奥氮平与利培酮治疗老年性痴呆精神行为症状的临床对比分析

Clinical comparative analysis of olanzapine and risperidone in the treatment of mental and behavioral symptoms of senile dementia

目的总结奥氮平与利培酮治疗老年性痴呆(SD)的效果以及对精神行为症状的影响。方法 112例SD患者,随机分为实验组和对照组,每组56例。实验组患者采用奥氮平治疗,对照组患者采用利培酮治疗。对比两组患者的治疗效果、药物不良反应发生情况,治疗前及治疗2、4、8周的痴呆病理行为评定量表(BEHAVE-AD)分值。结果实验组患者治疗总有效率91.07%高于对照组的76.79%,差异具有统计学意义(P<0.05)。两组患者治疗2、4、8周的BEHAVE-AD分值均低于治疗前,且实验组患者治疗2、4、8周的BEHAVE-AD分值均低于对照组,差异均具有统计学意义(P<0.05)。实验组患者失眠、锥体外系反应、激惹反应发生率分别为3.6%、3.6%、3.6%,均明显低于对照组的14.3%、17.9%、14.3%,差异均具有统计学意义(P<0.05);两组患者嗜睡、乏力发生率对比,差异无统计学意义(P>0.05)。结论相对于利培酮,奥氮平在SD治疗方面具有安全性、有效性等整体优势,可作为首选药物。

Objective To summarize the effects of olanzapine and risperidone in the treatment of senile dementia(SD) and its influence on mental behavioral symptoms. Methods A total of 112 SD patients were randomly divided into experimental group and control group, with 56 cases in each group. The experimental group was treated with olanzapine, and the control group was treated with risperidone. Comparison were made on treatment effect, occurrence of adverse drug reactions and behavior pathology in Alzheimer’s disease rating scale(BEHAVE-AD) score before treatment and after 2, 4, 8 weeks of treatment between the two groups. Results The experimental group had significantly higher total treatment effective rate as 91.07% than 76.79% in the control group, and the difference was statistically significant(P<0.05). Both groups had lower BEHAVE-AD score after 2, 4 and 8 weeks of treatment than those before treatment, and the experimental group had lower BEHAVE-AD score after 2, 4 and 8 weeks of treatment than the control group. Their difference was statistically significant(P<0.05). The experimental group had obviously lower incidence of insomnia, extrapyramidal reaction and irritation reaction respectively as 3.6%, 3.6% and 3.6% than 14.3%, 17.9% and 14.3% in the control group, and their difference was statistically significant(P<0.05). Both groups had no statistically significant difference in incidence of sleepiness and fatigue(P>0.05). Conclusion Compared with risperidone, olanzapine has the overall advantages of safety and effectiveness in the treatment of SD, and can be used as the preferred drug.