多奈哌齐联合奥氮平治疗伴精神行为症状阿尔茨海默病的疗效分析

Efficacy of donepezil combined with olanzapine in the treatment of Alzheimer’s disease with behavioral and psychological symptoms

目的探讨多奈哌齐联合奥氮平对伴有精神行为症状的阿尔茨海默病(AD)患者的治疗效果。方法 106例伴精神行为症状的AD患者,按照随机数字表法分为观察组与对照组,各53例。两组均服用多奈哌齐治疗,其中观察组联用奥氮平治疗,对照组联用利培酮治疗。比较两组疗效,治疗前后阿尔茨海默病行为病理评定量表(BEHAVE-AD)、改良爱丁堡-斯堪的那维亚量表(MESSS)、阿尔茨海默病评价量表-认知量表(ADAS-cog)评分、总胆固醇(TC)、甘油三酯(TG)及空腹血糖(FPG)水平,不良反应发生情况。结果观察组治疗总有效率为96.23%,高于对照组的83.02%,差异有统计学意义(P<0.05)。治疗后,两组BEHAVE-AD、MESSS、ADAS-cog评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组TC、TG、FPG水平高于治疗前及对照组治疗后,差异有统计学意义(P<0.05);对照组TC、TG、FPG水平与治疗前比较,差异无统计学意义(P>0.05)。观察组椎体外系反应、失眠发生率分别为1.89%、0,低于对照组的15.09%、11.32%;总体不良反应发生率15.09%低于对照组的37.74%,差异均有统计学意义(P<0.05)。结论多奈哌齐联合奥氮平对改善AD患者精神行为症状的疗效较好,值得临床推广借鉴。

Objective To discuss the therapeutic effect of donepezil combined with olanzapine in the treatment of Alzheimer’s disease(AD) patients with behavioral and psychological symptoms. Methods A total of 106 AD patients with behavioral and psychological symptoms were divided into observation group and control group according to random numerical table, with 53 cases in each group. The observation group was treated with olanzapine and donepezil, and the control group was treated with risperidone and donepezil. The efficacy, behavioral pathology in Alzheimer’s disease(BEHAVE-AD), modified Edinbergh-Scandinavia stroke scale, Alzheimer’s disease assessment scale-cognitive subscale(ADAS-cog) score, total cholesterol(TC), triglycerides(TG) and fasting plasma glucose(FPG) before and after treatment and occurrence of adverse reactions were compared between the two groups. Results The total effective rate of treatment of the observation group was 96.23%, which was higher than 83.02% of the control group, and the difference was statistically significant(P<0.05). After treatment, BEHAVE-AD, MESSS and ADAS-cog score of the two groups were lower than those before treatment, and the observation group was lower than the control group, and the difference was statistically significant(P<0.05). After treatment, TC, TG and FPG of the observation group were higher than those before treatment and the control group after treatment, and the difference was statistically significant(P<0.05). There was no significant difference in the levels of TC, TG and FPG in the control group before and after treatment(P>0.05). The incidence of extravertebral reaction and insomnia of the observation group were 1.89% and 0, which were lower than 15.09% and 11.32% of the control group, and total incidence of adverse reactions 15.09% was lower than 37.74% of the control group, and the difference was statistically significant(P<0.05). Conclusion Donepezil combined with olanzapine shows good efficacy in improving behavioral and psychological symptoms of AD patients, and it is worthy of clinical promotion and reference.