盐酸多奈哌齐治疗血管性痴呆的临床研究  

Clinical research of donepezil hydrochloride in treatment of vascular dementia

作　　者：任向阳[1] 李玮[2] 郑锐锋[3] 杨致远[1] 魏立平[1] 

机构地区：[1]洛阳市中心医院神经内科,河南洛阳市471009 [2]华中科技大学同济医学院协和医院神经内科,湖北武汉市430022 [3]中国中医研究院西苑医院急诊科,北京市100079

出　　处：《中国康复理论与实践》2004年第9期540-541,共2页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的观察盐酸多奈哌齐治疗血管性痴呆患者轻、中度认知功能障碍的有效性和安全性。方法 60例血管性痴呆患者以SAS软件分为治疗组和对照组各 3 0例。治疗组服用盐酸多奈哌齐片 5mg ,4周后增至 10mg ,每晚睡前服 ;对照组服用吡拉西坦 80 0mg ,3次 /d ,饭前口服。疗程均为 12周。以简易精神状态检查 (MMSE)和中国修订成人韦克斯勒智力量表 (WAIS RC)为主要评价指标 ,日常生活活动能力量表 (ADL)和临床综合调查表 (CGI)为次要评价指标。结果两组MMSE评分在治疗后均明显提高 (P <0 0 1) ,治疗组提高 (2 88± 2 85 ) ,对照组提高 (1 62± 2 3 3 ) (P <0 0 5 ) ;WAIS RC评分治疗组治疗后明显提高 (P <0 0 1) ,对照组治疗前后WAIS RC评分无显著性差异 (P >0 0 5 ) ;两组治疗后ADL和CGI的SI均降低 ;盐酸多奈哌齐组总有效率为 80 % ,吡拉西坦组为 5 6% ,两组的药物相关的不良反应无显著性差异。结论盐酸多奈哌齐能改善血管性痴呆患者的认知功能 ,疗效可能优于吡拉西坦 ,应用盐酸多奈哌齐ObjectiveTo assess the clinical efficacy and safety of donepezil in treating the mild to moderate cognitive impairment of vascular dementia.Methods60 patients with vascular dementia were randomly divided into therapy group (donepezil 5 mg/d for 4 weeks, and then increased to 10 mg/d) and control group (piracetan 800 mg,3 /d). All patients were assessed with Mini Mental State Examination (MMSE), Wechsler Adult Intelligence Revised in China (WAIS RC), Activities of daily living (ADL), and Clinical Global Impression (CGI), before and 12 weeks after treatment. ResultsMMSE scores improved significantly in both groups after the treatment. The therapy group produced significantly better scores than the control groups on the MMSE(P<0 05). WAIS RC scores improved significantly in the therapy groups(P<0 01), but there was no significant difference for control groups(P>0 05), before and after treatment. Severity Improvement(SI) score of ADL and CGI in the both groups decreased. The total efficiencies of donepezil and piracetan groups were 86% and 56% respectively. There was no significant difference in adverse effects between two groups. ConclusionDonepezil can improve the cognitive function of patients with vascular dementia, which seems better than that of piracetan, and it is fairly safe for vascular dementia patients to take donepezil 10 mg a day.

关 键 词：血管性痴呆 盐酸多奈哌齐 吡拉西坦 

分 类 号：R749.1[医药卫生—神经病学与精神病学]