摘要
目的:观察盐酸多奈哌齐联合氯氮平治疗阿尔茨海默病(AD)伴精神行为障碍的疗效。方法:选取2016年7月至2018年6月在某院接受治疗的AD患者116例,采用随机数字表法将患者分为实验组和对照组,各58例。2组均给予常规基础治疗,对照组采用盐酸多奈哌齐治疗,实验组在此基础上增加氯氮平治疗,2组均连续治疗6个月。比较2组患者治疗前后认知功能、行为障碍、AD严重程度及日常生活能力,并记录2组不良反应发生情况。结果:与治疗前比较,治疗后2组患者定向力、语言能力、注意力和计算力、记忆力及回忆力评分均明显升高,且实验组明显高于对照组(P<0.05或P<0.01)。与治疗前比较,治疗后2组患者幻觉、妄想、攻击行为、行为紊乱、焦虑恐惧、昼夜节律紊乱评分均明显降低,且实验组明显低于对照组(P<0.05或P<0.01)。与治疗前比较,治疗后2组ADAS-Cog评分均明显降低,且实验组明显低于对照组(P<0.01);2组ADL评分均明显升高,且实验组明显高于对照组(P<0.01)。2组总不良反应发生率无明显差异(P>0.05)。结论:盐酸多奈哌齐联合氯氮平可更明显地改善AD患者认知功能和行为障碍,提高患者日常生活活动能力,安全性高,值得临床推广应用。
OBJECTIVE To observe the efficacy of donepezil hydrochloride combined with clozapine in the treatment of Alzheimer’s disease(AD) with mental and behavioral disorders.METHODS A total of 116 AD patients treated in one hospital from July 2016 to June 2018 were selected and divided into experimental group and control group by random number table method, 58 cases for each group. Both groups were treated with routine basic therapy, while the control group was treated with donepezil hydrochloride, and the experimental group was treated with clozapine in addition to donepezil hydrochloride. Both groups were treated continuously for 6 months. Cognitive function, behavioral disorders, AD severity and daily living ability were compared between the two groups before and after treatment, and adverse reactions were recorded. RESULTS Compared with those before treatment, the scores of orientation, language ability, attention and calculation ability, memory and recall in the two groups were significantly higher after treatment, and the scores in the experimental group were significantly higher than those in the control group(P<0.05 or P<0.01). Compared with those before treatment, the scores of hallucination, delusion, aggressive behavior, behavior disorder, anxiety and fear, circadian rhythm disorder in the two groups were significantly lower after treatment, and the scores in the experimental group were significantly lower than those in the control group(P<0.05 or P<0.01). Compared with those before treatment, the ADAS-Cog scores of the two groups were significantly lower after treatment, and the ADL scores of the experimental group were significantly lower than those of the control group(P<0.01);the ADL scores of the two groups were significantly higher, and the experimental group was significantly higher than that of the control group(P<0.01). There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).CONCLUSION Donepezil hydrochloride combined with clozapine can significantly improve the cognitive function and behavioral disorders of AD patients, and improve their activities of daily living. It is safe and worthy of clinical application.
作者
林荫
罗海东
张云志
陈圣丽
LIN Yin;LUO Hai-dong;ZHANG Yun-zhi;CHEN Sheng-li(Psychological counseling and treatment center, Hainan provincial Anning Hospital,Hainan Haikou 570200, China;The third department of psychiatry, Hainan provincial Anning Hospital,Hainan Haikou 570200, China)
出处
《中国医院药学杂志》
CAS
北大核心
2019年第14期1476-1479,共4页
Chinese Journal of Hospital Pharmacy
基金
海南省自然科基金项目(编号:817371)
关键词
盐酸多奈哌齐
氯氮平
阿尔茨海默病
不良反应
donepezil hydrochloride
clozapine
Alzheimer’s disease
adverse reactions
