ABSTRACT
OBJECTIVE:To observe the effects and safety of Congrong yishen granule combined with Donepezil hydrochloride tablet on mental state and quality of life in patients with Parkinson disease with dementia(PDD). METHODS:A total of 60 PDD patients were randomized into control group and treatment group,with 30 cases in each group. Both groups were given drugs for Parkinson disease. Control group was additionally given Donepezil hydrochloride tablet 5 mg,qd;treatment group was additionally given Congrong yishen granules 2 g,bid,on the basis of control group. The treatment lasted for 6 months in both groups. MMSE, MoCA,ADAS-Cog,ADL-R and TCM symptom score were observed in 2 groups before and after treatment. The occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in MMSE,MoCA, ADAS-Cog,ADL-R or TCM symptom score between 2 groups (P>0.05). After treatment,MMSE and MoCA score of 2 groups were increased significantly,while ADAS-Cog,ADL-R and TCM symptom score were decreased significantly;the treatment group were better than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLU-SIONS:Congrong yishen granule combined with donepezil hydrochloride tablet can significantly improve mental state and cogni-tive ability of PDD patients,and relieve clinical symptoms with good safety.
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Objective To inves1tigate the needs and influencing factors of patients with cerebrovascular disease and their caregivers in rural areas.Methods An online questionnaire designed by World Stroke Organization for stroke patients and their caregivers was used,and modified appropriately according to China's national conditions.A questionnaire survey about general situation,and needs for psychological support,stroke-related knowledge,diagnosis and nursing,social support,and functional recovery in inpatients with cerebrovascular disease and their caregivers in rural areas was performed.Results A total of 514 patients with stroke and their caregivers (n =514) completed the questionnaires.93.0％ of the patients had the needs for mental support,followed by clinical diagnosis and nursing (84.8％),stroke knowledge (74.7％),social support and functional recovery (53.5％);95.1％ of the caregivers had the needs for mental support,followed by stroke knowledge (89.9％),clinical diagnosis and nursing (84.0％),social support,and functional recovery (66.3％).The degree of need for stroke knowledge,social support,and functional recovery in caregivers was higher than that in the patients (all P ＜ 0.05).Multiple linear regression analysis showed that age,gender,degree of education,the National Institutes of Health Stroke Scale score,and the time from the first stroke onset were the influencing factors of needs for patients with cerebrovascular disease and their caregiver.Conclusions Many needs have not been met in patients with cerebrovascular disease and their caregivers,especially the psychological demand.The regional and individual services should be provided according to the different demands in patients with cerebrovascular disease and their caregivers,enhance the awareness of the prevention and treatment of stroke,and continuously improve the construction of rural health service system.
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Objective To investigate the sleep quality and the risk factors for sleep disorders in population at high-risk for stroke:.Methods A cross-sectional survey was conducted in population at highrisk for stroke:in Water Park and Wangdingdi Communities,Nankai District,Tianjin in March 2016.The residents were divided into either a good sleep group or a sleep disorder group according to the Pittsburgh Sleep Quality Index (PSQI).Multivariate logistic regression analysis was used to determine the risk factors affecting sleep quality.They also divided into a stroke history group and a non-stroke history group according to the high-risk population with or without previous history of stroke.The sleep quality was compared between the 2 groups,and the correlation between sleep disorders and stroke outcomes was analyzed.Results A total of 565 residents at high-risk for stroke were enrolled in the study,and 178 01.5％) had sleep disorders.The age in the sleep disorder group was significantly older than that in the good sleep group (66.70 ±8.97 years vs.62.87 ±9.46 years;t =4.540,P＜0.001).The proportions of female (68.0％ vs.49.1％;x2 =16.190,P ＜ 0.001),hypertension (69.7％ vs.57.9％;x2 =7.154,P =0.005),ischemic heart diseases (48.9％ vs.35.4％;x2 =9.253,P =0.002),history of previous stroke or transient ischemic attack (TIA) (30.9％ vs.18.9％;x2 =10.080,P =0.001),and carotid plaques (71.9 vs.53.7％;x2 =16.688,P ＜0.001) in the sleep disorder group were higher than those in the good sleep group.Multivariate logistic regression analysis showed that after adjusting for age and sex,the history of previous stroke or TIA (odds ratio [OR] 1.712,95％ confidence interval [CI] 1.105-2.653;P =0.016),and carotid plaques (OR 1.583,95％ CI 1.003-2.498;P =0.048) were the dependent risk factors for sleep disorders.The total score of PSQI in patients with previous stroke was significantly higher than that in patients without previous stroke (7.25 ±4.71 vs.6.13 ±4.20,t =-2.578,P =0.010).The sleep latency score (1.24 ± 1.06 vs.0.95 ± 1.02;t =-2.868,P =0.004) and sleep disorder score (1.23 ± 0.63 vs.1.07 ± 0.61;t =-2.622,P =0.009) in patients with previous stroke history were significantly higher than those without.According to the modified Rankin Scale scores,the patients with a history of stroke were divided into a good outcome group (0-2) and a poor outcome group (＞2),including 105 (82.0％) and 23 patients (18.0％),resectively.The proportion of patients with sleep disorders (78.3％ vs.35.2％;x2 =14.251,P＜0.001) and the PSQI score (median and four percentile interval:6 [3-8] vs.12 [8-18];Z =-4.392,P ＜0.001) in the poor outcome group were significantly higher than those in the good outcome group.Conclusions The incidence of sleep disorder is high in the high-risk population,the previous stroke or TIA history and carotid plaques are the independent risk factors for sleep disorder in the high-risk population,and sleep disorder is associated with the poor outcomes of strokes.Therefore,attention should be paid to the sleep quality of this stroke high-risk population and control the risk factors of causing sleep disorders,especially for those with a history of stroke.This will help reduce the risk of stroke.