重复经颅磁刺激治疗老年痴呆精神行为症状的效果评估及研究

Evaluation and Study of the Effect of Repetitive Transcranial Magnetic Stimulation in Treatment of Mental and Behavioral Symptoms of Alzheimer Disease

目的:探讨老年痴呆精神行为症状采取重复经颅磁刺激(rTMS)治疗的效果。方法:选取2014年12月-2016年6月本院收治的符合ICD-10阿尔茨海默病痴呆并伴有精神行为症状诊断标准的住院患者100例,按照随机数字表法将其分为研究组和对照组,每组各50例。对照组患者采取非典型抗精神病药物治疗,研究组采取rTMS治疗。治疗前、治疗后第2周、第8周分别采用蒙特利尔认知评估量表(MoCA)评分、日常生活能力量表(ADL)评分、阿尔茨海默病行为病理(BEHAVE-AD)评分评价两组患者的临床疗效;比较两组患者不良反应发生情况。结果:治疗前,两组患者MoCA、ADL、BEHAVE-AD评分比较,差异均无统计学意义(P>0.05);治疗后第2周,研究组患者MoCA、ADL、BEHAVE-AD评分均较治疗前改善(P<0.05);治疗后第8周,两组患者MoCA、ADL、BEHAVE-AD评分均较治疗前改善(P<0.05);且治疗后第2、8周,研究组患者MoCA、ADL、BEHAVE-AD评分均优于对照组(P<0.05);两组均有不良反应发生,但两组患者各不良反应发生情况比较,差异均无统计学意义(P>0.05)。结论:rTMS治疗老年痴呆精神行为症状能取得比较良好的效果,可更快、更好地改善认知功能、日常生活能力及病理症状,同时安全性高,值得推广。

Objective:To investigate the effect of repeated transcranial magnetic stimulation(rTMS)in treatment of mental and behavioral symptoms of Alzheimer disease.Method:100 cases of hospitalized patients with ICD-10 Alzheimer disease dementia and diagnostic criteria for psycho behavioral symptoms from December 2014 to June 2016 were selected.according to the random number table method,they were divided into study group and control group,50 cases in each group.The control group was treated with atypical antipsychotics,and study group was treated with rTMS.Before treatment,after treatment(second weeks,eighth weeks),the Montreal cognitive assessment scale(MoCA)score,daily life ability scale(ADL)score and Alzheimer disease behavioral pathology(BEHAVE-AD)score were used to evaluate the clinical efficacy of two groups,and the incidence of adverse reactions of two groups was compared.Result:Before treatment,the scores of MoCA,ADL and BEHAVE-AD of two groups were compared,the differences were not statistically significant(P>0.05),after second weeks of treatment,the scores of MoCA,ADL and BEHAVE-AD in study group were better than those of before treatment(P<0.05),after eighth weeks of treatment,the scores of MoCA,ADL and BEHAVE-AD of two groups were better than those of before treatment(P<0.05),after second weeks and eighth weeks of treatment,the scores of Moca,ADL and BEHAVE-AD in study group were all better than those of control group(P<0.05).There were adverse reactions in two groups,but the incidence of adverse reactions of two groups was compared,the differences were not statistically significant(P>0.05).Conclusion:RTMS has better effect in treatment of mental and behavioral symptoms of Alzheimer disease,can improve cognitive function,activities of daily living and pathological symptoms faster and better,has high safety and is worth promoting.