计算机辅助认知训练联合多奈哌齐治疗卒中后认知障碍

目的研究计算机辅助认知训练联合多奈哌齐治疗卒中后认知障碍的临床疗效。方法筛选脑卒中后轻中度血管性认知障碍的患者83例,随机分为2组。其中,对照组42例予脑卒中规范治疗并口服盐酸多奈哌齐5 mg,qd;观察组41例在上述治疗基础上应用计算机辅助认知训练,40 min/d,每周5 d。治疗前及6周后应用蒙特利尔认知测验(MoCA)评价总体认知功能;数字广度测验评估注意力及工作记忆;连线测验评估执行功能;动物流畅性测验评估语言功能;改良Barthel指数(MBI)评估患者日常生活活动能力。结果治疗6周后,观察组和对照组在MoCA评分、数字广度测验正背及倒背、连线测验B-连线测验A、言语流畅性测验、日常生活能力评分均明显改善,差异有统计学意义(P<0.01)。其中,观察组在MoCA、数字广度测验正背及倒背、言语流畅性测验、日常生活能力评分方面较对照组明显提高,差异有统计学意义(P<0.05)。结论计算机辅助认知训练联合多奈哌齐治疗卒中后认知障碍,能显著改善患者整体认知功能、注意力、工作记忆、言语能力、日常生活能力,提高患者的生活质量。

Study on computer-assisted cognitive training system combined with donepezil for treatment of post-stroke cognitive impairment

Objective To evaluate the efficacy of computer-assisted cognitive training combined with donepezil in the treatment of patients with post-stroke cognitive impairment.Methods Eighty-three patients with post-stroke cognitive impairment were randomly assigned into control group(n=42),orally donepezil 5 mg per day,and observation group(n=41),orally the same dose donepezil combined with computer-assisted cognitive training for 6 weeks.The outcomes includethe global cognitive function was assessed by Montreal Cognitive Assessment(MoCA);the attention function and working memory were assessed by Digital Span(DS);the executive function was assessed by Trail Making Test(TMT);the language funetion was assessed by verbal Fluency test(VFT)the ability of daily life was assessed by Modified Barthel Index(MBI).Primary and secondary outcomes would be measured respectively at baseline and the end of the treatment.Results The MoCA,DS-forward,DS-backward,TMTB-TMTA,VFT,MBI of two groups were significantly improved after treatment(P<0.01).The observation group was particularly better than control group at the scores of MoCA,DS-forward,DS-backward,VFT,MBI(P<0.05).Conclusion Computer-assisted cognitive training combined with donepezil,which can significantly improve the overall cognitive function,attention,working memory,speech,ability of daily life,is more effective in the treatment of post-stroke cognitive impairment.