多奈哌齐联合奥氮平治疗老年痴呆伴发精神行为症状患者的临床效果

Clinical effect of Donepezil combined with Olanzapine in the treatment of senile dementia patients with mental and behavioral symptoms

目的探讨奈哌齐联合奥氮平治疗老年痴呆伴发精神行为症状患者的临床效果。方法选取本院2019年5~9月收治的50例伴有精神行为症状的老年痴呆患者为研究对象,根据治疗方式不同分为对照组和研究组,每组各25例。对照组给予多奈哌齐治疗,研究组给予多奈哌齐+奥氮平治疗。观察研究两组患者治疗前后的BEHAVE-AD评分、不良反应发生情况、WCST认知功能。结果两组治疗前的BEHAVE-AD评分比较,差异无统计学意义(P>0.05);两组治疗8周后的BEHAVE-AD评分低于治疗4、6周后,治疗6周后的BEHAVE-AD评分低于治疗4周后,差异有统计学意义(P<0.05)。研究组治疗4、6、8周后的BEHAVE-AD评分均低于对照组,差异有统计学意义(P<0.05)。研究组治疗后的不良反应总发生率低于对照组,差异有统计学意义(P<0.05);两组治疗前的WCST总测验数、随机错误数、持续错误数、正确反应数、分类数比较,差异无统计学意义(P>0.05)。研究组治疗后的WCST总测验数、随机错误数、持续错误数均低于对照组,正确反应数、分类数均高于对照组,差异有统计学意义(P<0.05)。结论采用多奈哌齐+奥氮平联合治疗能够改善老年痴呆伴发精神行为症状,提高认知能力,且具有良好的安全性。

Objective To investigate the clinical effect of Donepezil combined with Olanzapine in the treatment of senile patients suffering from dementia with mental and behavioral symptoms.Methods A total of 50 senile dementia patients with mental and behavioral symptoms who were admitted to our hospital from May to September in 2019 were randomly selected as the research subjects.According to different treatments,they were divided into the control group and the study group,with 25 cases in each group.In the control group,Donepezil was used,and in the study group,Donepezil+Olanzapine was adopted.The BEHAVE-AD scores before and after treatment,the occurrence of adverse reactions and the Wisconsin card sorting test(WCST)cognitive function score of the two groups were observed and compared.Results There was no statistically significant difference in the BEHAVE-AD scores between the two groups before treatment(P>0.05).The BEHAVE-AD scores of the two groups after 8 weeks of treatment were lower than those of 4 and 6 weeks after treatment,and the BEHAVE-AD scores of the two groups after 6 weeks of treatment were lower than those of 4 weeks after treatment,with statistical significance(P<0.05).The BEHAVE-AD scores of the study group at 4,6,8 weeks after treatments were all lower than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the study group after treatment was lower than in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in the WCST total test trials,random error number,perseverative error number,correct response trials and categories number between the two groups before treatment(P>0.05).After treatment,the WCST total test trials,random error number,and perseverative error number in the study group were lower than those of the control group,the correct response trials and categories number of the study group after treatment were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The combined treatment of Donepezil and Olanzapine can improve the senile dementia patients with mental and behavioral symptoms associated and enhance cognitive ability in good safety.