多奈哌齐联合奥氮平在精神行为异常症状血管性痴呆中认知恢复情况研究

A case study of donepezil combined olanzapine treatment in recovery of spirit abnormal behavior symptoms in vascular dementia cognitive

目的探讨多奈哌齐联合奥氮平在精神行为异常症状血管性痴呆中的认知恢复情况。方法选取我院2012年2月至2015年1月期间收治的100例伴有精神行为异常症状的血管性痴呆患者,随机分为观察组(n=50)和对照组(n=50),观察组给予大剂量多奈哌齐联合奥氮平治疗,对照组给予小剂量多奈哌齐联合奥氮平治疗,并比较两组患者治疗前及治疗后4周、6周、12周的AD病理行为评分表(BEHAVE-AD)、简易智能精神状态检查量表(MMSE)及日常生活活动能力量表(ADL)评分情况,并观察不良反应发生情况。结果两组治疗前BEHAVE-AD、MMSE、ADL评分差异无统计学意义(P>0.05)。两组治疗后不同时段BEHAVE-AD评分均低于治疗前,MMSE评分和ADL评分均高于治疗前,差异有统计学意义(P<0.05),而观察组治疗后12周下降或升高更为显著,与对照组比较差异有统计学意义(P<0.05)。治疗后4周及治疗后6周BEHAVE-AD、ADL及MMSE评分与对照组比较比较差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论采用大剂量多奈哌齐联合奥氮平治疗伴有精神行为异常症状的血管性痴呆可明显提高临床疗效,改善患者认知功能,值得在临床上推广应用。

Objective To investigate the effect of donepezil combined with olanzapine treatment on behavioral and psychological symptoms of vascular dementia. Methods 100 cases with the spirit of behavioral and psychological symptoms in our hospital of vascular dementia were randomly divided into observation group and control group. 50 cases of observation group were treated with donepezil combined with ammonia; 50 cases in the control group were treated with olanzapine. The behavioral pathology in Alzheimer＇s disease rating scale（BEHAVE-AD） score,mini mental state examination（MMSE） score and activity of daily living scale（ADL） score before and after treatment of 4 weeks, 6 weeks, 12 weeks,and the occurrence of adverse reactions between the two groups after treatment were compared. Results BEHAVE-AD score, ADL and MMSE score before treatment and after 4 weeks of treatment and after 6 weeks of treatment had no significant difference（P〉0.05）; after 12 weeks of treatment, there were significant differences between groups（P〈0.05）.The incidence of adverse reactions between two groups was not significantly different（P〉0.05）. Conclusion The use of donepezil combined with olanzapine for treatment of spirit abnormal behavior symptoms in vascular dementia cognitive can significantly improve the clinical efficacy and cognitive function.