Clinical Study Of Antidementia 1 On Treatment Of Vascular Dementia

Vescular dementia (VD) is a kind of dementia syndrome caused by cerebral vascular factors that cause substantial damage to mental impariment in at least three of the following:language,memory,visual spatial skills, emotion, pesonality and cognitive function(sucha as calculation,abstract judgment).It's clinical characteristics including acut or subacut onset,ladder-like decline and chronic or fluctuant aggravation. Global prevalence of dementia suggest that The number of people with dementia will double every 20 years to 81.1 million by 2040.As the cognitive function and the ablity of the daily living decline,the quality of life was damaged,and represent a significant economic burden. oreover it has been provede that VD is the only type of dementia that can be prenventde.So it's significant to study the etiopathogenisis, pathogenesy and risk factors about the VD.The aim of this study is evaluate the clinical efficacy of Chinese medicin antidementia NO.1 in treament of patients with VD and investigate the changes of cognitive function,activity of daily living, analyze the mechanism of Chinese medicin and provide a theoretical basis for clinical treatment of VD in the end.The etiopathogenisis contains two aspects.one is cerebrovascular disease include cerebral infarction(CI), cerebral amyloid angiopathy(CAA), et.and the other one is risk factors such as diabetes ,dyslipidemia,Hypertension ,stock Cardiovascular disease, dyslipidemia, and so on.The treatment of VD include prevention and synptomatic treatment. Some evidence suggests that effectively managing these risk factors may prevent cognitive decline/dementia. Such as BP-lowering with antihypertensive agents, regulate the level of blood glucose with insulin,and there is now increasing empirical evidence that alterations in lifestyle factors may decrease an individual's risk of developing dementia. The evidence is strongest for increasing an individual's level of physical activity, followed by the cessation of smoking. The medicines of synptomatic treatmentincluding ChEI,NMDA receptor antagonists, microcirculation- impro- ving angents and neuroprotecatants,etc.From the view of evidence-basede medicine, The efficacy of acetylcholine esterase inhibitors (AchEI) and NMDA receptor antagonists h in the treatment of mild to moderate VD is documented.The experimental drug is antidementia 1, This drug is mainly contains Polygonum Multiflorum Thumb,Herba Cistanchis,Rhizoma gastrodiae,Ginseng Leaf. Many experiments which have confirmed that these ingredients can inhibit the anticholinesterase activity, clean up free radical, protect nerve cell providing the Pharmacological basis for the treatment of vascular dementia .The drugs for contral group is Huperzine A, a kind of AchEI which can easily through the blood brain barrier,has been confirmed that can improve memory and cognitive function.In the early 1990s ,huperzine A was approved by Department of Health for treating AD. The pharmacology and clinical research has confirmed that Huperzine A can inhibit the activity in the brain AchE, improve brain activity of AchE, improve memory and learning ability of patients,and was accepted as a kind of drug for treatment of vascular dementia. According to the draft of diagnostic criteria of VD formulated by neurology branch of Chinese Medical Association in 2002, The national institute of nervous system diseases and stroke and Switzerland international association of neuroscience research(NNINDS-AIREN)),78 patients was divided into two groups Randomly. There are 48cases in the treatment group, 32 cases in the controll group. Evaluation antidementia 1's efficacy and safety through the observation of patients'cognitive function ,daily behavior ability and the safety evaluation result . There is no significant difference between Two groups in age, gender, education level and the ADL MMSE test score. There is no significant difference between the two groups'therapeutic efficacy . After treatment,the MMSE scores of two group were all increased, especially in orientation force, delayed recall ability, concentration and computing power and language ability, but Instant recall ability wasn't improved.At the same time,the cognitive function efficiency between two groups was not statistically significant. Activities of daily living was not improved in both two groups after treatment. Every indexes about safty was normal.Antidementia 1is safety and utility on mild-to-moderate VD.In short,Antidementia 1 can improve the cognitive function state,but no significant improvement been seen in activities of daily living,I think maybe due to the time of treatment was not lang enough and VD's clinical characteristics : chronic or fluctuant aggravation.Therefor,it should be a long-term and combind treatment fou VD. Not only need to continue to study for the pathogenesis and effective treatment methods, also should popularize related knowledge,at same time,the patients should to Cooperate actively, change unhealthy lifesytle, control risk factors.In addation,it need patients'familiy and all society to participate in it to improve the quality and prognosis of the patients.