多奈派齐联合尼莫地平治疗血管性痴呆的疗效观察

目的探讨多奈哌齐联合尼莫地平治疗血管性痴呆的疗效及安全性。方法将60例血管性痴呆随机分成两组,即尼莫地平治疗组(对照组)和尼莫地平联合多奈哌齐治疗组(治疗组),治疗前及治疗后12周均应用简易智力状态检查量表(MMSE)、临床痴呆程度量表(CDR)及日常生活活动能力量表(ADL)评分法进行评价。结果治疗12周后,治疗组MMSE、ADL积分明显提高,CDR积分明显降低,与治疗前比较差异有统计学意义(P<0.01),两组均无明显不良反应。结论尼莫地平是治疗血管性痴呆的有效药物之一,与多奈哌齐合用疗效更显著、安全。     

尼莫地平与多奈派齐治疗血管性痴呆的随机对照研究

目的研究多奈派齐治疗血管性痴呆的临床疗效和安全性。方法血管性痴呆患者120例,随机分为多奈派齐组和尼莫地平组各60例。在基础治疗的基础上,多奈派齐组给予多奈派齐5 mg,每晚1次;尼莫地平组给予尼莫地平30 mg,3次/d;均连续治疗24周。治疗前后由专人进行简易精神状态量表（MMSE）、临床痴呆量表（CDR）及日常生活活动能力量表（ADL）的评定。结果两组治疗24周后MMSE、ADL评分较治疗前均显著提高（P〈均0.01）,CDR评分均显著降低（P〈0.01）;两组治疗后以上评分比较差异无统计学意义。结论多奈派齐与尼莫地平治疗血管性痴呆安全有效,但尼莫地平价格便宜,故可作为治疗血管性痴呆的首选药物。     

多奈哌齐与尼莫地平联合治疗血管性痴呆的疗效

目的分析多奈哌齐与尼莫地平联合治疗血管性痴呆的临床疗效。方法血管性痴呆患者154例随机分为治疗组和对照组,每组77例,治疗组使用多奈哌齐联合尼莫地平,对照组使用尼莫地平,治疗结束后对两组进行治疗前后痴呆严重程度、认知能力及不良反应的评定。结果治疗组治疗前简易精神状态评估(MMSE)、日常生活活动能力(ADL)、临床痴呆评定(CDR)、长谷川痴呆修正量表(HDS-R)评分与对照组无显著差异;而治疗后四项指标评分与对照组差异显著(P0.05)。结论多奈哌齐与尼莫地平联合治疗血管性痴呆的疗效明显优于单一的尼莫地平,安全性较高,能缓解痴呆患者的认知功能障碍,减少不良反应,提高生活质量。     

多奈哌齐联合尼莫地平治疗血管性痴呆病人72例的临床观察

目的观察盐酸多奈哌齐联合尼莫地平治疗血管性痴呆病人的临床疗效,及对智能状态量表(MMSE)和日常生活能力量表(ADL)评分的影响。方法将72例VD病人随机分为两组,每组36例。对照组予以尼莫地平治疗,观察组予以盐酸多奈哌齐联合尼莫地平治疗。比较两组治疗效果及治疗前后MMSE、ADL评分。结果治疗后,观察组总有效率为80.56%,对照组总有效率为52.78%(P0.05);对照组MMSE、ADL评分均低于观察组(P0.05)。结论多奈哌齐联合尼莫地平可改善血管性痴呆病人MMSE评分,提高日常生活能力,优于单独使用尼莫地平。     

Clinical study of combined treatment with piracetam and nimodipine for vascular dementia after cerebral infarction

目的 评价吡拉西坦联合尼莫地平治疗脑梗塞后血管性痴呆的疗效.方法 将64例脑梗塞后血管性痴呆患者按照入院日期随机分为2组,单日为A组(32例),给予吡拉西坦联合尼莫地平治疗;双日为B组(32例),给予尼莫地平治疗.治疗前和治疗后3、6个月进行简易智能状态检查量表(MMSE)、画钟试验(CDT)、日常生活能力量表(ADL)及临床痴呆程度量表(CDR)评估.结果 A组治疗后3、6个月在MMSE、CDT、ADL、CDR评分方面明显优于B组(P＜0.05),A组总有效率为93.75％,显著高于B组(P＜0.05).结论 吡拉西坦联合尼莫地平治疗脑梗塞后血管性痴呆效果显著,能明显改善老年期血管痴呆患者认知及生活能力,且不良反应小.     

