盐酸多奈哌齐联合经颅磁刺激治疗脑卒中后认知障碍的疗效观察

Efficacy of Donepezil Hydrochloride Combined with Transcranial Magnetic Stimulation in the Treatment of Cognitive Impairment After Stroke

目的探究盐酸多奈哌齐与经颅磁刺激联合治疗脑卒中后认知障碍的疗效。方法选择2019年6月-2021年6月广东省工伤康复中心诊治的脑卒中后认知障碍患者35例,采用“信封法”分为对照组18例和观察组17例。两组患者均予以常规治疗,对照组给予经颅磁刺激治疗,观察组给予盐酸多奈哌齐联合经颅磁刺激治疗,为期8周。对比两组脑血流动力学、认知功能、日常生活能力及不良反应。结果治疗后观察组脑平均血流速度(Vm)、血流最大峰值流速(Vs)高于对照组,差异有统计学意义(P<0.05);治疗后观察组Addenbrooke改良认知评估量表(ACE-R)各维度评分高于对照组,躯体功能量表(PSMS)、工具性日常生活能力量表(IADL)评分低于对照组,差异有统计学意义(P<0.05);治疗期间两组未见不良反应发生。结论在脑卒中后认知障碍患者中予以盐酸多奈哌齐与经颅磁刺激联合治疗,能够改善脑血流动力学及认知功能,提高日常生活能力,安全可靠。

Objective To explore the efficacy of donepezil hydrochloride combined with transcranial magnetic stimulation in the treatment of cognitive impairment after stroke.Methods 35 patients with post-stroke cognitive impairment treated in our hospital from June 2019 to June 2021 were selected and divided into 18 cases in the control group and 17 cases in the observation group by“envelope method”.Both groups were given routine treatment,the control group was given transcranial magnetic stimulation,and the observation group was given donepezil hydrochloride combined with transcranial magnetic stimulation for 8 weeks.Cerebral hemodynamics,cognitive function,activities of daily living and adverse reactions were compared between the two groups.Results After treatment,the average cerebral blood flow velocity(Vm)and maximum peak blood flow velocity(Vs)in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05);after treatment,the scores of ACE-R in the observation group were higher than those in the control group,and the scores of PSMS and IADL in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);no adverse reactions occurred in the two groups during treatment.Conclusion Donepezil hydrochloride combined with transcranial magnetic stimulation in patients with cognitive impairment after stroke can improve cerebral hemodynamics and cognitive function,improve the ability of daily living,which is safe and reliable.