多奈哌齐联合丁苯酞治疗血管性痴呆的临床疗效及对神经功能恢复的影响

Clinical Efficacy of Donepezil Combined with Butylphthalide in the Treatment of Vascular Dementia and its Effect on the Recovery of Neurological Function

目的研究多奈哌齐联合丁苯酞治疗血管性痴呆的临床疗效及对神经功能恢复的影响。方法选取2021年7月-2022年7月吉水县人民医院诊治的90例血管性痴呆患者为研究对象,采用随机数字表法分为对照组(n=45)和观察组(n=45)。对照组采用丁苯酞治疗,观察组在对照组基础上给予多奈哌齐治疗,比较两组临床疗效、神经功能缺损(mRs)评分、日常生活能力(ADL)评分、简易精神状态(MMSE)评分、炎性因子水平[肿瘤坏死因子(TNF)-α、白细胞介素(IL-6)]以及不良反应发生情况。结果观察组治疗总有效率为95.56%,高于对照组的84.44%(P<0.05);两组治疗后mRs评分低于治疗前,ADL、MMSE评分均高于治疗前,且观察组mRs评分低于对照组,ADL、MMSE评分均高于对照组(P<0.05);两组治疗后TNF-α、IL-6水平均低于治疗前,且观察组低于对照组(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论多奈哌齐联合丁苯酞治疗血管性痴呆的临床疗效良好,可促进神经功能恢复,改善认知水平,降低炎症因子水平,提升日常生活能力,且不增加不良反应发生几率。

Objective To study the clinical efficacy of donepezil combined with butylphthalide in the treatment of vascular dementia and its effect on the recovery of neurological function.Methods A total of 90 patients with vascular dementia diagnosed and treated in Jishui County People's Hospital from July 2021 to July 2022 were selected as the research objects,and they were divided into control group(n=45)and observation group(n=45)by random number table method.The control group was treated with butylphthalide,and the observation group was treated with donepezil on the basis of the control group.The clinical efficacy,neurological deficit(mRs)score,activity of daily living(ADL)score,mini-mental state examination(MMSE)score,inflammatory factor levels[tumor necrosis factor(TNF)-α,interleukin(IL-6)]and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 95.56%,which was higher than 84.44%in the control group(P<0.05).After treatment,the mRs scores of the two groups were lower than those before treatment,and the ADL and MMSE scores were higher than those before treatment,while the mRs scores of the observation group were lower than those of the control group,and the ADL and MMSE scores were higher than those of the control group(P<0.05).After treatment,the levels of TNF-αand IL-6 in the two groups were lower than those before treatment,and those in the observation group were lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Donepezil combined with butylphthalide has a good clinical effect in the treatment of vascular dementia,which can promote the recovery of neurological function,improve cognitive level,reduce the level of inflammatory factors,improve the ability of daily life,and do not increase the incidence of adverse reactions.