利培酮或喹硫平联合多奈哌齐治疗老年痴呆伴精神行为障碍患者的临床效果及安全性

Clinical Efficacy and Safety of Risperidone or Quetiapine Combined with Donepezil in the Treatment of Senile Dementia Patients with Psychobehavioral Disorders

目的探讨老年痴呆采用利培酮联合多奈哌齐或喹硫平联合多奈哌齐治疗的临床效果以及安全性。方法按照用药方案不同,将辽宁省阜新市第四人民医院2016年8月至2018年8月收治的140例老年痴呆伴精神行为障碍患者分为对照组和试验组,对照组(n=70)给予利培酮+多奈哌齐联合治疗,试验组(n=70)给予喹硫平+多奈哌齐联合治疗,比较两组临床效果、副反应量表(TESS)评分、简易智力状态检查量表(MMSE)评分、阿尔茨海默病病理行为评分表(BEHAVE-AD)评分。结果试验组治疗有效率为91.43%,与对照组的90.00%比较,差异无统计学意义(P>0.05);治疗后,两组MMSE评分、BEHAVE-AD评分比较,差异无统计学意义(P>0.05);治疗第2周、4周、6周、8周,试验组TESS评分均明显低于对照组,且随着时间增加而不断降低,组间比较差异有统计学意义(P<0.05)。结论利培酮或喹硫平联合多奈哌齐治疗老年痴呆伴精神行为障碍临床效果显著,均可有效改善患者的认知功能、精神行为症状,但喹硫平药物的不良反应更少。

Objective To explore the clinical effects and safety of risperidone combined with donepezil or quetiapine combined with donepezil in the treatment of senile dementia. Methods According to different medication schemes, 140 cases of senile dementia patients with mental and behavioral disorders admitted to Fuxin Fourth People’s Hospital of Liaoning Province from August 2016 to August 2018 were divided into control group and experimental group. The control group(n=70) was treated with risperidone, combined with donepezil, while the experimental group(n=70) was treated with quetiapine, combined with donepezil. The clinical effects, TESS score, MMSE score and BEHAVE-AD score of Alzheimer’s disease were compared between the 2 groups. Results The clinical treatment efficiency of the experimental group was 91.43%, there was no significant difference compared with 90.00% of the control group(P>0.05);there was no significant difference in MMSE score and BEHAVE-AD score between the 2 groups(P>0.05);the TESS score of the control group was higher than that of the experimental group, in the 2 nd, 4 th, 6 th, 8 th week of treatment. And the score kept decreasing as time went on. The differences between the groups were significant difference(P<0.05). Conclusion Risperidone or quetiapine combined with donepezil in the treatment of senile dementia with mental and behavioral disorders has a significant clinical effects. Both of them have effective cognitive function and psychobehavioral symptoms, but quetiapine has fewer adverse reactions.