尼莫地平联合盐酸多奈哌齐对老年痴呆患者认知功能及日常生活能力的影响

目的探讨尼莫地平联合盐酸多奈哌齐对老年痴呆患者认知功能及日常生活能力的影响。方法老年痴呆患者70例随机分组,对照组35例,给予盐酸多奈哌齐治疗;观察组35例,在对照组基础上联合尼莫地平治疗,两组均连续治疗7周。对比两组临床疗效、不良反应,治疗前、治疗3、7周后简易精神状态检查量表(MMSE)评分、日常生活自理量表(ADL)评分及临床痴呆量表(CDR)评分。结果观察组总有效率高于对照组(P<0.05);治疗3、7周后观察组MMSE、ADL评分高于对照组,CDR评分低于对照组(P<0.05)。结论尼莫地平与盐酸多奈哌齐联合治疗老年痴呆患者,能有效改善认知功能和痴呆状态,提高日常生活能力,减少不良反应,疗效显著。     

多奈哌齐片联合尼莫地平治疗血管性痴呆45例的疗效

目的:观察多奈哌齐联合尼莫地平治疗血管性痴呆的临床疗效。方法:45例年龄在54~76岁的血管性痴呆患者被随机分为多奈哌齐+尼莫地平组(24例)和石杉碱甲+吡拉西坦组(21例),测定两组患者治疗前后的简明精神状态检查表(MMSE)评分和日常生活活动评分(ADL),并进行两组疗效的比较。结果:与治疗前比较,治疗后多奈哌齐+尼莫地平组的MMSE评分[(15.8±6.3)分比(21.6±7.4)分]显著提高,ADL评分[(50.3±6.4)分比(40.2±7.1)分]显著下降,石杉碱甲+吡拉西坦组MMSE评分[(14.6±6.9)分比(18.5±7.2)分]显著提高,ADL评分[(49.3±7.8)分比(43.5±8.2)分]显著下降,P均0.01;但两组治疗后无显著差异(P=0.08,0.07)。结论:多奈哌齐联合尼莫地平治疗血管性痴呆的疗效与多奈哌齐+尼莫地平相当。     

脑血疏口服液联合多奈哌齐、尼莫地平治疗血管性痴呆的临床疗效

目的观察脑血疏口服液联合多奈哌齐、尼莫地平治疗血管性痴呆的临床疗效。方法将128例血管性痴呆病人随机平均分为两组,对照组给予多奈哌齐联合尼莫地平治疗,试验组给予脑血疏口服液联合多奈哌齐、尼莫地平治疗,其中多奈哌齐、尼莫地平的治疗方案同对照组。4周为1个疗程,均治疗3个疗程,治疗前后采用简易智能状态检查量表(MMSE)、日常生活能力量表(ADL)及脑电图(EEG)评估治疗效果、脑电异常率、P300潜伏值及波幅变化,记录病人用药后不良反应发生的情况。结果治疗后,试验组总有效率高于对照组,差异有统计学意义(P0.05),试验组在MMSE、ADL量表评分较对照组均差异有统计学意义(P0.05)。试验组脑电异常率也较对照组降低,P300潜伏期较对照组明显缩短,且其波幅较对照组明显升高,差异具有统计学意义(P0.05)。结论脑血疏口服液联合多奈哌齐、尼莫地平治疗血管性痴呆可获得良好的疗效,可有效改善病人认知功能与日常生活能力。     

