多奈哌齐联合高压氧疗法治疗血管性痴呆的疗效及对患者认知能力的影响
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摘要
目的:探讨多奈哌齐联合高压氧疗法治疗血管性痴呆的疗效及对患者认知能力的影响。方法:选取2014年4月至2017年10月广东省人民医院南海医院收治的血管性痴呆患者60例,采用随机数字表法分为对照组和观察组,每组30例。对照组患者给予吡拉西坦联合高压氧治疗,观察组患者给予多奈哌齐联合高压氧治疗。比较两组患者简易精神状态检查表(mini mental status examination,MMSE)评分、Blessed-Roth评分、日常生活能力量表(activity of daily living scale,ADL)评分、临床疗效及不良反应发生情况的差异。结果:治疗后,两组患者MMSE、Blessed-Roth和ADL评分较治疗前明显改善,且观察组患者明显优于对照组,差异均有统计学意义(P<0.05);观察组患者的总有效率为86.67%(26/30),明显高于对照组的56.67%(17/30),差异有统计学意义(P<0.05);观察组、对照组患者不良反应发生率分别为6.67%(2/30)、10.00%(3/30),差异无统计学意义(P>0.05),对症处理后均得到控制。结论:多奈哌齐联合高压氧疗法治疗血管性痴呆的疗效显著,能够明显改善患者的认知能力,提高生活质量,且安全性较高。
OBJECTIVE: To probe into the efficacy of donepezil combined with hyperbaric oxygen therapy(HBOT) in treatment of vascular dementia and its effect on patients' cognitive function. METHODS: 60 patients with vascular dementia admitted into Nanhai Hospital of Guangdong General Hospital from Apr. 2014 to Oct. 2017 were selected and divided into control group and observation group via random number table, with 30 cases in each group. The control group was given piracetam combined with HBOT, while the observation group was given donepezil combined with HBOT. Differences in mini mental status examination(MMSE), Blessed-Roth scores, scores of activity of daily living scale(ADL), clinical efficacy and incidences of adverse drug reactions between two groups were compared. RESULTS: After treatment, the MMSE, Blessed-Roth and ADL scores of both groups had been significantly improved, and those of observation group were significantly better than the control group, with statistically significant differences(P<0.05); the total effective rate of observation group was 86.67%(26/30), which was significantly higher than that of the control group(56.67%, 17/30), with statistically significant difference(P<0.05); the incidences of adverse drug reactions of observation group and control group were respectively 6.67%(2/30) and 10.00%(3/30), the difference had no statistical significance(P>0.05). The condition of both groups were controlled after symptomatic treatment. CONCLUSIONS: The efficacy of donepezil combined with HBOT in treatment of vascular dementia is remarkable, which can effectively improve patients' cognitive function and quality of life, with high safety.
OBJECTIVE: To probe into the efficacy of donepezil combined with hyperbaric oxygen therapy(HBOT) in treatment of vascular dementia and its effect on patients' cognitive function. METHODS: 60 patients with vascular dementia admitted into Nanhai Hospital of Guangdong General Hospital from Apr. 2014 to Oct. 2017 were selected and divided into control group and observation group via random number table, with 30 cases in each group. The control group was given piracetam combined with HBOT, while the observation group was given donepezil combined with HBOT. Differences in mini mental status examination(MMSE), Blessed-Roth scores, scores of activity of daily living scale(ADL), clinical efficacy and incidences of adverse drug reactions between two groups were compared. RESULTS: After treatment, the MMSE, Blessed-Roth and ADL scores of both groups had been significantly improved, and those of observation group were significantly better than the control group, with statistically significant differences(P<0.05); the total effective rate of observation group was 86.67%(26/30), which was significantly higher than that of the control group(56.67%, 17/30), with statistically significant difference(P<0.05); the incidences of adverse drug reactions of observation group and control group were respectively 6.67%(2/30) and 10.00%(3/30), the difference had no statistical significance(P>0.05). The condition of both groups were controlled after symptomatic treatment. CONCLUSIONS: The efficacy of donepezil combined with HBOT in treatment of vascular dementia is remarkable, which can effectively improve patients' cognitive function and quality of life, with high safety.
引文
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[14] 方力华.胞磷胆碱与多奈哌齐治疗血管性痴呆的疗效比较[J].中国实用神经疾病杂志,2016,19(4):73-74.
[15] 周燚炎,程卫东,孙晓芬,等. 胆碱酯酶抑制剂联合谷氨酸受体拮抗剂和降血脂药三联疗法治疗血管性痴呆的疗效观察及安全性评估[J].中国全科医学,2013,15(35):4160-4162.
[16] 郭爱梅,林述凯,石秋艳,等. 胆碱酯酶抑制剂对血管性痴呆大鼠认知功能的影响[J].中华老年心脑血管病杂志,2012,14(3):311-314.
[2] Venkat P,Chopp M,Chen J.Models and mechanisms of vascular dementia[J].Exp Neurol,2015,272:97-108.
[3] 李忠泽,胡玉英.中医药治疗血管性痴呆研究进展[J].亚太传统医药,2016,12(4):58-60.
[4] 张立,邢艳丽,熊伟南.血管性痴呆治疗的研究进展[J].医学综述,2015,21(8):1414-1417.
[5] 王爱华.高压氧治疗血管性痴呆症的疗效观察[J].中国实用医药,2013,8(20):113-114.
[6] 吴松伟.多奈哌齐联合康复训练对脑卒中后血管性认知障碍的作用[J].中国实用神经疾病杂志,2015,18(23):86-87.
[7] 李明静.轻度认知障碍中MOCA和MMSE的应用评价[J].内蒙古医学杂志,2011,43(11):1313-1314.
[8] Winchester J,Dick MB,Gillen D,et al.Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year[J].Arch Gerontol Geriatr,2013,56(1):96-103.
[9] 张海娟,叶璐,郑小波.ADL评定改良巴氏指数评价表在高干病房中的应用[J].中国老年保健医学,2014,12(5):113-114.
[10] 张翠云,卢祖能,章军建,等. 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[J].中国临床保健杂志,2016,19(3):236-239.
[11] O'Brien JT,Thomas A.Vascular dementia[J].Lancet,2015,386(10004):1698-1706.
[12] 林平. 尿微量白蛋白与急性缺血性脑卒中的关系[M].大连:大连医科大学,2014:7714.
[13] 江志滨,卢峰,李波,等.阿加曲班配合高压氧对老年缺血性脑卒中患者的Barthel指数、神经认知功能评分及血液流变学的影响[J].医学研究杂志,2016,45(7):138-141.
[14] 方力华.胞磷胆碱与多奈哌齐治疗血管性痴呆的疗效比较[J].中国实用神经疾病杂志,2016,19(4):73-74.
[15] 周燚炎,程卫东,孙晓芬,等. 胆碱酯酶抑制剂联合谷氨酸受体拮抗剂和降血脂药三联疗法治疗血管性痴呆的疗效观察及安全性评估[J].中国全科医学,2013,15(35):4160-4162.
[16] 郭爱梅,林述凯,石秋艳,等. 胆碱酯酶抑制剂对血管性痴呆大鼠认知功能的影响[J].中华老年心脑血管病杂志,2012,14(3):311-314.