多奈哌齐与尼莫地平联合治疗老年期血管性痴呆的临床观察

目的探讨多奈哌齐与尼莫地平联合治疗老年期轻、中度血管性痴呆患者的疗效及安全性。方法将94例老年期血管性痴呆患者,采用随机表法分为3组:多奈哌齐与尼莫地平联合治疗组(联合治疗组,31例)、多奈哌齐组(31例)和尼莫地平组(32例)。分别在治疗前和治疗3、6个月后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)和临床痴呆程度量表(CDR)的评估。结果治疗3个月后,与联合治疗组比较,多奈哌齐组和尼莫地平组患者的MMSE评分明显减少,ADL评分明显增加,差异有统计学意义(P0.05);3组患者CDT和CDR评分,差异无统计学意义(P0.05)。治疗6个月后,与联合治疗组比较,多奈哌齐组和尼莫地平组患者的MMSE和CDT评分明显减少,ADL和CDR评分明显增加,差异有统计学意义(P0.05)。结论联合治疗能明显改善老年期血管性痴呆患者的认知功能、日常生活能力及社会活动功能,优于单独服用多奈哌齐或尼莫地平,且安全性好。

Clinical study of combined treatment with donepezil and nimodipine for vascular dementia of old patients

Objective To investigate the safety and the efficacy of combination of donepezil and nimodipine in treating old patients with mild and moderate vascular dementia (VaD).Methods Ninety-four old patients with VaD were randomly divided into 3 groups,mini-mental state examination (MMSE) ,activities of daily living(ADL),clinical dementia rating scale and clock drawing test of 3 groups were assessed and compared before treatment and 3,6 months after treatment. Results After treating for 3 months,the score of MMSE(21.7± 3.8) and ADL(43.8±4.8) were obviously improved in the group of combination treatment than those in the groups only treated with donepezil(MMSE:18.2 ±3.7,ADL:45.9 ± 4.4,or nimodipine (MMSE:18.1 ± 3.3,ADL: 46.8 ± 5.5,P < 0.05),especially after treating for 6 months,there was significant difference in the 4 scores between the three groups (P < 0.05).Only mild and transient adverse events were observed.Conclusion Combination treatment with donepezil and nimodipine is safe and can markedly ameliorate the cognitive function and behavioral abilities and activity of daily living as compared with trearment with single donepezil or nimodipine in old patients with VaD.