盐酸多奈哌齐治疗血管性痴呆有效性及安全性临床分析

目的评估盐酸多奈哌齐治疗轻、中度血管性痴呆的临床疗效以及安全性。方法 95例可能或可疑血管性痴呆患者,随机分为3组,治疗1组患者每日服用盐酸多奈哌齐5 mg,共48周;治疗2组患者每日服用盐酸多奈哌齐5 mg,共24周,第25～36周隔日服用一次盐酸多奈哌齐5 mg,第37～48周停药;对照组30例,随访共48周。每12周随访一次,评估采用ADAS-cog、ADL、MMSE、CDR量表。结果治疗12、组MMSE、ADAS-cog评分与对照组比较均有统计学差异（P〈0.05）。治疗1、2组治疗后ADAS-cog、ADL、MMSE、CDR评分均较治疗前改善（P〈0.05）。结论盐酸多奈哌齐能显著改善轻、中度血管性痴呆患者的认知功能,且短期减药、停药不会导致认知功能恶化。     

尼莫地平联合多奈派齐治疗轻中度血管性痴呆58例疗效观察

目的观察尼莫地平联合多奈派齐治疗轻中度血管性痴呆的疗效。方法将116例轻中度血管性痴呆患者随机分为两组：观察组58例,采用尼莫地平联合多奈派齐治疗;对照组58例,采用多奈派齐治疗;疗程18周。比较两组患者的治疗效果。结果治疗后18周,两组患者MMSE、ADL评分均比治疗前明显提高,差异有统计学意义（P〈0.05）;观察组ADL评分高于对照组,差异有统计学意义（P〈0.05）。结论尼莫地平联合多奈派齐治疗轻中度血管性痴呆的疗效优于单用多奈派齐治疗。     

天麻素联合多奈哌齐治疗血管性痴呆疗效分析

目的观察天麻素与多夸哌齐联合治疗血管性痴呆的临床治疗效果。方法我们采用随机、对照研究的方法,将48例老年血管性痴呆患者分为多奈哌齐组（对照组）、多奈哌齐联合天麻素治疗组（联合治疗组）,观察2组患者简易智能量表、日常生活功能量表、Hachinski缺血量表及脑电图等指标的变化,并观察不良反应。结果研究显示2组痴呆量表评分、生活质量评分及脑电图表现均有明显改善,而药联合治疗组改善更明显,与对照组比较有统计学差异。结论天麻素联合多奈哌齐能改善血管性痴呆患者生活质量及脑功能。     

盐酸多奈哌齐治疗血管性痴呆的有效性和安全性

目的　评价盐酸多奈哌齐治疗血管性痴呆的有效性及安全性。方法　选择 4 0例血管性痴呆患者 ,用盐酸多奈哌齐进行 12周的治疗 (5mg/d) ,按简易精神状态量表 (MMSE)、临床痴呆量表 (CDR)及日常生活自理量表 (ADL)进行治疗前后的疗效评定。结果　盐酸多奈哌齐治疗 12周后较治疗前MMSE、CDR及ADL分数分别改善 4 .1、0 .7、8.2分 ,差异有显著性意义。 4 0例患者中 ,2例出现头晕、恶心 ,1例出现运动减少、肌肉强直等帕金森综合征的表现 ,1例出现轻度的躁动、情绪易激惹等阳性精神症状。结论　盐酸多奈哌齐能有效治疗血管性痴呆患者 ,对患者的认知功能、痴呆程度和日常生活自理能力均有改善。     

补阳还五汤加味联合胞磷胆碱注射液治疗血管性痴呆的疗效观察

目的观察补阳还五汤加味联合胞磷胆碱注射液治疗血管性痴呆的临床疗效。方法将80例辨证为气虚血瘀证的血管性痴呆患者随机分为治疗组和对照组,每组40例。两组基础治疗相同,对照组给予尼莫地平片口服,治疗组给予补阳还五汤加味煎服,胞磷胆碱注射液静脉输注治疗。两组在治疗前后分别进行简易精神状态量表（MMSE）及日常生活能力量表（ADL）评分。结果治疗组总有效率为97．5％,明显优于对照组的77．5%（P〈0．05）。两组治疗后MMSE和ADL评分较治疗前明显提高（P〈0．01）,但治疗组明显优于对照组（P〈0．05或P〈0．01）。结论补阳还五汤加味联合胞磷胆碱注射液治疗血管性痴呆疗效显著,能够显著改善患者认知功能及日常生活能力。     

