多奈哌齐合并奥氮平治疗老年痴呆精神行为症状的对照研究

A Controlled Study of Donepezil Combining with Olazapine on Alzheimer's Disease with Behavioral and Psychological Symptoms

目的:探讨多奈哌齐合并奥氮平治疗老年痴呆精神行为症状的疗效和安全性。方法:90例伴精神行为症状的痴呆病人随机分为多奈哌齐合并奥氮平组(研究组)与单用奥氮平组(对照组)。治疗前及治疗第4、8周末以MMSE评分评价认知功能,以BEHAVE-AD评分评定精神行为症状的改善,以ADL评价其日常生活能力。以TESS评定记录治疗中各项药物不良反应。结果:研究组MMSE评分较治疗前提高2分以上,研究组组内比较差异具有统计学意义(P<0.05),对照组差异无统计学意义。BEHAVE-AD量表评分两组组内治疗前、后比较,差异均有统计学意义(P<0.05),在8周组间比较差异具有统计学意义(P<0.05)。两组组间ADL评分在8周比较差异具有统计学意义(P<0.05)。两组均无不能耐受的不良药物反应。结论:多奈哌齐合并奥氮平治疗老年痴呆精神行为症状安全有效且优于单用奥氮平。此外,多奈哌齐合并奥氮平可以改善患者的认知功能。

Objective：To evaluate the efficacy and safety of Donepezil on Alzheimer＇s disease with behavioral and psychological symptoms. Methods：90 patients with BPSD were randomized into two groups treated with Donepezil ading olanzapine,or olanzapine alone respectively for 8 weeks. All patients were assessed by Mini Mental State Examination （MMSE） for the cognitive function, by BEHAVE-AD for BPSD, and by Activities of Daily Living Scale （ADL） for daily function at the baseline and at the end of the 4th,Sth week of the treatment. We use Treatment Emergent Symp- toms Scale （TESS） to evaluate the side effects. Results：At the end of the 8th week,the score of MMSE was increased for more than 2 points in Donepezil adding olanzapine group. It was a significant increase for the score of MMSE between the base line and the 8th weekend（P^0. 05）. But there was no significant change in olanzapine group at the 8th weekend. At the end of 8th week, both the donepezil adding olanzapine group and olanzapine group have significantly improvement on the score of BEHAVE AD, there was significant difference between the two groups（P〈0.05）. The donepezil adding olanzapine group had significantly decreased for the score of ADL at the end of the treatment, there was significant difference between the two groups（P〈0. 05）. There were no severe side effects in both groups. Conclusion： The Donepezil adding olanzapine could improve the behavioral and psychological symptoms of Alzheimer＇ s disease and was relatively safe. Furthermore Donepezil adding olanzapine could raise the cognitive function of patients with Alzheimer.