盐酸多奈哌齐联合尼莫地平在改善血管性痴呆患者认知功能和自理能力中的作用

Effects of donepezil hydrochloride combined with nimodipine on cognitive function and self-care ability in patients with vascular dementia

目的观察和分析盐酸多奈哌齐联合尼莫地平在改善血管性痴呆(Va D)患者认知功能和自理能力的作用。方法选取80例Va D患者作为研究对象,应用随机数字表分为观察组和对照组,每组各40例。对照组患者给予口服盐酸多奈哌齐进行治疗,观察组给予口服盐酸多奈哌齐联合尼莫地平进行治疗。对两组患者的疗效、临床有效率、治疗前、治疗4周时、治疗8周时的简易精神状态检查表(MMSE)评分、临床痴呆量表(CDR)评分、日常生活自理量表(ADL)评分、Barthel指数评分及治疗期间的不良反应发生率进行观察和比较。结果观察组患者的疗效分布及临床有效率均优于对照组(U=3.512、χ~2=4.501,P<0.05),在治疗第8周时,两组患者的MMSE评分、CDR评分、ADL评分、Barthel指数评分均较治疗前显著改善,且观察组患者上述评分优于对照组,差异均有统计学意义(P<0.05),两组患者不良反应发生率差异无统计学意义(χ~2=0.251,P>0.05)。结论相对单独应用盐酸多奈哌齐,应用盐酸多奈哌齐联合尼莫地平治疗Va D,可获得更好的治疗效果,显著提高患者的认知功能和生活自理能力,且具有较高的安全性。

Objective To observe and analyze the effects of donepezil hydrochloride combined with nimodipineon cognitive function and self-care ability in patients with vascular dementia( Va D). Methods Eighty patients with Va D were selected as subjects and randomly divided into observation group and control group,40 cases in each group.The patients of control group were treated with oral donepezil hydrochloride,the patients of observation group were treated with oral donepezil hydrochloride combined with nimodipine. The therapeutic effects,clinical efficiency,mini mental state examination( MMSE) score,clinical dementia scale( CDR) score,activities of daily living scale( ADL) score,Barthel index score before treatment,4 weeks and 8 weeks after treatment and incidences of adverse reactions during treatment of patients in the two groups were observed and compared. Results The distribution of the therapeutic effects and clinical efficiency of observation group were better than those of control group( U = 3. 512,χ~2= 4. 501,P < 0. 05).At 8th week of the treatment,the MMSE score,CDR score,ADL score,Barthel index score were improved in both groups,while these indicators in observation group was better than control group,and the differences were statistically significant( P < 0. 05). The difference of incidence of adverse reactions between two groups was not statistically significant( χ~2= 0. 251,P > 0. 05). Conclusion Compared with donepezil hydrochloride,donepezil hydrochloride combined with nimodipine can achieve better therapeutic effects in the treatment of Va D. Combination therapy can improve cognitive function and life self-care ability.