【摘要】

摘要：目的 探讨多奈哌齐单倍剂量序贯治疗血管性痴呆（VD）的效果。
方法 纳入2012年5年-2014年5月医院收治的VD患者60例作为研究对象，采用数字随机表法分为A组、B组、C组各20例，A组给予多奈哌齐单倍剂量序贯治疗，第1～24周每日口服多奈哌齐5mg/d，第25～36周间隔1日口服5mg，第37-48周停药，B组给予盐酸美金刚20mg口服，C组给予安慰剂治疗，3组总疗程均为48周。评估临床疗效及不良用药反应，采用简易智能状态测量表（MMSE）、蒙特利尔认知评估量表中文版（MOCA）评估认知功能，采用日常生活能力（ADL）量表（Barthel指数）评估独立生活能力，采用神经精神科问卷（NPI）评估受试者的精神行为症状。
结果 A组总治疗有效率为90.0%与B组的75.0%、C组的65.0%相比，无明显差异（P＞0.05），A组不良用药反应发生率20.0%与B组的15.0%无明显差异（P＞0.05）。A组治疗后MMSE、ADL、MOCA评分高于B组、C组，NPI评分低于B组、C组，B组、C组组间差异明显（P＜0.05）。
结论 多奈哌齐单倍剂量序贯治疗VD的疗效与盐酸美金刚无异，但在改善认知功能上更具优势。

【Abstract】

Abstract: Objective To investigate the effects of donepezil single-dose sequential therapy in the treatment of vascular dementia (VD).
Methods 60 cases of patients with VD who were treated in our hospital from May 2012 to May 2014 were included in the study. According to the random number table method, the patients were divided into group A, B and C with 20 cases in each group. Group A group was treated with donepezil single-dose sequential therapy. In the 1st to 24th week, the patients orally took donepezil 5mg/d, in the 25th ~ 36th week, 5mg every other day and in the 37th to 48th week, medication stopped. Group B was treated with oral administration of memantine hydrochloride 20mg, and group C was treated with placebo. The total course of treatment was 48 weeks in the 3 groups. The clinical curative effect and adverse drug reactions were evaluated. The Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (Chinese version) (MOCA) were used to evaluate cognitive function, and the activities of daily living (ADL) scale (Barthel index) was used to evaluate the independent living ability; The Neuropsychiatric Inventory (NPI) was used to evaluate the symptoms of mental behaviors of subjects.
Results The total effective rate of treatment in group A was 90.0%. Compared with that in group B (75.0%) and group C (65.0%), there were no significant differences (P＞0.05). There was no significant difference in the incidence rate of adverse drug reactions between group A (20.0%) and group B (15.0%) (P＞0.05). After treatment, the scores of MMSE, ADL and MOCA in group A were higher than those in group B and group C while NPI score was lower than that in group B and group C (P＜0.05).
Conclusion   There was no significant difference in effects between donepezil single-dose sequential therapy and memantine hydrochloride in the treatment of VD. However, the former has more advantages in improving cognitive function.