目的 探討多奈哌齊聯(lián)用奧氮平治療腦血管病伴發(fā)精神行為癥狀的療效。方法 2012年2月-2017年2月選擇在咸陽市核工業(yè)二一五醫(yī)院診治的腦血管病伴發(fā)精神行為癥狀患者84例作為研究對象，根據(jù)入院順序，按照隨機信封抽簽原則分為觀察組與對照組各42例，對照組給予奧氮平10 mg，1次/d，觀察組在對照組治療的基礎上給予多奈哌齊5 mg，均治療觀察4周。比較兩組臨床療效、簡易精神狀態(tài)檢查量表（MMSE）評分、認知功能狀況及不良反應。結果 觀察組的總有效率是95.2%，顯著高于對照組的81.0%（P<0.05）。治療后觀察組的反應時是（487.24±30.23）s，對照組的是（545.30±31.49）s；治療后觀察組的正確數(shù)是（285.30±11.44）個，對照組的是（251.44±13.09）個；治療后觀察組的漏劃數(shù)是（18.49±6.46）個，對照組的是（38.28±4.56）個；兩組對比差異明顯（P<0.05）。與治療前相比，治療后觀察組與對照組治療的MMSE評分顯著提高（P<0.05）；與治療后對照組的MMSE評分相比，觀察組的顯著提高（P<0.05）。觀察組的不良反應發(fā)生率31.0%，對照組不良反應發(fā)生率28.6%，兩組不良反應程度均較輕微，對比無明顯差異。結論 多奈哌齊聯(lián)用奧氮平治療腦血管病伴發(fā)精神行為癥狀能改善患者的認知功能與神經(jīng)心理學狀況，安全性比較好，從而提高治療效果。

Objective To evaluate the curative effect of donepezil combined with olanzapine in the treatment of cerebrovascular disease with mental symptoms. Methods From February 2012 to February 2017, 84 patients of cerebrovascular disease with mental symptoms in our hospital for diagnosis and treatment were selected as the research object, all of the patients were divided into observation group and control group with 42 cases in each group accorded to the order of admission, in accordance with the principle of random draw envelope. The control group was given olanzapine treatment, the observation group was given donepezil combined with olanzapine in the treatment. Results The total effective rate of the observation group and the control group was 95.2% and 81.0% respectively, and the total effective rate of the observation group was significantly higher than that of the control group (P<0.05). The reaction time, the correct number and the number of drain strokes in observation group after treatment were (487.24±30.23) s, (285.30±11.44) and (18.49±6.46), the control group were (545.30±31.49) s, (251.44±13.09) and (38.28±4.56), that compared between the two groups were significant differences (P<0.05). The MMSE scores of the observation group and the control group after treatment were significantly higher than that before treatment (P<0.05), and the scores of MMSE in the observation group after treatment was significantly higher than those in the control group (P<0.05). The incidence of adverse reactions was 31% in the observation group and 28.6% in the control group. The adverse reactions in the two groups were mild and there was no significant difference between the two groups. Conclusion Donepezil combined with olanzapine in the treatment of cerebrovascular disease with mental symptoms can improve cognitive function and neuropsychological status with good security, thereby enhance the therapeutic effect.