喹硫平联合颅磁刺激治疗老年痴呆精神行为症状的临床效果

Clinical effect of Quetiapine combined with cranial magnetic stimulation on psychobehavioral symptoms of senile dementia

目的探讨喹硫平联合颅磁刺激治疗老年痴呆精神行为症状的临床效果。方法选取2012年10月~2018年6月青岛市精神卫生中心接收的老年性痴呆伴有不同程度精神行为症状患者100例,采用随机数字表法分为对照组(50例)和研究组(50例),对照组与研究组均给予常规治疗,其中对照组给予喹硫平治疗,研究组在对照组的基础上采用重复经颅磁刺激治疗,连续治疗12周。评价并比较两组的临床疗效,比较两组患者治疗前后的认知功能(MoCA)、生活能力(ADL)、智力状态(SIL)及精神行为症状(NPI),比较两组患者治疗期间的不良反应发生情况。结果研究组的临床总有效率为92.00%,明显高于对照组的76.00%,差异有统计学意义(P < 0.05);治疗后两组MoCA、SIL评分均高于治疗前,且研究组高于对照组,差异有统计学意义(P < 0.05);治疗后两组ADL、NPI评分均低于治疗前,且研究组低于对照组,差异有统计学意义(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)。结论喹硫平联合颅磁刺激治疗老年痴呆精神行为症状临床效果确切,可明显改善患者的精神行为症状、认知功能、智力状态及生活能力,安全性较高,为临床治疗提供参考。

Objective To study the clinical effect of Quetiapine combined with transcranial magnetic stimulation in the treatment of mental and behavioral symptoms of senile dementia. Methods From October 2012 to June 2018, 100 patients of senile dementia with different degrees of mental and behavioral symptoms who were treated in Qingdao Mental Health Center were selected. They were divided into control group (50 cases) and study group (50 cases) by random number table method. Patients in both groups were given conventional treatment, the control group was treated with Quetiapine, and the study group was treated with repetitive transcranial magnetic stimulation on the basis of control group, both two groups were treated for 12 weeks. The clinical efficacy of the two groups was evaluated and compared. The cognitive function (MoCA), life ability (ADL), intelligence state (SIL) and mental and behavioral symptoms (NPI) of the two groups before and after treatment was compared. The adverse reactions of the two groups during treatment were compared. Results The total clinical effective rate was 92.00% in the study group, which was significantly higher than 76.00% in the control group, the difference was statistically significant (P < 0.05). After treatment, the scores of MoCA and SIL in the two groups were higher than those before treatment, and the study group was higher than that in the control group, the differences were statistically significant (P < 0.05). After treatment, the scores of ADL and NPI in the two groups were lower than those before treatment, and the study group was lower than that in the control group, the differences were statistically significant (P < 0.05). There was no statistically difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Quetiapine combined with transcranial magnetic stimulation is effective in the treatment of mental and behavioral symptoms of senile dementia. It can significantly improve the mental and behavioral symptoms, cognitive function, intelligence state and living ability of the patients. It has a high security, and it can provide a reference for clinical treatment.