老年期痴呆的精神行为症状及美金刚的临床疗效研究

目的探讨老年期痴呆患者精神行为症状及美金刚的改善作用。方法选择老年期痴呆有精神行为症状的患者61例,随机分为2组,美金刚组(美金刚+多奈哌齐+尼莫地平)31例,对照组(多奈哌齐+尼莫地平)30例,分别在治疗前和治疗12周后进行简易智能状态检查量表(MMSE)、临床痴呆程度量表(CDR)及神经精神科问卷(NPI)的评估。结果老年期痴呆患者精神行为症状多见。美金刚组与对照组患者治疗前MMSE、CDR及各项症状的NPI评分差异无统计学意义(P>0.05)。美金刚组患者治疗12周后激越/攻击行为、焦虑、易激惹/不稳定性、情感高涨/欣快、夜间行为异常、食欲进食改变的NPI评分及NPI总分明显改善;对照组患者治疗12周后易激惹/不稳定性、夜间行为异常、食欲进食改变的NPI评分及NPI总分明显改善,差异有统计学意义(P<0.05)。美金刚组患者治疗12周后MMSE评分、激越/攻击行为、易激惹/不稳定性、食欲进食改变的NPI评分及NPI总分较对照组明显改善(P<0.05)。结论美金刚能有效改善老年期痴呆精神行为症状,减轻家庭负担。     

Combination of intensive cognitive rehabilitation and donepezil therapy in Alzheimer's disease (AD)

Acetylcholinesterase inhibitors (AchEIs) are extensively used in Alzheimer's disease (AD) while reality orientation therapy (ROT) is a cognitive rehabilitation indicated for mentally deteriorated patients. We aimed to evaluate the efficacy of the combination of donepezil with an intensive ROT with active participation of the caregiver. Patients with AD (n = 100, mean age 78.4 ± 4.3 years) initiated treatment with donepezil, 5 mg/day; 62 of them underwent a 3-week, daily ROT and physical reactivation training with the caregiver (Group A); 38 participants received only donepezil therapy (Group B). All subjects were tested for cognitive and functional abilities at baseline, at the end of the training program, and after 2 months of follow-up. There was a significant improvement in mini-mental state examination (MMSE) score (p < 0.001) and the AD assessment scale-cognitive (ADAS-Cog) subscale (p < 0.001), without changes in impaired activity of daily living (ADL) and instrumental ADL (IADL) after intensive ROT training in Group A. MMSE was maintained after 2 months in-home ROT continuation. There were no significant changes in MMSE in drug-only treated patients (Group B) after 3 weeks, with a non-significant tendency to improvement in ADAS-Cog. Our results suggest benefit of an intensive ROT program in dementia patients receiving donepezil that seems to be maintained as far as ROT is continued by the caregiver.     

Donepezil provides greater benefits in mild compared to moderate Alzheimer's disease: Implications for early diagnosis and treatment

We assessed the cognitive and functional outcomes of donepezil treatment in mild versus moderate Alzheimer's disease (AD) patients. We performed a 6-month prospective, observational, multicenter study of the progression of cognitive and functionality abilities in a large sample patients with AD who initiated treatment with donepezil in monotherapy. According to baseline mini mental state examination (MMSE), patients were divided in two groups: mild AD (MMSE ≥ 21) and moderate AD (MMSE < 21). Patients were evaluated with the memory alteration test (M@T) and the Alzheimer's disease functional assessment and change scale (ADFACS) at baseline and at 6 months. A total of 403 patients finished the study (mild AD = 152; moderate AD = 251). The MMSE total score and M@T score remained stable at 6 months in the whole sample, with MMSE memory domain and M@T free and cued recall domains improving significantly from baseline. Total ADFACS, instrumental (IADL) and basic activities of daily living (BADL) got significantly worse, with the worsening being significantly greater in the moderate AD group. Significant differences between the groups favoring mild AD were observed for MMSE memory, orientation and language domains, M@T temporal orientation and semantic memory domains, and for IADL. We concluded that in AD patients on donepezil, cognition remains stable at 6 months. The beneficial effect of donepezil treatment, in terms of cognition and functionality, is greater for mild than for moderate AD.     

