奥卡西平辅助治疗痴呆患者攻击行为的疗效研究

The efficacy of oxcarbazepine in adjunctive treatment for aggressive behavior in patients with dementia

目的评价奥卡西平辅助治疗痴呆患者攻击行为的临床疗效。方法将96例患者分为2组,1组为奥卡西平联喹硫平组,另1组为喹硫平组,用简易智能状态检查量表(MMSE)、痴呆病理行为评定量表(BEHAVE-AD)、副反应量表(TESS)于治疗前、治疗第1,2,4,6,8周末评价临床疗效及不良反应。结果奥卡西平联喹硫平组总有效率为84.8%,喹硫平组总有效率为87.5%,与治疗前比较2组对痴呆的精神行为症状(BPSD)有肯定疗效,2组在第4周有显著性差异(P<0.05),在第8周无显著性差异,且2组间治疗4、6周末BEHAVE-AD总分和攻击行为因子分有显著性差异(P<0.05);2组间不良反应发生率有显著性差异(P<0.01)。结论奥卡西平联喹硫平治疗BPSD疗效确切,既减少了喹硫平的用量,又减少了药物不良反应,同时对攻击行为控制较快及疗效相对明显。

Objective To explore clinical efficacy of oxcarbazepine in adjunctive treatment for aggressive behavior in dementia patients. Meth- ods Fifty patients with AD and 46 patients with mental disorders caused by cerebrovascular disease were divided into two groups. One group was treated with quetiapine in combination with oxcarbazepine, and the other with quetiapine monotherapy. MMSE, BEHAVE - AD and TESS were administered for accessing efficacy and adverse effect at baseline, the 1 st, the 2nd, the 4th , the 6th and the 8th week after treatment respectively. Re- suits The total response rates for quetiapine in combination with oxcar- bazepine and quetiapine monotherapy were 84. 8 % and 87.5 % respec- tively. All the two therapies were effective for BPSD in dementia pa- tients. The difference between two groups was statistically significant at the 4th week, and was not at the 8th week. The total scores of BEHAVE - AD and the factor scores of aggressive behavior between two groups at the 4th and 6th week were significantly different （ P 〈 0.05 ）. The adverse effect rates between two groups were significantly different （ P 〈 0. 01 ）. Conclusion The efficacy of quetiapine combination with oxcarbazepine for BPSD is definite. The adjunctive therapy can reduce the dose of que- tiapine, relieve the adverse effect of medicine, and control offensive be- havior more rapidly and more effectively.