综合干预对阿尔茨海默病患者精神行为症状的影响

Effect of comprehensive intervention on behavioral and psychological symptoms of patients with Alzheimer’s disease

目的:探索综合干预对阿尔茨海默病(AD)患者精神行为症状的影响。方法:选取AD患者180例,采用随机对照研究设计将其分为观察组和对照组各90例,观察组接受综合干预,对照组接受日常照护干预。分别于治疗前及治疗后3个月、6个月使用阿尔茨海默病病理行为评分量表(BEHAVE-AD)及日常生活能力量表(ADL)对2组患者进行评估,并采用痴呆伴发精神行为障碍(BPSD)发生率、抗精神病药物服药率、再住院率评估患者的整体改善情况。结果:治疗3个月后,2组患者BEHAVE-AD评分较治疗前均明显降低(均P<0.01),观察组ADL评分较治疗前明显降低(P<0.01),但对照组与治疗前比较差异无统计学意义;治疗6个月后,2组患者与治疗前和治疗3个月后比较,BEHAVE-AD和ADL评分均明显降低(均P<0.01),且观察组治疗3个月和6个月后,与对照组同时间点比较,BEHAVE-AD和ADL评分均明显降低(均P<0.01)。结论:针对阿尔茨海默病患者的综合干预可以改善精神行为症状,提高日常生活能力。

Objective:To explore the effect of comprehensive intervention model on behavioral and psychological symptoms of patients with Alzheimer’s disease(AD).Methods:Totally,180 patients with AD were randomized into treatment group(n=90)and control group(n=90).The treatment group received“caregiver-symptom-environment”comprehensive intervention,and the control group received daily care intervention.Behavioral pathology in AD rating scale(BEHAVE-AD)and activity of daily living scale(ADL)were used before intervention and 3 and 6 months after intervention.The incidence of behavioral and psychological symptoms of dementia(BPSD),the rate of taking antipsychotics and the rate of readmission were used to evaluate the overall improvement of patients.Results:After 3 months of treatment,the BEHAVE-AD scores in the two groups were significantly lower than those before treatment(both P<0.01),and the ADL scores in the treatment group were significantly lower than those before treatment(P<0.01),but there was no significant difference in the control group before and after treatment.After 6 months of treatment,the BEHAVE-AD and ADL scores in the two groups were significantly lower than before and after 3 months of treatment(both P<0.01),and after 6 months of treatment in the treatment group,compared with the control group before treatment,and at the same time point after 3 months of treatment,the BEHAVE-AD and ADL scores were significantly reduced(all P<0.01).Conclusions:Comprehensive intervention can reduce the behavioral and psychological symptoms and improve the activity of daily living of patients with AD.