多奈哌齐联合耳穴压豆治疗轻中度血管性痴呆患者临床疗效分析  

Clinical efficacy of donepezil combined with auricular point pressing bean in treatment of mild-to-moderate vascular dementia:an analysis study

作　　者：王春凤[1] 杨明辉[1] WANG Chunfeng;YANG Minghui(Department of Encephalopathy,Henan Province Hospital of TCM,Zhengzhou 450002,Henan Province,China)

机构地区：[1]河南省中医院脑病科,郑州市450002

出　　处：《内科》2022年第2期141-144,156,共5页Internal Medicine

基　　金：国家中医临床研究基地业务建设科研专项课题(2019JDZX061)。

摘　　要：目的观察多奈哌齐片联合耳穴压豆治疗轻中度血管性痴呆患者的临床疗效。方法选取2020年2月至2021年4月在我院诊治的轻中度血管性痴呆患者110例为研究对象,利用随机数字法将患者分为对照组和观察组各55例。对照组患者口服多奈哌齐片治疗,观察组患者口服多奈哌齐片联合耳穴压豆治疗,疗程30 d。检测比较两组患者治疗前后的日常生活能力量表(ADL)、简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分;采用彩色多普勒检测比较两组患者的大脑前动脉、中动脉及后动脉的血流速度;检测比较两组患者的超氧化物歧化酶(SOD)、同型半胱氨酸(Hcy)、过氧化脂质(LPO)水平;比较两组患者的临床疗效及不良反应发生情况。结果治疗期间对照组脱落3例,观察组脱落1例。治疗30 d后,两组患者的ADL、MMSE、MoCA评分均明显升高,观察组患者的评分显著高于对照组,差异有统计学意义(P<0.05);两组患者大脑前动脉、中动脉、后动脉的血流速度均明显增快,观察组患者血流速度显著大于对照组,差异有统计学意义(P<0.05)。治疗30 d后,两组患者的SOD水平均明显升高,Hcy、LPO水平均明显降低;观察组患者的SOD水平显著高于对照组,Hcy、LPO水平显著低于对照组,差异有统计学意义(P<0.05)。观察组患者的治疗总有效率(96.3%)明显高于对照组(80.8%),差异有统计学意义(P<0.05)。治疗期间,两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论多奈哌齐片联合耳穴压豆可明显提高轻中度血管性痴呆患者的认知功能及脑血流速度,改善患者的氧化应激状况。Objective To observe the clinical efficacy of donepezil tablets combined with auricular point pressing bean in the treatment of mild-to-moderate vascular dementia.Methods 110 patients with mid-to-moderate vascular dementia treated in our hospital from February 2020 to April 2021 were enrolled as the research objects,and they were randomly divided into control group and observation group,with 55 cases in each group.The patients in the control group were given donepezil tablets treatment,while patients in the observation group received donepezil tablets combined with auricular point pressing bean,for a 30-day treatment course.The scores of activity of daily living scale(ADL),mini-mental state examination(MMSE)and montreal cognitive assessment(MoCA)were detected and compared between the two groups before and after treatment.The blood flow velocity of the anterior cerebral artery,middle cerebral artery and posterior cerebral artery were detected and compared by color doppler.And the levels of superoxide dismutase(SOD),homocysteine(Hcy)and lipid peroxide(LPO)were detected and compared between the two groups.The clinical efficacy and the occurrence of adverse reactions of the two groups were compared.Results During treatment,the control group dropped 3 cases and the observation group dropped 1 case.After 30 days of treatment,the scores of ADL,MMSE and MoCA in the two groups increased significantly,and the scores in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).The blood flow velocity of anterior cerebral artery,middle cerebral artery and posterior cerebral artery significantly faster in both groups and were significantly greater in the observation group than those in the control group,with statistically significant differences(P<0.05).After 30 days of treatment,SOD levels in both groups increased significantly,while the Hcy and LPO levels significantly decreased;the observation group reached higher level of SOD and lower levels of Hcy

关 键 词：血管性痴呆 多奈哌齐 耳穴压豆 认知功能 

分 类 号：R749.13[医药卫生—神经病学与精神病学]