多奈哌齐联合喹硫平治疗阿尔茨海默病精神行为症状的对照研究

目的 探讨在多奈哌齐联合喹硫平治疗阿尔茨海默病（AD）患者精神行为症状（BPSD）的临床疗效和风险.方法 70例AD患者,随机分为两组,研究组36例,均予多奈哌齐联合喹硫平,对照组34例,均予多奈哌齐,疗程共12周.采用痴呆病理行为评定量表（BEHAVE-AD）、简易智力状态检查（MMSE）和不良反应量表（TESS）评价治疗效果.结果 两组患者治疗12周的MMSE评分均较治疗前有所提高（P＜0.05）,研究组治疗12周后BEHAVE-AD总分比对照组明显下降（P＜0.05）,研究组总有效率为88.9%,对照组总有效率为55.9%,研究组疗效优于对照组（P＜0.01）.研究组不良反应相对多而轻,主要不良反应为嗜睡、头晕和便秘,两组间不良反应差异无统计学意义（P ＞0.05）.结论 多奈哌齐联合喹硫平治疗AD的精神行为症状效果较好,不良反应较轻,安全性良好.

Donepezil combined with quetiapine in treatment of Alzheimer's disease with behavioral and psychological symptoms

Objective To investigate the efficacy and side effects of donepezil combined with quetiapine in treatment of Alzheimer＇s disease with behavioral and psychological symptoms （BPSD）. Methods Seventy patients with Alzheimer＇s disease were randomly divided into two groups： in study group （n=36） patients received donepezil and quetiapine and in control group （n=34） patients received donepezil, the treatment lasted for 12 weeks. The clinical efficacy was evaluated by Behavioral Pathology in AIzheimer＇s Disease Rating Scale （BEHAVE-AD） and Mini Mental State Examination （MMSE）; the side effects were evaluated by Treatment Emergent Symptoms Scale （TESS）. Results After 12 week treatment,the scores of MMSE in both groups were significantly higher than those before treatment（P〈0.05 ）, there were no statistical differences between two groups（ P 〉0.05 ）. The total scores of BEHAVE-AD decreased remarkably in study group after 12 week treatment （P〈0.05）. The overall effective rate was 88.9% in study group and 55.9% in control group （P〈0.01）. The side effects in study group were more frequent, but were milder in severity. The main side effects were sleepiness, dizziness and constipation, there were no statistical differences in side effects were no between two groups（P 〉0.05）. Conclusion Donepezil combined with quetiapine can markedly improve BPSD with mild side effects.