不同剂量多奈哌齐治疗血管性痴呆的疗效观察及安全性评估

Efficacy and safety evaluation of different doses of donepezil in treatment of vascular dementia

目的探讨多奈哌齐治疗血管性痴呆(VD)的最佳治疗剂量及安全性。方法选取2014年1—12月期间,我院收治的VD患者70例为研究对象,采用对照研究,将患者随机分为5 mg组和10 mg组,每组35人;两组均接受降压、降糖、调脂、局部改善血液循环及抗血小板凝集等基础治疗外,分别予多奈哌齐每次5 mg、10 mg进行治疗;两组均接受12周的治疗,比较治疗前后两组患者MMSE及ADL指标的变化情况,以TESS评定药物不良反应,探讨治疗效果及安全性。结果在治疗后,两组患者的MMSE评分均有所提高,ADL评分均有所下降,与治疗之前比较,差别有统计学意义(P<0.05);但5 mg组和10 mg组之间比较,差别无统计学意义(P>0.05);两组TESS比较差别有统计学意义(P<0.05)。结论 5 mg多奈哌齐可有效改善VD患者的MMSE及ADL指标,获得较好的治疗效果,且5 mg组的不良反应比10 mg组轻,使用更安全,值得进一步推广应用。

Objective To study the dosage and safety evaluation of the best treatment of donepezil in treatment of vascular dementia. Methods Selected during 70 cases of patients with Vascular dementia in our hospital January 2014 to December 2014 as the research object. Adopted the control study,patients were randomly divided into group 5mg and group 10 mg, each group of 35 people; Two groups were received antihypertensive,antidiabetic,lipid,improved the local blood circulation and antiplatelet aggregation based treatment,were treated with donepezil,each time 5mg,10 mg treatment; The two group received 12 weeks of therapy,compared two groups of patients before and after treatment of MMSE and ADL index,evaluated the adverse drug reactions with TESS,to investigate the therapeutic effect and safety. Results After treatment,two groups of patients with MMSE score increased,ADL scores were decreased,compared with before treatment,the difference was statistically significant（ P〈0. 05）; And the difference was no statistically significant of 5mg between 10 mg group; The difference was statistically significant in TESS of 5mg between 10 mg group（ P〈0. 05）. Conclusions 5mg donepezil can significantly improve MMSE and ADL index of the patients,achieve good treatment effect,and the adverse reactions is lower in 5mg group than 10 mg group,the use of more security,which is worthy of further popularization and application.