奥氮平联合利培酮治疗老年痴呆所致精神障碍的对照研究

目的:探讨奥氮平联合利培酮与单用奥氮平治疗老年期痴呆伴行为和精神障碍(BPSD)的疗效及不良反应。方法:将65例BPSD患者分为奥氮平联合利培酮组与单用奥氮平组,治疗6周。采用痴呆病理行为评定量表(BEHAVE-AD)评定疗效,简易精神状况量表(MMSE)评定患者痴呆状况,以副反应量表(TESS)评定不良反应。结果:两组治疗后BEHAVE-AD评分显著减少(P<0.05)。奥氮平联合利培酮组在治疗6周末MMSE评分较治疗前显著升高(P<0.05),奥氮平组治疗前后MMSE评分差异无显著性(P>0.05),两组比较差异无显著性(P>0.05)。奥氮平联合利培酮组不良反应少于奥氮平组(x2=4.03,P<0.05),两组在口干、嗜睡及失眠、体质量增加方面差异有显著性(P<0.05)。结论:奥氮平联合利培酮组与单用奥氮平对BPSD患者的精神行为症状均有较好的疗效,疗效相当。奥氮平联合利培酮在认知功能及药物的安全性方面优于单用奥氮平。

The comparative study of Risperidone combined Olanzapine in the treatment of behavioral and psychological symptoms associated with senile dementia

Objective:To study the efficacy and safety of Risperidone combined Olanzapine and Olanzapine in the treatment of behavioral and psychological symptoms of senile dementia(BPSD).Methods:65 patients with BPSD were divided into two groups at random.One group of patients was treated by Risperidone combine Olanzapine for 6 weeks while another group of patients was treated by Olanzapine for same period.The effect and adverse effect were evaluated by adopting the behavioral pathology in Alzheimer’s disease Scale(BEHAVE-AD),Mini-Mental Status Scale(MMSE) and Treatment Emergent Symptom Scale(TESS).Results: The BEHAVE-AD scores of two groups decrease significantly after the treatment(P<0.01).The difference of BEHAVE-AD score between two groups is not statistically significant(P>0.05).The MMSE scores of Risperidone combined Olanzapine groups increase significantly after the treatment(P<0.05).The difference of MMSE score between before and after in the Olanzapine groups is not statistically significant(P>0.05).The difference between two groups is not statistically significant(P>0.05).The patients with symptoms of dry-mouth,somnolence,insomnia,getting weight in Olanzapine group are more than those in Risperidone combined Olanzapine group(P<0.05).Conclusions: The efficacy of Risperidone combined Olanzapine in the treatment of BPSD is the same as that of Olanzapine,but Risperidone combined Olanzapine is safer than Olanzapine.