利培酮或喹硫平与多奈哌齐联合使用对老年痴呆患者精神行为症状的治疗效果

目的 研究利培酮或者喹硫平与多奈哌齐联合使用对老年痴呆患者精神行为症状的治疗效果。方法 选择2015年1月-2017年12月许昌市第二人民医院的198例老年痴呆患者，随机分为利培酮组以及喹硫平组。利培酮组采用利培酮联合多奈哌齐治疗，喹硫平组采用喹硫平联合多奈哌齐治疗。两组治疗2个月后，比较MMSE评分、BEHAVE-AD评分以及TESS评分。结果 利培酮组与喹硫平组的有效率相比无明显差异。两组治疗后的认知功能MMSE评分均明显升高，同组治疗前后比较差异有统计学意义（P<0.05），但两组间相比无明显差异。两组治疗后的幻觉、偏执妄想、行为紊乱、昼夜节律紊乱、攻击行为、焦虑恐惧以及情感障碍评分值均明显降低，同组治疗前后比较差异有统计学意义（P<0.05），但两组间相比无明显差异。喹硫平组治疗1个月和2个月后的TESS评分均明显低于利培酮组，差异有统计学意义（P<0.05）。结论 利培酮或者喹硫平与多奈哌齐联合使用均可以有效改善老年痴呆患者的精神行为症状，但与利培酮相比，喹硫平的不良反应更少，更适合用于老年痴呆患者的治疗。

Effect of risperidone or quetiapine combined with donepezil in treatment of psycho behavioral symptoms in Alzheimer's patients

Objective To investigate the clinical effect of risperidone or quetiapine combined with donepezil in the treatment of psycho behavioral symptoms in Alzheimer''s patients.Methods Selected 198 cases of Alzheimer''s patients who were treated in our hospital from January 2015 to December 2016,divided into two groups randomly.The risperidone group was treated with risperidone combined with donepezil,the quetiapine group was treated with quetiapine combined with donepezil.After two months of treatment,the MMSE score,BEHAVE-AD score and TESS score of the two groups were compared.Results There was no significant difference in the efficiency of the risperidone group and the quetiapine group.The cognitive function MMSE scores in the two groups were significantly increased (P< 0.05),but there was no significant difference between the two groups.The scores of hallucinations,paranoid delusions,behavioral disorders,circadian rhythm disorders,aggressive behaviors,anxiety and fear,and affective disorders in the two groups decreased significantly (P< 0.05),but there was no significant difference between the two groups.The TESS score of the quetiapine group was significantly lower than risperidone group (P< 0.05).Conclusion Risperidone or quetiapine combined with donepezil can effectively improve the mental and behavioral symptoms of Alzheimer''s disease,but compared with risperidone,quetiapine has fewer side effects and is more suitable for the treatment of Alzheimer''s disease.