盐酸多奈哌齐联合氯氮平治疗AD伴精神行为障碍的临床研究

A clinical Study of Donepezil Hydrochloride Combined with Clozapine in the Treatment of AD with Mental and Behavior Disorder

目的分析对阿尔茨海默病(AD)伴精神行为障碍患者实施盐酸多奈哌齐联合氯氮平治疗的临床效果。方法于2018年8月—2020年10月方便择取68例AD伴精神行为障碍患者,以入院时间先后予以分组,每组34例,对照组实施盐酸多奈哌齐治疗,研究组实施盐酸多奈哌齐联合氯氮平治疗,对组间效果进行对照。结果治疗后研究组时间定向力评分(3.44±0.15)分、地点定向力评分(3.84±0.05)分、即刻回忆评分(2.46±0.52)分、注意力与计算力评分(4.02±0.86)分、回忆力评分(2.54±0.45)分均高于对照组,妄想(1.05±0.47)分、行为紊乱(1.26±0.65)分、昼夜节律紊乱(1.56±0.22)分、幻觉(0.78±0.40)分、攻击行为(1.07±0.56)分、焦虑恐惧(0.88±0.44)分均低于对照组,差异有统计学意义(t=10.003、26.921、3.294、4.471、4.277、5.075、4.135、4.794、4.782、4.601、6.068,P<0.05);研究组不良反应发生率为23.53%,对照组不良反应发生率为17.65%,差异无统计学意义(χ^(2)=0.360,P>0.05)。结论对AD伴精神行为障碍患者而言,实施盐酸多奈哌齐联合氯氮平治疗,可改善认知功能,同时也可以改善行为障碍,且具备较高的安全性,临床价值显著。

Objective To analyze the clinical effect of donepezil hydrochloride combined with clozapine in patients with Alzheimer's disease(AD)with mental behavior disorder.Methods From August 2018 to October 2020,68 patients with AD with mental behavior disorder were conveniently selected and divided into groups according to the time of admission,34 cases in each group.The control group received donepezil hydrochloride treatment,and the study group received donepezil hydrochloride combined with clozapine treatment,the effect between groups were compared.Results After treatment,the study group's time orientation score(3.44±0.15)points,place orientation score(3.84±0.05)points,immediate recall score(2.46±0.52)points,attention and calculation score(4.02±0.86)points,reminiscence score(2.54±0.45)points were higher than the control group,delusion(1.05±0.47)points,behavior disorder(1.26±0.65)points,circadian rhythm disorder(1.56±0.22)points,hallucinations(0.78±0.40)points,aggressive behavior(1.07±0.56)ponts and anxiety and fear(0.88±0.44)points were lower than those of the control group,the difference was statistically significant(t=10.003,26.921,3.294,4.471,4.277,5.075,4.135,4.794,4.772,4.601,6.068,P<0.05);The incidence of adverse reactions in the study group was 23.53%,and the incidence of adverse reactions in the control group was 17.65%,the difference was not statistically significant(χ^(2)=0.360,P>0.05).Conclusion For patients with AD with mental and behavioral disorders,the treatment of donepezil hydrochloride combined with clozapine can improve cognitive function and at the same time improve behavioral disorders,and has high safety and significant clinical value.