黄蒲通窍胶囊治疗血管性痴呆的临床观察

目的观察黄蒲通窍胶囊治疗血管性痴呆(VaD)患者的临床疗效及安全性。方法将符合纳入病例标准的90例VaD患者随机分成3组,即西药多奈哌齐治疗组(A组),中医辨证后运用黄蒲通窍胶囊组(B组)和中医辨证后使用黄蒲通窍胶囊合用多奈哌齐组(C组)。疗程为60d。观察3组治疗后中医证候积分;神经心理学量表检查包括:简明精神状态检查量表(MMSE)、日常生活能力量表(ADL)、阿尔茨海默病评定量表-认知分量表(ADAS-Cog)。测定血液流变学及血清同型半胱氨酸(Hcy)。结果黄蒲通窍胶囊可以显著改善中医证候积分、ADL、MMSE、ADAS-cog积分,降低血Hcy且无明显不良反应。结论黄蒲通窍胶囊可以改善VaD患者的临床症状,是治疗血管性痴呆的安全有效药物。     

Sleep disturbance is associated with decreased daily activity and impaired nocturnal reduction of blood pressure in dementia patients

Our aim was to investigate the relationships between sleep disturbance and activities of daily living (ADL) and 24-h blood pressure patterns in institutionalized dementia patients. Using 107 institutionalized dementia patients (32 males and 75 females, mean age 76.3 years), patients with a mini mental state examination (MMSE) score <24 were classified into four groups based on ADL (normal or declined) and nocturnal reduction in blood pressure (dipper or non-dipper). The sleep/wake state was visually monitored hourly for 14 consecutive days, and daytime and nighttime sleep ratios were determined. MMSE scores were significantly lower in the declined ADL group than in the normal ADL group. The nighttime sleep ratio of the non-dipper/declined ADL group was significantly lower than in the other groups. Sleep disturbance was associated with the deterioration of MMSE scores, low ADL, and impaired nocturnal reduction in blood pressure in dementia patients.     

醒脑启智胶囊对血管性痴呆病人血液流变学的影响

目的观察醒脑启智胶囊对血管性痴呆病人血液流变学的影响.方法将血管性痴呆病人随机分为治疗组92例和对照组90例,治疗组服用醒脑启智胶囊,对照组服用舒血宁片(银杏叶提取物),6周为1个疗程,两个疗程后观察病人精神状态简易速检表(MMSE)和日常生活自理能力量表(ADL-R)积分以及血液流变学的变化.结果两组治疗后MMSE评分较治疗前显著升高(P＜0.01),ADL-R评分较治疗前显著降低(P＜0.01),治疗后治疗组MMSE和ADL-R评分与对照组比较有统计学意义(P＜0.05);两组治疗后全血高切黏度、全血低切黏度、纤维蛋白原较治疗前显著降低(P＜0.05或P＜0.01);治疗组还可显著降低血浆黏度、红细胞比容(P＜0.05或P＜0.01),治疗后治疗组全血高切黏度、全血低切黏度、红细胞比容与对照组比较有统计学意义(P＜0.05).结论醒脑启智胶囊不仅可明显改善血管性痴呆病人的认知功能,提高病人的日常生活自理能力,而且可改善病人血液流变学,减少痴呆的危险因素.     

Sleep disturbance is associated with decreased daily activity and impaired nocturnal reduction of blood pressure in dementia patients

Our aim was to investigate the relationships between sleep disturbance and activities of daily living (ADL) and 24-h blood pressure patterns in institutionalized dementia patients. Using 107 institutionalized dementia patients (32 males and 75 females, mean age 76.3 years), patients with a mini mental state examination (MMSE) score <24 were classified into four groups based on ADL (normal or declined) and nocturnal reduction in blood pressure (dipper or non-dipper). The sleep/wake state was visually monitored hourly for 14 consecutive days, and daytime and nighttime sleep ratios were determined. MMSE scores were significantly lower in the declined ADL group than in the normal ADL group. The nighttime sleep ratio of the non-dipper/declined ADL group was significantly lower than in the other groups. Sleep disturbance was associated with the deterioration of MMSE scores, low ADL, and impaired nocturnal reduction in blood pressure in dementia patients.