喹硫平联合丙戊酸钠缓释片治疗阿尔茨海默病精神行为症状的疗效观察

Efficacy of quetiapine combined with sodium valproate sustained-release tablets in the treatment of mental and behavioral symptoms of Alzheimer′s disease

目的探讨喹硫平联合丙戊酸钠缓释片治疗阿尔茨海默病(Alzheimer’s disease,AD)精神行为症状的临床疗效。方法选取2015年2月-2018年1月本中心收治的AD精神行为症状患者108例为研究对象,随机分为研究组与对照组,各54例。对照组患者给予丙戊酸钠缓释片治疗,研究组患者给予喹硫平联合丙戊酸钠缓释片治疗,治疗结束后评价2组患者的临床疗效,对比治疗前后阿尔茨海默病病理行为评分(BEHAVE-AD)、简明精神病评定量表(BPRS)评分、简易精神状态检查表(MMSE)评分、炎症因子及血管内皮指标水平,并观察2组患者不良反应发生情况。结果研究组患者的总有效率显著高于对照组(P <0.05);治疗后,2组患者的BEHAVEAD评分、BPRS评分均低于治疗前,MMSE评分高于治疗前(P <0.05);研究组患者的BEHAVE-AD、BPRS、MMSE评分改善情况均优于对照组(P <0.05);治疗后,2组患者的一氧化氮(NO)、血管内皮生长因子(VEGF)水平均较治疗前升高,白介素(IL-1)、肿瘤坏死因子-α(TNF-α)水平较治疗前降低,且研究组患者的NO、VEGF水平高于对照组,IL-1、TNF-α水平低于对照组(P <0.05);研究组与对照组的不良反应发生率相比差异无统计学意义(P>0.05)。结论喹硫平联合丙戊酸钠缓释片治疗AD患者的精神行为症状疗效显著,可有效控制患者精神行为症状,并能使患者智力提高,值得临床推广应用。

Objective To investigate the clinical efficacy of quetiapine combined with sodium valproate sustained release tablets in the treatment of the symptoms of Alzheimer′s disease(AD).Methods From February 2015 to January 2018,108 AD patients with psychobehavioral symptoms were randomly divided into study group and control group with 54 cases for each.Patients in the control group were treated with sodium valproate sustained-release tablets only,while patients in the study group with quetiapine combined with sodium valproate sustained-release tablets.The pathological behavior score(BEHAVE-AD),intelligence score,(BPRS)score,inflammatory factor and vascular endothelial index were compared before and after treatment,and the adverse reactions of the two groups were observed.Results The total effective rate of the patients in the study group was significantly higher than that in the control group(P<0.05).After the treatment,the BEHAVE-AD and BPRS scores of the two groups were lower than those before the treatment,and the MMSE score was higher than that before the treatment(P<0.05),and the BEHAVE-AD and BPRS scores in the study group were lower than those in the control group,and the MMSE score in the study group was higher than in the control group(P<0.05);after treatment,the level of NO and VEGF in the two groups were higher than those before the treatment,and the level of IL-1 and TNF-αwere lower than those before the treatment,and the level of NO and VEGF in the study group were higher than those in the control group.The level of IL-1 and TNF-αwere lower than those in the control group(P<0.05),and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Quetiapine combined with sodium valproate sustained-release tablets is effective in the treatment of mental and behavioral symptoms in AD patients.It can effectively control the mental and behavioral symptoms of AD patients and can improve the intelligence of patients.It is worth popularizing in clinical practice.