认知训练治疗阿尔茨海默病的疗效观察

The effects of cognitive training on mild-to-moderate Alzheimer＇s disease patients

目的 观察认知训练治疗早中期阿尔茨海默病（AD）的临床疗效.方法 采用单盲随机对照方法.入选的32例早中期AD患者中,16例（认知训练组）进行认知训练联合药物治疗,16例（对照组）进行沟通对照联合药物治疗,治疗期为10周.在治疗前及治疗10周后,运用简易精神状态筛查量表（MMSE）、Fuld物体记忆测验（FOM）、词语流畅性测验（RVR）、画钟测验（CDT）、连线测验A（TMT-A）、数字广度测验（WAIS-DS）、积木测验（WISC-BD）、日常生活活动（ADL）能力量表、神经精神科问卷（NPI）等对患者进行评定.结果 治疗10周后,认知训练组的MMSE、TMT-A和NPI的改善均优于对照组,差异具有统计学意义（P＜0.05,P＜0.01）.结论 认知训练治疗可稳定和改善早中期AD患者的认知功能和精神行为症状.

Objective To determine the efficacy of individual cognitive training （CT） in the treatment of cognitive and neuropsychiatric symptoms in patients with mild to moderate Alzheimer disease （ AD）. Methods A randomized, controlled, rater-blind clinical trial recruited 32 AD patients. AH patients were assigned to a CT group （n = 16） or a control group （a time and attention control, n = 16） for 10 weeks. All outcome measures were administered at baseline and follow-up. The cognitive status was evaluated using the Mini Mental State examination （MMSE） , a clock-drawing test （CDT） , Fuld＇s object memory evaluation （FOME） , a rapid verbal retrieval （RVR） , digit span assessments （DS） , block designing （BD）, and the A version of the trail making test （TMTA）. The patients＇ functional status was evaluated using an activities of daily living （ADL） scale. Any psychological and behavioural disorders were evaluated with the Neuropsychiatry Inventory （ NPI）. Results Patients receiving CT showed greater average improvements in NPI total score, TMT-A score and MMSE total score than the controis at week 10. There was no statistically significant benefit for CT-treated patients in terms of ADL score. Conclusions Cognitive training can raise the NPI total scores and MMSE total scores of patients with mild to moderate AD.