联合美金刚和叶酸治疗中度Alzheimer病临床效果

Clinical Study of Memantine Combined with Folic Acid in the Treatment of Moderate Alzheimer Disease

目的观察联合美金刚和叶酸治疗中度Alzheimer病的临床疗效。方法选择2018年11月—2019年11月78例中度Alzheimer病,根据治疗方法不同分为观察组和对照组,每组39例。对照组予多奈哌齐治疗,观察组在对照组基础上联合美金刚和叶酸治疗。比较两组临床疗效、简易智力状态检查量表(MMSE)、Alzheimer病评定量表-认知量表(ADAS-cog)、日常生活活动能力量表(ADL)、Alzheimer病行为病理评定量表(BEHAVE-AD)评分,以及血清β淀粉样蛋白(Aβ)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)水平变化,采用副反应量表(TESS)评价药物安全性。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组MMSE、ADL评分均较治疗前升高,ADAS-cog、BEHAVE-AD总分均较治疗前降低,血清Aβ、IL-6、TNF-α水平均较治疗前降低,BDNF水平较治疗前升高,且观察组降低或升高程度大于对照组(P<0.05)。治疗2周、1、2及3个月时,两组TESS评分比较差异均无统计学意义(P>0.05)。结论联合美金刚和叶酸治疗中度Alzheimer病疗效确切,能改善认知功能及生活质量,调节血清相关因子水平,促进脑神经修复,且安全性高。

Objective To observe the clinical efficacy of Memantine combined with Folic Acid in the treatment of moderate Alzheimer disease.Methods In total,78 patients with moderate Alzheimer disease from November 2018 to November 2019 were selected as the research subjects,and the patients were divided into observation group and control group according to different treatment methods,with 39 cases in each group.The control group was treated with Donepezil,and the observation group was treated with Memantine combined with Folic Acid on the basis of the control group.The clinical efficacy,Mini-Mental State Examination(MMSE),Alzheimer's Disease Assessment Scale-Cognitive Scale(ADAS-cog),Activities of Daily Living(ADL),Alzheimer's Disease Behavioral Pathology Scale(BEHAVE-AD)score,and changes in the levels of serological indicatorsβamyloid(Aβ),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),homocysteine(Hcy),brain-derived neurotrophic factor(BDNF)were compared,and the safety of the drug was evaluated by using Treatment Emergenct Side-effect Scale(TESS).Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,MMSE and ADL scores in both groups were increased compared with those before treatment,ADAS-cog total score and BEHAVE-AD total score were decreased compared with those before treatment.Serum Aβ,IL-6 and TNF-αlevels were decreased compared with those before treatment,and the level of BDNF was higher than that before treatment.The degree of decrease or increase in the observation group was greater than that in the control group(P<0.05).At 2 weeks,and 1,2 and 3 months after treatment,there was no significant difference in TESS scores between the two groups(P>0.05).Conclusion Memantine combined with Folic Acid in the treatment of moderate Alzheimer disease has a definite curative effect,which can improve cognitive function and quality of life,regulate the level of serum-related factors,and promote the repair of cranial nerves,with good safety.