摘要
目的探讨多奈哌齐联合奥氮平对阿尔茨海默病(AD)患者认知和精神行为症状的改善作用。方法选取2016年8月～2017年12月在该院精神科门诊治疗的AD患者84例,分为观察组与对照组,各42例。两组患者均采用奥氮平片治疗,开始用量2.5 mg/次,1次/d,逐渐调整为5～15 mg/次,1次/d,睡前口服,观察组在此基础上加用多奈哌齐片5 mg/次,1次/d,口服。两组均连用2个月。评估两组患者治疗前后认知和精神行为症状变化,并比较临床效果及不良反应。结果治疗2个月后,两组MMSE评分较前明显上升,BEHAVE-AD评分较前明显下降(P<0.05或P<0.01),且观察组变化幅度较对照组更明显(P<0.05);同时观察组临床总有效率高于对照组(χ～2=4.46,P<0.05)。对照组出现不良反应7例(16.67%),观察组发生10例(23.81%),症状较轻,两组比较差异无统计学意义(χ～2=0.66,P>0.05)。结论多奈哌齐联合奥氮平治疗AD患者的疗效明显优于单纯的奥氮平治疗,不良反应少,能显著改善患者的认知和精神行为症状。
Objective To investigate the improvement of treatment combining donepezil and olanzapine on the cognition and behavioral and psychological symptoms（BPS） of patients with Alzheimer Disease （AD）. Methods 84 patients with AD treated in the outpatient department of psychiatry in this hospital from August, 2016 to December, 2017 were selected and divided into observation group and control group with 42 patients in each. Patients in two groups were treated with olanzapine started with 2.5 mg/time, once a day and gradually adjusted to 5-15 mg/time, once a day, by oral administration before bedtime. Patients in observation group were treated with additional donepezil（5 mg/time, once a day, oral administration）. Treatments in two groups lasted two months. The changes of cognition and BPS in two groups before and after treatment were evaluated and the clinical effectiveness and adverse reaction were compared. Results Two months after treatment, scores of MMSE in two groups increased significantly compared with before while scores of BEHAVE-AD decreased significantly（P〈0.05, P〈0.01）.The amplitude of changes in observation group was more significant than that in control group（P〈0.05）. The clinical total rate of effectiveness in observation group was higher than control group（χ2=4.46, P〈0.05）.7 cases（16.67%） of adverse reaction occurred in control group while 10 case（23.81%） in observation group. The symptoms were mild and there was no statistical difference between two groups（χ2=0.66, P〉0.05）. Conclusion The effectiveness of treatment combining donepezil and olanzapine in AD patients is better than treatment of olanzapine alone. Treatment combining donepezil and olanzapine have fewer adverse reaction and could improve the cognition and BPS significantly.
作者
鲍佑元
齐钢桥
BAO Youyuan;QI Gangqiao(Department of Psychiatry,Taizhou Second People＇s Hospital in Zhejiang Province,Taizhou 317200,China)
出处
《中国现代医生》
2018年第26期31-33,37,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2018KY899)
关键词
阿尔茨海默病
多奈哌齐
奥氮平
认知
精神行为症状
Alzheimer disease
Donepezil
Olanzapine
Cognition
Behavioral and psychological symptoms
