显；治疗后3个月CDR评分[（1．6±0．5）分、（1．3±0．5）分]、MMSE评分[（23．3±3．5）分、（25．6±3．2）分]及ADL评分[（39．6±11．2）分、（33．3±12．5）分]均有明显改善，且B组患者上述指标改善更明显。结论认知功能训练联合盐酸多奈哌齐治疗脑卒中认知功能障碍较单独盐酸多奈哌齐有更好的临床疗效，可以更明显地改善患者的症状，提供患者的生活质量。

Objective To explore the clinical effect of cognitive function training joint hydrochloride donepe- zil in the treatment of cerebral stroke cognitive dysfunction. Methods 60 cerebral stroke patients with cognitive dys- function were divided into two groups randomly, each group 30 cases. The patients of the two groups were given corre- sponding improving circulation and other conventional treatment measures, including giving hydrochloride donepezil treatment to A group and cognitive function training on the based treatment of group A to group B. Before treatment and after treatment 1 month, 3 months, clinical dementia rating scale （CDR）, simple mental state scale of mini-mental state examination （MMSE） and daily life events scale （ADL） ability evaluation were compared between the two groups. Results Of the two groups, CDR scores [ （ 2.3 ± 0.5 ） points, （ 1.9± 0. 6 ） points ] and ADL [ （ 43.3 ± 12.5 ） points, （39.6 ± 12.2） points ] were lower than those before treatment [ （2.6 ± 0. 6） points, （2.6± 0. 5 ） points, （49.6 ± 11.2） points, （48.3 ± 12.5 ） points ] （ all P 〈 0.05 ）, and M MSE scores [ （ 20.6 ± 3.2 ） points, （ 21.0 ± 3.5 ） points] were no different to those before treatment[ （ 19.3 ± 3.5 ） points, （ 19.6 ± 3.2） points] ;3 months after treatment, CDR scores [ （ 1.6 ± 0.5 ） points, （ 1.3 ± 0.5 ） points ], MMSE scores [ （ 23.3 ± 3.5 ） points （25.6 ± 3.2） points ] and ADL scores [ （ 39.6 ±11. 2） points （33.3 ± 12.5 ） points ] were significantly improved, and which of B group improved obviously. Conclusion Cognitive function training joint hydrochloride donepezil in the treatment of cerebral stroke cognitive dysfunction is more effective than hydrochloride donepezil alone, and can more obviously im- prove the symptoms of patients, and promote the quality of life, and it is worth for clinical application.