普罗布考联合多奈哌齐治疗阿尔茨海默病的效果及对精神行为症状的影响

Efficacy of propucol combined with donepezil in treatment of Alzheimer's disease and its effect on psychobehavioral symptoms

目的探讨普罗布考联合多奈哌齐治疗阿尔茨海默病(AD)的效果和对精神行为症状的影响。方法抽取2018年11月至2020年11月郑州大学附属郑州中心医院收治的AD患者156例, 按随机数字表法分为联合组(78例)与单一组(78例), 单一组采用多奈哌齐治疗, 联合组采用普罗布考联合多奈哌齐治疗, 比较两组疗效和治疗前后总体衰退量表(GDS), 临床痴呆评定量表(CDR), 精神行为症状(NPI), 个人和社会功能量表(PSP)评分, 血清炎性因子水平包括白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α), 血清神经递质水平包括乙酰胆碱(Ach)、谷氨酸(Glu)、5-羟色胺(5-HT), 不良反应发生率。结果联合组总有效率92.31%(72/78)较单一组78.21%(61/78)高(P<0.05);治疗后, 联合组GDS、CDR评分较单一组低(P<0.05);治疗后, 联合组NPI评分较单一组低, PSP评分较单一组高(P<0.05);治疗后, 联合组血清IL-1β、TNF-α水平较单一组低(P<0.05);治疗后, 联合组血清Ach、Glu、5-HT水平较单一组高(P<0.05);联合组不良反应发生率7.69%(6/78)与单一组10.26%(8/78)比较, P>0.05。结论普罗布考联合多奈哌齐治疗AD患者可提高疗效, 调节血清炎性因子和神经递质表达, 减轻痴呆程度, 提高认知功能, 改善精神行为症状和个体功能, 并具有用药安全性。

Objective To investigate the efficacy of propucol combined with donepezil in the treatment of Alzheimer's disease(AD)and its effect on psychobehavioral symptoms.Methods A total of 156 patients with AD in Zhengzhou Central Hospital Affiliated to Zhengzhou University from November 2018 to November 2020 were selected and divided into combined group(n=78)and single group(n=78)according to random number table method.The single group received donepezil,while the combined group received propucol combined with donepezil.The Global Deterioration Scale(GDS),clinical dementia rating scale(CDR),mental symptoms(NPI),personal and social function scale(PSP)score,serum levels of inflammatory factors including interleukin 1 beta(IL-1β),tumor necrosis factor alpha(TNF-α),serum levels of serum neurotransmitter levels including acetylcholine(Ach),glutamic acid(Glu),5-hydroxytryptamine(5-HT)before and after the treatment,the incidence of adverse reactions were compared between the two groups.Results The total effective rate of combined group was 92.31%(72/78),which was higher than 78.21%(61/78)of single group(P<0.05).After treatment,the GDS and CDR scores of combined group were lower than those of single group(P<0.05).After treatment,the NPI score of combined group was lower than that of single group,and the PSP score was higher than that of single group(P<0.05).After treatment,the levels of serum IL-1βand TNF-αin combined group were lower than those in single group(P<0.05).After treatment,the serum levels of Ach,Glu and 5-HT in combined group were higher than those in single group(P<0.05).The incidence of adverse reactions in the combined group was 7.69%(6/78)compared with 10.26%(8/78)in the single group,P>0.05.Conclusions Probucol combined with donepezil in the treatment of patients with AD can improve the efficacy,regulate the expression of serum inflammatory factors and neurotransmitters,reduce the degree of dementia,improve cognitive function,improve mental and behavioral symptoms and individual function,and has the safety of medication.