内科

目的探讨盐酸多奈哌齐联合重复经颅磁刺激（rTMS）治疗老年痴呆的效果及对患者认知功能的影响。方法选取2017年6月至2019年6月我院收治的老年痴呆患者86例，采用随机数字法分为观察组和对照组，每组43例，两组患者均给予常规治疗及盐酸多奈哌齐片治疗。在此基础上，观察组患者给予rTMS治疗，对照组患者给予rTMS伪治疗，持续治疗3个月。比较两组患者的临床疗效；比较两组患者治疗前后的认知功能（MoCA）和独立生活能力（ADL）；比较两组患者的不良反应发生情况。结果观察组患者的临床疗效明显优于对照组，治疗总有效率（90.7%）显著高于对照组（72.1%），差异有统计学意义（P＜0.05）。治疗前，两组患者的MoCA和ADL评分比较，差异无统计学意义（P＞0.05）；治疗3个月后，两组患者的MoCA和ADL评分均明显升高，观察组患者的评分显著高于对照组，差异有统计学意义（P＜0.05）。治疗期间，观察组患者的不良反应发生率（20.9%）低于对照组（27.9%），但差异无统计学意义（P＞0.05）。结论盐酸多奈哌齐联合rTMS治疗老年痴呆患者临床效果显著，可显著提高患者的认知功能和独立生活能力，但不增加患者的不良反应。

ObjectiveTo explore the effects of donepezil hydrochloride combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of senile dementia and their influences on cognitive function. MethodsA total of 86 patients with senile dementia admitted to our hospital from June 2017 to June 2019 were divided into observation group and control group by the random number method, with 43 cases in each group. Both groups were received conventional treatment and administrated donepezil hydrochloride tablets, based on which patients in the observation group were given rTMS for treatment, whereas patients in the control group were given rTMS pseudo treatment, for a continuously three-month treatment. The clinical efficacy was compared between the two groups. The Montreal cognitive assessment (MoCA) and the activities of daily living (ADL) before and after treatment were compared between the two groups, the occurrence of adverse reactions between the two groups was compared as well. ResultsThe clinical efficacy of the observation group was significantly superior to that of the control group, and the total effective rate of the observation group (90.7%) was significantly higher than that of the control group (72.1%), and the differences were statistically significant (P＜0.05). There were no statistically significant differences in pre-treatment MoCA and ADL scores between the two groups (P＞0.05). After 3 months of treatment, the MoCA and ADL scores of the two groups significantly increased, and the scores of the observation group were significantly higher than those of the control group, with statistically significant differences (P＜0.05). During the treatment period, the incidence of adverse reactions in the observation group (20.9%) was lower than that in the control group (27.9%), but the difference was not statistically significant (P＞0.05). ConclusionDonepezil hydrochloride combined with rTMS has a significantly clinical effect in the treatment of patients with senile dementia, which can significantly improve the cognitive function and independent living ability in patients, but it does not increase the adverse reactions in patients.