康复训练联合阿托伐他汀治疗皮质下缺血性血管性痴呆的疗效观察

Effectiveness of rehabilitation training combined with atorvastatin for subcortical ischemic vascular dementia

目的:观察康复训练联合阿托伐他汀对皮质下缺血性血管性痴呆(SIVD)患者的认知功能及日常生活活动能力的改善作用。方法:56例SIVD患者随机分为2组各28例,观察组采用康复训练联合阿托伐他汀治疗,对照组采用多奈哌齐治疗。2组患者分别在治疗前、治疗后1及6个月时进行简易精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)及Barthel指数(BI)的评定。结果:治疗1个月时,2组MMSE、MoCA及BI评分组间及组内比较均差异无统计学意义;治疗6个月时,2组患者的MMSE、MoCA、Bl指数均较治疗前及治疗1个月时显著升高(P<0.05);且观察组各项评分更高于对照组(P<0.01)。观察组总有效率明显高于对照组(P<0.05)。结论:康复训练联合阿托伐他汀对SIVD患者的认知功能及日常行为能力有明显的远期疗效,且明显优于多奈哌齐治疗。

Objective：To investigate the effectiveness of rehabilitation training combined with atorvastatin in the treatment of subcortical ischemic vascular dementia（SIVD）on cognitive function and activities of daily living.Methods：A total of 56 patients with SIVD were enrolled consecutively and randomly divided into 2groups：rehabilitation training combined with atorvastatin group（observation group）and donepezil group（control group）.Mini-mental state examination（MMSE）,Montreal cognitive assessment（MoCA）and Barthel index（BI）were assessed and compared between the two groups before treatment,and at first and 6th month after treatment.Results：The cognitive function and behavioral abilities were similar in the two groups at the end of the first month.However,the MMSE,MoCA and Barthel indexes were significantly higher at the 6th month than those before treatment and at the first month in the two groups（P〈0.05）,and they were even higher in the observation group than in the control group（P〈0.01）.A higher effective rate was found in the observed group than that in the control group（P〈0.05）.Conclusion：Rehabilitation training combined with atorvastatin showed an obvious long-term effectiveness on the cognitive function and activities of daily living recovery in patients with SIVD,and its effectiveness is superior to donepezil.