CCRT治疗对轻度认知症患者认知功能的影响

Effects of Computer Cognitive Remediation Therapy on Cognitive Function in Patients with Alzheimer’s Disease Dementia

目的探讨计算机认知矫正治疗(CCRT)对轻度认知症患者认知功能的影响.方法将105例轻度认知症患者随机分为两组,对照组(n=52)给予多奈哌齐治疗12月,CCRT组(n=53)在此基础上联合运用CCRT,共持续12个月.采用简易精神状况检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、威斯康星卡片分类测验(WCST)、17项版汉密尔顿抑郁量表(HAMD-17)、汉密尔顿抑郁量表(HAMA)评估患者认知功能、执行功能、情绪状态变化.结果干预6个月后,CCRT组MMSE、Mo CA评分较干预前明显升高,且明显高于对照组(P<0.05);干预12个月后,CCRT组MMSE、Mo CA评分均显著高于对照组(P<0.05).干预6个月后,CCRT组WCST中正确反应数、完成分类数较干预前明显升高,持续错误数、随机错误数较干预前明显下降(P<0.05),除完成卡片总数外其余指标均明显优于对照组(P<0.05);干预12个月后,CCRT组WCST各指标评分均显著优于对照组(P<0.05).干预6、12个月后,CCRT组HAMA、HAMD评分均较干预前明显降低,且明显低于对照组(P<0.05).结论小剂量药物结合CCRT治疗轻度认知症患者,不仅可有效改善患者的认知功能,还有助于缓解焦虑抑郁情绪.

Objective To explore the influence of computer cognitive remediation therapy(CCRT)on cognitive function in patients with Alzheimer’s disease dementia.Method A total of 105 patients with Alzheimer’s disease dementia were randomly divided into two groups.The control group(n=52)was given low-dose donepezil treatment for 12 mouths,and the CCRT group(n=53)was combined with CCRT for 12 months.The changes in cognitive function,executive function and emotional state were assessed by using MMSE,MoCA,WCST,HAMD-17 and HAMA.Results After 6 months intervention,MMSE and MoCA scores of the CCRT group were significantly higher than those of the control group(P<0.05).After 12 months intervention,MMSE and MoCA scores of the CCRT group were significantly higher than those of the control group(P<0.05).After 6 months intervention,the number of correct response and completed classification in WCST in the CCRT group were significantly higher than those before intervention,while the number of persistent errors and random errors were significantly lower than those before intervention(P<0.05).All indexes except the total number of completed cards were significantly better than those in the control group(P<0.05).After 12 months intervention,WCST scores of CCRT group were significantly better than those of the control group(P<0.05).HAMA and HAMD scores in the CCRT group were significantly lower than those in the control group at 6 and 12 months after intervention,and were significantly lower than those in the control group(P<0.05).Conclusion Low-dose drugs combined with CCRT for the treatment of Alzheimer’s disease dementia can not only effectively improve the cognitive function,but also help to relieve anxiety and depression.