Effect of donepezil combined with nicergoline in the treatment of vascular dementia
10.3760/cma.j.cn101721-20250421-00176
- VernacularTitle:多奈哌齐联合尼麦角林治疗血管性痴呆患者的效果
- Author:
Wei LIU
1
;
Linyang CUI
1
;
Yu WANG
1
;
Peng ZHAO
1
Author Information
1. 天津医科大学总医院神经内科，天津 300052
- Publication Type:Journal Article
- Keywords:
Vascular dementia;
Donepezil;
Nicergoline;
Activity of daily living;
Cognitive function;
Lipoprotein-associated phospholipase A2
- From:
Clinical Medicine of China
2025;41(4):281-287
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of donepezil combined with nicergoline in the treatment of vascular dementia (VD).Methods:A total of 108 VD patients admitted to Tianjin Medical University General Hospital between June 2022 and June 2024 were enrolled. Participants were stratified and randomized by computer into an observation group ( n=54) and a control group ( n=54). The control group received standardized VD management plus oral donepezil, while the observation group received additional nicergoline. Both groups underwent 6 months of continuous treatment. Symptom remission time (memory decline, intellectual deterioration, behavioral abnormalities, impaired daily living skills), activity levels[basic activities of daily living (BADL), instrumental activities of daily living (IADL), total activities of daily living (ADL) score, cognitive function[mini-mental state examination (MMSE), vascular dementia assessment scale-cognitive (VDAS-cog)], serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels, clinical efficacy and adverse reaction rates were compared between groups. Normally distributed continuous data were expressed as xˉ±s, independent t-test was used on intergroup comparison, paired t-test was used on comparison before and after treatment. Non-normally distributed data were expressed as M( Q1,Q3) and compared by Mann-Whitney U test. Categorical data were presented as n(%) and analyzed by χ2 test. Results:After 6 months of treatment, symptom remission time of memory decline, intellectual deterioration, behavioral abnormalities and daily living impairment were significantly shorter in the observation group[(24±4) days vs. (30±4) days, t=7.41, (30±8) days vs. (36±9) days, t=3.73, (17±4) days vs. (24±4) days, t=9.30, (41±14) days vs. (49±16) days, t=2.56, all P<0.05]. BADL, IADL, ADL, and MMSE scores increased in both groups after treatment[observation group: (24.2±5.2) points vs. (17.6±3.5) points, (42.7±2.9) points vs. (29.1±6.6) points, (66.7±4.6) points vs. (46.9±4.1) points, (23.5±1.7) points vs. (16.5±2.2) points, t =11.15, 21.04, 33.45, 26.38, respectively, all P<0.001; control group: (21.3±4.9) points vs. (16.9±3.4) points, (39.7±3.8) points vs. (31.1±6.9) points, (60.8±4.3) points vs. (47.9±5.2) points, (21.1±1.3) points vs. (17.1±2.3) points, t=7.79, 11.81, 19.96, and 16.33, respectively, all P<0.001], with greater improvement in the observation group t=2.98,4.61,6.89,8.24, all P<0.05). VDAS-cog and Lp-PLA2 decreased in both groups compared to before treatment[observation group: (40±4) points vs. (51±7) points, (123±19) μg/L vs. (190±25) μg/L, t=15.25, 22.23, respectively, both P<0.001; control group: (44±4) points vs. (54±7) points, (140±23) μg/L vs. (192±25) μg/L, t=11.99,16.14, respectively, both P<0.001], with greater reduction in the observation group t=4.99, 4.01, both P<0.05).The total effectiveness was higher in observational group compared to control group[94.4% (51/54) vs. 81.9% (44/54), χ2=4.29, P=0.038]. The difference of adverse reactions between groups was not significant( χ2=0.38, P=0.540). Conclusion:Donepezil combined with nicergoline significantly improves clinical outcomes in VD patients, accelerating symptom remission, attenuating vascular inflammation (reduced Lp-PLA2), and enhancing daily living capacity and cognitive function.
