不同剂量多奈哌齐联用奥氮平在改善阿尔茨海默病病人的认知功能与精神症状的临床效果

目的:观察分析不同剂量多奈哌齐联用奥氮平对改善阿尔茨海默病病人认知功能和精神症状的作用,为临床用药提供指导.方法:选取95例阿尔茨海默病病人作为研究对象,按照随机数字表法分为观察组49例和对照组46例.2组均服用奥氮平,并在此基础上观察组给予多奈哌齐10 mg/d,而对照组为5 mg/d,睡前口服,治疗时间为6个月.结果:2组病人治疗前的神经精神科问卷(NPI)、护理苦恼程度和简易智力状态检查量表(MMSE)评分之间差异均无统计学意义(P>0.05).治疗6个月后,观察组的NPI、MMSE评分和护理苦恼程度均明显优于对照组(P<0.01);且治疗后2组NPI、MMSE评分和护理苦恼程度均明显优于治疗前(P<0.01).观察组在情绪高涨、淡漠、幻觉、妄想、激惹、行为失控、易怒方面的评分明显优于对照组(P<0.01).结论:给予10 mg/d多奈哌齐联合奥氮平在改善阿尔茨海默病病人的精神症状和认知功能方面更加有效.

The clinical effect of different doses of donepezil combined with olanzapine in improving cognitive function and mental symptoms in patients with Alzheimer's disease

Objective:To analyze the effects of different doses of donepezil combined with olanzapine on cognitive function and mental symptoms of patients with Alzheimer's disease(AD),and provide the guidance in clinical medication. Methods:Ninety-five patients with AD from January 2010 to December 2015 were divided into the observation group and control group according to the random number table method. The observation group and control group were treated with olanzapine combined with 10 mg/d and 5 mg/d donepezil by oral for 6 months,respectively. Results:The differences of the scores of NPI and MMS,and degree of care distress between two groups before treatment were not statistically significant(P>0. 05). After 6 months of treatment,the scores of NPI and MMSE,and degree of care distress in observation group were better than those in control group(P <0. 01),and which after treatment was significantly better than that before treatment in two groups(P <0. 01). The scores of high emotion,apathy,hallucination,delusion, irritability and uncontrollable behavior in observation group were significantly better than those in control group ( P < 0. 01 ). Conclusions:The 10 mg/d donepezil combined with olanzapine can effectively improve the psychiatric symptoms and cognitive function of patients with AD.