美金刚联合奥氮平治疗伴精神行为症状的阿尔茨海默病临床疗效

Clinical effect on memantine combined olanzapine to treat the behavioral and psychological symptoms of patients with Alzheimer′s disease

目的探讨美金刚联合奥氮平治疗伴精神行为症状(BPSD)的阿尔茨海默病患者的临床疗效。方法选取重庆市精神卫生中心老年科2013年4月至2014年12月收治的阿尔茨海默病伴行为和精神障碍住院患者120例,以随机数字表法将其分为美金刚治疗组(A组)、奥氮平治疗组(B组)和美金刚联合奥氮平治疗组(C组),各40例。治疗前和治疗后第2、4、8、12周分别予阿尔茨海默病病理行为评定量表(BEHAVE-AD)评定BPSD、蒙特利尔认知评估量表(MOCA)评价疗效,药物副反应量表(TESS)评定药物的不良反应。结果三组患者BEHAVE-AD评分在治疗后第2、4、8、12周末均较治疗前降低,差异有统计学意义(P<0.05);治疗第2、12周末后,C组BEHAVE-AD评分减分率与A、B组比较,差异均有统计学意义(P<0.05)。A、C组治疗前与同组治疗第12周末MOCA评分比较,差异均有统计学意义(P<0.05);B组治疗前与治疗第12周末MOCA评分比较,差异无统计学意义(P>0.05);A、C组治疗第12周末MOCA评分比较,差异无统计学意义(P>0.05)。A、C组不良反应发生率明显低于B组,差异均有统计学意义(P<0.05);A组不良反应发生率与C组比较,差异无统计学意义(P>0.05)。结论美金刚联合奥氮平能快速、有效控制阿尔茨海默病患者的BPSD,改善患者认知功能,且不良反应小。

Objective To study the clinical effect on memantine combined olanzapine to treat the behavioral and psy chological symptoms of patients with Alzheimer＇s disease. Methods According to random number table, 120 cases of the behavioral and psychological symptoms patients with Alzheimer＇s disease from April 2013 to December 2014 in Department of Geriatrics,the Mental Health center of Chongqing were divided into three groups ,memantine treatment group （group A）, olanzapine treatment group （group B ）, olanzapine combined memantine treatment group （group C）, 40 cases in each group. Before the treatment and at 2,4,8,12weeks during therapy,the behavioral pathology in Alzheimer＇s disease rating scale （BEHAVE-AD） and Montreal cognitive assessment （MOCA）were used to evaluate curative effect, treatment emergent symptom scale （TESS）to evaluate drug adverse reactions. Results The BEHAVE-AD score in among three groups at 2,4,8,12 weeks during therapy were lower than those before the treatment, the differences were statistically significant （P〈 0.05 ） ;at 2,4,8,12 weeks during therapy, the reducing score rate of BEHAVE-AD score in group A compared with group B, the differences were statistically signifieant（P〈0.05 ）. The MOCA score in group A, C at 12 weeks during therapy compared with that before the treatment,the differences were statistically significant（P〈0.05 ）, but group B was no statistically signifieant（P〉0.05 ） ; The MOCA score in group A at 12 weeks during therapy compared with group C, the difference was no statistically significant （P〉0.05）.The incidence of adverse reactions in group A, C were obviously lower than group B, the differences were statistically significant （P〈0.05） ;but group A compared with group C,the difference was no statistically significant （P〉0.05）.Conclusion Treatments by memantine combined olanzapine can quickly and effectively control the behavioral and psychological symptoms of patients with Alzheimer＇s disease, improve cognitive function and have less adverse reaction.