【摘要】 目的 基于“神志病”视角,探究生慧益智汤联合盐酸多奈哌齐对轻中度阿尔茨海默病(Alzheimer,s disease,AD)患者精神行为症状(behavioral and psychological symptoms of dementia,BPSD)的临床疗效。方法 选取符合纳入标准的AD患者70例,随机分为治疗组和对照组,每组35例。对照组患者给予盐酸多奈哌齐,治疗组患者给予生慧益智汤联合盐酸多奈哌齐治疗,疗程6个月。治疗前后采用AD认知评定量表(Alzheimer’s disease assessment scale-cognitive subscale,ADAS-cog)和神经精神症状问卷(neuropsychiatric inventory,NPI)评分,评估患者认知功能及精神行为异常表现,并观察治疗期间药物不良反应。结果 治疗后2组患者ADAS-cog、NPI评分较治疗前均显著降低(P<0.05),治疗组明显低于对照组(P<0.05)。NPI在抑郁、焦虑、情感淡漠领域,2组患者治疗后评分均低于治疗前(P<0.05),且治疗组明显低于对照组(P<0.05);此外治疗组患者治疗后妄想、易激惹、睡眠/夜间行为异常评分低于治疗前(P<0.05),且评分低于对照组(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论 轻中度AD患者BPSD以抑郁、淡漠、易激惹、焦虑、睡眠/夜间行为异常、妄想为主,生慧益智汤联合多奈哌齐能整体改善认知功能、减轻上述BPSD症状。中西医结合疗效优于单用多奈哌齐,值得临床推广应用。更多还原

【Abstract】 Objective To observe the clinical effect of Shenghui Yizhi decoction combined with donepezil hydrochloride on behavioral and psychological symptoms of dementia(BPSD) in patients with mild-to-moderate Alzheimer’s disease.Methods 70 patients with mild to moderate AD were randomly divided into treatment group and control group, with 35cases in each group. The control group patients were given donepezil hydrochloride, and the treatment group patients were treated with Shenghui Yizhi decoction in addition, and the course of treatment was 6 months. Alzheimer ’ s disease assessment scale-cognitive subscale(ADAS-cog) and neuropsychiatric inventory(NPI) were used before and after treatment to evaluate the cognitive function and behavioral and psychological symptoms of dementia. The adverse drug reactions were observed during the treatment. Results After treatment, the ADAS-cog and NPI scores in the two groups decreased significantly compared with those before treatment(P<0. 05). The improvements of the treatment group were significantly better than those of the control group(P<0. 05). NPI scores in the fields of depression, anxiety and apathy after treatment were lower than those before treatment(P<0. 05), and compared with the control group, the scores were significantly lower in the treatment group(P<0. 05). In addition, NPI scores of delusion, irritability, and sleep and night time behavior disorders in the treatment group after treatment were lower than those before treatment(P<0. 05), and the improvements were better than those in the control group(P<0. 05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0. 05). Conclusion BPSDs of patients with mild to moderate AD are mainly characterized by depression, apathy, irritability, anxiety, sleep and night time behavior disorders, and delusion. Shenghui Yizhi decoction combined with donepezil hydrochloride can improve cognitive function and relieve the above BPSD symptoms, and reduce score of TCM syndrome. The effect of integrated traditional Chinese and western medicine is better than that of donepezil hydrochloride alone, which is worthy of clinical promotion.更多还原