多奈哌齐单用及与美金刚联用治疗中、重度阿尔茨海默病的临床对比研究

目的:探讨多奈哌齐单用及与美金刚联用治疗中、重度阿尔茨海默病(AD)的临床疗效和安全性。方法:选取2018年3月至2020年3月于四川省医学科学院·四川省人民医院(东院)就诊的100例中、重度AD患者作为研究对象,采用随机数字表法将其分为对照组和治疗组,各50例。对照组给予多奈哌齐单药治疗(初始剂量为5 mg/d,睡前服用;4周后剂量改为10 mg/d,睡前服用,服药时间共为6个月)。治疗组患者在对照组治疗基础上联用美金刚治疗(初始剂量为5 mg/d,如无不良反应者每周剂量增加5 mg,直至增加至20 mg/d,服药时间共为6个月)。比较两组患者治疗前后蒙特利尔认知评估量表(MoCA)评分、简易智力状态检查量表(MMSE)评分、日常生活能力量表(ADL)评分及治疗有效率和不良反应发生情况。结果:与同组治疗前比较,两组患者治疗后的MoCA、MMSE和ADL评分均显著升高(P<0.05)。治疗后,与对照组比较,治疗组患者MoCA、MMSE、ADL评分和总有效率均显著升高(P<0.05),而不良反应发生率显著降低(P<0.05)。结论:多奈哌齐联合美金刚相较于多奈哌齐单药治疗中、重度AD具有更好的临床疗效,更有助于改善AD患者的神经功能,且安全性较好。

Comparison of Clinical Efficacy of Donepezil Monotherapy versus Donepezil Combined with Memoriam in the Treatment of Moderate and Severe Alzheimer's Disease

OBJECTIVE:To investigate the clinical efficacy and safety of donepezil monotherapy versus donepezil combined with memoriam in the treatment of Alzheimer’s disease(AD).METHODS:Totally 100 patients with moderate and severe AD who received medical care in Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital(East Hospital)from March 2018 to March 2020 were enrolled as study subjects,and then were divided into control group and treatment group randomly.Control group was given donepezil monotherapy treatment(initial dose of 5 mg/d,before bedtime;after 4 weeks,the dose was changed to 10 mg/d before bedtime;the total medication time was 6 months).Treatment group was treated with memantine(initial dose was 5 mg/d,the dose of those without adverse reactions was increased by 5 mg until 20 mg/d,for 6 months)on the basis of the control group,with 50 patients in each group.Montreal cognitive assessment scale(MoCA)score,MMSE score,ADL score,treatment response rate and the occurrence of ADR were compared between 2 groups before and after treatment.RESULTS:Compared with same group before treatment,MoCA score,MMSE score and ADL score of the two groups were significantly improved after treatment(P<0.05).After treatment,compared with control group,MoCA score,MMSE score,ADL score and total response rate in the treatment group were significantly increased(P<0.05),while the incidence of ADR was decreased significantly(P<0.05).CONCLUSIONS:Donepezil combined with memantine has better clinical efficacy than donepezil monotherapy in the treatment of moderate and severe AD,and is helpful to improve the neurological function of AD patients,with good safety.