【摘要】 目的观察多奈哌齐联合美金刚治疗老年性痴呆患者认知功能和行为能力的改善作用及安全性。方法将30例老年性痴呆患者随机分为多奈哌齐对照组和多奈哌齐联合美金刚试验组。疗程16周,每4周随访1次,评估简易精神状态量表(MMSE);治疗16周后进行有效性评估:采用阿尔茨海默病评定量表的认知分量表(ADAS-Cog)评定患者认知功能;采用临床医生访谈时对病情变化的印象补充量表(CIBIC-Plus)评价患者总体功能变化情况;采用神经精神科问卷(NPI)了解患者精神行为症状的变化;采用日常生活能力量表(ADL)了解患者日常功能情况。结果 29例患者完成最后随访,对照组MMSE,ADAS-Cog,CIBIC-Plus,NPI,ADL评分治疗前后比较有统计学意义(P<0.05);试验组MMSE,ADAS-Cog,CIBIC-Plus,NPI,ADL评分治疗前后比较有统计学意义(P<0.05);治疗前两组各量表评分比较无统计学意义;治疗16周后,两组比较,试验组较对照组患者NPI评分明显下降(P<0.05),表现在脱抑制和激越等情绪方面;CIBIC-Plus总体功能变化实验组较对照组好转明显(P<0.05),余各项评分两组间无显著性差异(P>0.05)。结论多奈哌齐及多奈哌齐联合美金刚治疗老年性痴呆均有效,后者更优于前者,尤其对情绪方面的阳性症状控制较好,且具有良好的安全性和耐受性。更多还原

【Abstract】 Objective To explore the role of donepezil combined with memantine in improving cognitive function and behavioral capacity in Alzheimer’s disease(AD) patients and its safety. Methods 30 AD patients(aged 71士4.5) from either outpatient or inpatient department of Hebei People’s Hospital were randomly divided into two groups: 15 cases in control group were assigned to receive donepezil plus conventional therapy, and 15 cases in trial group to receive donepezil combined with memantine. The clinical efficacies were evaluated at 0 day and reevaluated at 16 weeks using different scales such as MMSE(mini-mental state examination),ADAS-Cog(Alzheimer’s Disease Assessment Scale-cognitive subscale),CIBIC-Plus (Clinicians Interview Based Impression of Change-Plus),ADL(activity of daily life) and NPI(non-cognitive disturbance).Statistical contrast analysis was performed on the endpoint scores of the two groups.Results There were significant differences in MMSE, ADAS-Cog, CIBIC-Plus ,ADL and NPI scores between the control group and the trial group(P<0.05 ). Conclusion Donepezil can improve effectively the cognitive function, the daily living skills and psychological symptoms. Its combination with memantine is superior to its single use with a higher safety.更多还原