Therapeutic effectiveness of Donepezil hydrochloride in combination with butylphthalide for post-stroke cognitive impairment

Abstract

Objective: To study the therapeutic effectiveness of donepezil hydrochloride (DPZ) in combination with butylphthalide (BP) for the treatment of post-stroke cognitive impairment (PSCI).

Methods: In this retrospective study, the clinical data of 125 PSCI patients treated at the First Affiliated Hospital of Harbin Medical University from December 2019 to December 2023 were collected and analyzed. The patients were grouped into a joint group (n=75, receiving DPZ + BP) and a control group (n=50, receiving DPZ alone) according to their treatment regimen. Inter-group comparisons were then carried out from the perspectives of therapeutic effectiveness, safety (constipation, abdominal distension and pain, and gastrointestinal reactions), cognitive function (Montreal Cognitive Assessment Scale [MoCA], Chinese Stroke Scale [CSS]), Activities of Daily Living Scale (ADL), and serum biochemical indexes (neuron-specific enolase [NSE], high-sensitivity C-reactive protein [hs-CRP], nitric oxide [NO], and malondialdehyde [MDA]). In addition, a univariate analysis was carried out to identify factors affecting therapeutic effectiveness in PSCI patients.

Results: The joint group showed significantly better therapeutic effectiveness compared to the control group (P<0.05). There was a significant correlation between the type of stroke, treatment method, and therapeutic effectiveness in PSCI patients (P<0.05). There was no significant difference in the total incidence of adverse reactions (P>0.05). After the treatment, compared to the control group, the joint group demonstrated significant improvements in MoCA and ADL scores (all P<0.05) and reductions in CSS scores and levels of NSE, hs-CRP, NO, and MDA (all P<0.05).

Conclusions: DPZ in combination with BP is highly effective for the treatment of PSCI. It positively affects cognitive function and ADL, alleviates neurological deficits, and reduces abnormal serum biochemical indices without increasing the risk of adverse reaction.

Keywords: Donepezil hydrochloride; butylphthalide; cognitive impairment; stroke; therapeutic effectiveness.

Figure 1

Comparison of cognitive function. Note: ^aP<0.05 vs. before treatment; ^bP<0.01 vs. before treatment; ^cP<0.05 vs. control. MoCA, Montreal Cognitive Assessment Scale.

Figure 2

Comparison of neurological deficits. Note: ^aP<0.05 vs. before treatment; ^bP<0.01 vs. before treatment; ^cP<0.05 vs. control. CSS, Chinese Stroke Scale.

Figure 3

Comparison of ADL. Note: ^aP<0.05 vs. before treatment; ^bP<0.01 vs. before treatment; ^cP<0.05 vs. control. ADL, Activities of Daily Living Scale.

Figure 4

Comparison of serum biochemical indexes. The joint group showed markedly reduced NSE (A), hs-CRP (B), NO (C), and MDA (D) levels after treatment, lower compared to the control group. Note: ^aP<0.05 vs. before treatment; ^bP<0.01 vs. before treatment; ^cP<0.05 vs. control. NSE, neuron-specific enolase; hs-CRP, high-sensitivity C-reactive protein; NO, nitric oxide; MDA, malondialdehyde.