多奈哌齐和美金刚联合利培酮治疗阿尔茨海默病精神行为症状的效果分析

  目的  研究多奈哌齐、盐酸美金刚与利培酮联合治疗阿尔茨海默病(AD)精神行为症状(BPSD)的有效性和安全性。  方法  选取2017年1月—2019年6月杭州市第七人民医院收治的AD伴BPSD患者共150例，根据随机数字法随机分为利培酮组(A组)、利培酮+多奈哌齐组(B组)、利培酮+多奈哌齐+盐酸美金刚组(C组)，每组50例。比较3组治疗前及治疗12周后的阳性与阴性症状量表(PANSS)、蒙特利尔认知评估量表(MoCA)、血糖、甘油三酯、胆固醇及不良反应。评估治疗后3组治疗突发症状量表(TESS)评分。  结果  3组治疗后C组MoCA、PANSS评分明显改善。A组MoCA评分为(14.86±3.78)分，B组为(16.94±3.57)分，C组为(18.10±3.73)分，差异有统计学意义(F=9.858，P< 0.05)；A组PANSS评分为(110.52±11.55)分，B组为(99.96±8.47)分，C组为(86.14±5.48)分，差异有统计学意义(F=94.100, P < 0.05)。3组不良反应(口干、锥体外系反应)发生率比较差异无统计学意义(均P＞0.05)，治疗后血糖、血脂、TESS评分、利培酮使用量C组均较A组、B组改善更明显。  结论  利培酮+多奈哌齐与利培酮+多奈哌齐+盐酸美金刚治疗AD伴BPSD后改善认知功能效果较好，副反应较少，可有效减少利培酮药物的治疗剂量，提高患者生活质量。 

Efficacy analysis of donepezil and memogen combined with risperidone in the treatment of mental behavioural symptoms of Alzheimer's disease

  Objective  To analyse the efficacy and safety of donepezil and memantine combined with risperidone in the treatment of behavioural and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD).  Methods  A total of 150 patients with AD and BPSD who were admitted to Hangzhou Seventh People's Hospital from January 2017 to June 2019 were randomly divided into risperidone group (group A), risperidone+donepezil group (group B) and risperidone+donepezil+memogen group (group C) through a random number method, with 50 patients in each group. Before treatment, the positive and negative syndrome scale (PANSS), MOCA scale, blood sugar, triglyceride and cholesterol were recorded. Twelve weeks after treatment, the PANSS, MOCA scale, treatment emergent symptom scale (TESS), blood sugar, triglyceride, cholesterol test of the three groups were compared, with special attention to PANSS, MOCA scale, blood glucose, blood lipids and adverse reactions.  Results  After treatment, the MOCA and PANSS scores of group C patients were significantly improved compared with those of the other two groups. MOCA score of group A (14.86±3.78) points], group B (16.94±3.57) points] and group C (19.10±3.73) points], the difference was statistically significant (F=9.858, P < 0.05). PANSS scores were (110.52±11.55) points in group A, (99.96±8.47) points in group B and (86.14±5.48) points in group C, and the difference was statistically significant (F=94.100, P < 0.05). The incidence of adverse reactions was lower in group C than that in the other two groups, and the results were statistically significant. After treatment, the improvement of blood glucose, blood lipid, TESS and risperidone dosage in group C was more obvious than that in groups A and B.  Conclusion  Risperidone+donepezil group and risperidone+donepezil+memantine groups have better cognitive function improvement after treatment of BPSD, less side effects, reduced dose of risperidone drug treatment and improved quality of life.