老年期痴呆的精神行为症状及美金刚的临床疗效研究

目的探讨老年期痴呆患者精神行为症状及美金刚的改善作用。方法选择老年期痴呆有精神行为症状的患者61例,随机分为2组,美金刚组(美金刚+多奈哌齐+尼莫地平)31例,对照组(多奈哌齐+尼莫地平)30例,分别在治疗前和治疗12周后进行简易智能状态检查量表(MMSE)、临床痴呆程度量表(CDR)及神经精神科问卷(NPI)的评估。结果老年期痴呆患者精神行为症状多见。美金刚组与对照组患者治疗前MMSE、CDR及各项症状的NPI评分差异无统计学意义(P>0.05)。美金刚组患者治疗12周后激越/攻击行为、焦虑、易激惹/不稳定性、情感高涨/欣快、夜间行为异常、食欲进食改变的NPI评分及NPI总分明显改善;对照组患者治疗12周后易激惹/不稳定性、夜间行为异常、食欲进食改变的NPI评分及NPI总分明显改善,差异有统计学意义(P<0.05)。美金刚组患者治疗12周后MMSE评分、激越/攻击行为、易激惹/不稳定性、食欲进食改变的NPI评分及NPI总分较对照组明显改善(P<0.05)。结论美金刚能有效改善老年期痴呆精神行为症状,减轻家庭负担。

Clinical study of behavioral and psychological symptoms of senile dementia and the therapeutic efficacy of memantine

Objective To study the behavioral and psychological symptoms of dementia(BPSD) in old patients and the improving effect of memantine.Methods Sixty-one patients with BPSD were randomly divided into two groups:the memantine group(memantine+donepezil+ nimodipine,31 patients) and the control group(donepezil+nimodipine,30 patients).Before treatment and after 12 weeks of treatment,all patients were assessed with MMSE,CDR and the neuropsychiatric inventory scale(NPI).Results The BPSD in old dementia patients were common.Before treatment, the MMSE,CDR and NPI score of every symptom showed no significant difference(P>0.05) between the two groups.After 12 weeks of treatment,the NPI(agitation/aggressive behavior, anxiety,irritability/unsteadiness,rise in affection/euphoria,abnormal behavior during night, change of appetite/eating) scores and the total NPI score of the memantine group were significantly improved(P<0,05).After 12 weeks of treatment.NPI(irritability/unsteadiness,abnomal behavior during night,change of appetite/eating) score and total NPI score in control group were also significantly improved(P<0.05).After treatment for 12 weeks,MMSE,NPI(agitation/ agressive behavior,irritability/unsteadiness,change of appetite/eating) scores and total NPI score in memantine group were significantly improved compared with the control group(P<0.05). Conclusion Memantine can effectively improve BPSD symptoms and reduce caregiver burden.