盐酸多奈哌齐对痴呆患者认知行为症状的疗效及安全性

目的:研究盐酸多奈哌齐治疗痴呆行为和精神症状(behavioral and psychiatric symptoms of dementia,BPSD)的临床疗效及安全性。方法:研究对象选取本院2014年6月至2016年2月收治的BPSD患者108例,采用随机对照法将其分为对照组和观察组,每组各54例。对照组患者采用奥氮平治疗,观察组患者采用盐酸多奈哌齐。分别比较两组患者的痴呆病理行为评定量表(behavioral pathology in Alzheimer’s disease scale,BEHAVE-AD)、蒙特利尔认知评估量表(The Montreal Cognitive Assessment,MoCA)、日常生活能力量表(activity of daily living scale,ADL)评分,同时观察两组患者的不良反应,并采用治疗中需处理的不良反应症状量表(treatment emergent symptom scale,TESS)、锥体外系症状评定量表(extrapyramidal symptom rating scale,ESRS)评定。结果:观察组的治疗总有效率(79.73%)明显高于对照组(61.11%)(χ2=4.45,P=0.03)。治疗后,观察组的BEHAVE-AD评分(8.74±1.57)分明显低于对照组(14.85±2.14)分(t=17.53,P=0.00),观察组的Mo CA和ADL评分均明显高于对照组(P<0.01),CMAI评分明显低于对照组(P<0.01),观察组的TESS和ESRS严重度明显低于对照组(Z=4.28,P<0.01)。结论:盐酸多奈哌齐治疗BPSD的疗效明显,能有效改善患者的痴呆病理行为,同时提高认知功能及生活质量,且治疗安全性较高,值得在临床推广。

The efficacy and safety of the donepezil hydrochloride treatment of dementia cognitive behavioral symptoms (BPSD) patients

Objective:To study the effect of donepezil hydrochloride in the treatment of behavioral and psychological symptoms of dementia (BPSD) of the clinical efficacy and safety.Methods:The subjects were 108 BPSD patients in our hospital from June 2014 to February 2016,randomly divided into control group and observation group,54 cases in each.The control group patients were treated with olanzapine treatment,observation group was treated with donepezil hydrochloride.Compared two groups of the BEHAVE-AD,MoCA,ADL score,observed the adverse reactions,and used TESS and ESRS evaluated.Results:The total efficiency of observation group (79.73%) was significantly higher than the control group (61.11%)(χ2=4.45,P=0.03).After treatment, the BEHAVE-AD score in the observation group (8.74+1.57)points were significantly lower than the control group (14.85+2.14) points(t=17.53,P=0.00), the observation group of the MoCA and ADL scores were significantly higher than control group (P<0.01), CMAI score was significantly lower than the control group(P<0.01),observation group of the TESS and ESRS severity was significantly lower than the control group (Z=4.28,P<0.01).Conclusion:Donepezil hydrochloride in the treatment of BPSD had a significantly effect,can effectively improve the behavioral pathology in Alzheimer''s disease patients, and improve the cognitive function and quality of life, and higher treatment safety,it is worthy of clinical application.