多奈哌齐联合丁苯酞治疗老年血管性痴呆的应用效果

Effect of Donepezil Combined with Butylphthalide in Senile Patients with Vascular Dementia

目的:探讨多奈哌齐联合丁苯酞治疗老年血管性痴呆患者的临床效果。方法:选取2018年5月-2021年2月在本院就诊的94例老年血管性痴呆患者为研究对象。根据随机抽签的方法分为两组,对照组和观察组各47例。对照组患者使用丁苯酞胶囊,观察组患者在对照组患者用药基础上增加多奈哌齐胶囊。用药3个月后比较两组患者的临床效果和不良反应、认知功能(MMSE评分)、日常自理能力(Barthel指数)及血清中认知相关指标[同型半胱氨酸(Hcy)、基质金属蛋白酶-9(MMP-9)、S100-β钙结合蛋白(S100-β)和脂质过氧化物(LPO)]。结果:观察组治疗总有效率高于对照组(93.62%vs 78.72%,P<0.05);治疗后观察组和对照组的MMSE评分、Barthel指数均高于治疗前(P<0.05),且观察组高于对照组(P<0.05);治疗后观察组和对照组的血清Hcy、MMP-9、LPO和S100-β水平均下降(P<0.05),且观察组低于对照组(P<0.05);两组间不良反应发生率比较差异无统计学意义(P>0.05)。结论:多奈哌齐联合丁苯酞治疗老年血管性痴呆患者临床效果显著,可有效改善认知功能,降低血清Hcy、MMP-9、LPO和S100-水平。

Objective:To investigate the clinical effect of Donepezil combined with Butylphthalide in the treatment of senile patients with vascular dementia.Method:A total of 94 senile patients with vascular dementia in our hospital from May 2018 to February 2021 were selected as the research subjects.According to the random drawing method,they were divided into two groups,the control group and the observation group,47 cases in each.The control group was given Butylphthalide Capsule,the observation group was given Donepezil Capsule on the basis of control group.After 3 months of medication,the clinical effects and adverse reactions,cognitive function(MMSE score),daily self-care ability(Barthel index),and serum cognition-related indicators[homocysteine(Hcy),matrix metalloproteinase-9(MMP-9),S100-βcalcium binding protein(S100-β),lipid peroxides(LPO)]of the two groups were compared.Result:The total effective rate of observation group was higher than that of control group(93.62%vs 78.72%,P<0.05).After treatment,MMSE score and Barthel index of the observation group and the control group were higher than those before treatment(P<0.05),the MMSE score and Barthel index of the observation group were higher than those in the control group(P<0.05).After treatment,serum levels of Hcy,MMP-9,LPO and S100-βin the observation group and control group were decreased(P<0.05),and the indexes in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Donepezil combined with Butylphthalide has significant clinical efficacy in the treatment of patients with vascular dementia,which can effectively improve cognitive function and reduce serum levels of Hcy,MMP-9,LPO and S100-β.