【摘要】目的:探讨多奈哌齐联合抗精神病药物奥氮平治疗老年痴呆患者行为障碍的效果。方法:回顾性分析院老年精神科病区2015年12月至2017年12月收治的老年痴呆症患者76例,采用随机数法将其平均分为两组,其中A组38例采用多奈哌齐联合奥氮平,剩余38例为B组仅采用多奈哌齐治疗。比较在治疗前,治疗后4周、6周、8周两组患者阿尔茨海默病行为病理评分,日常生活能力评分和药物不良反应发生情况。结果:两组患者在治疗后第6周和第8周BEHAVE-AD 评分和ADL评分较治疗前明显降低,并且A组ADL评分在治疗第6周和第8周均明显高于B组,差异均具有统计学意义(P<0.05)。其中A组治疗总有效率为92.1%,B组治疗后总有效率为84.2%,A组不良反应发生率为26.32%(10/38),B组不良反应发生率为21.05%(8/18),两组不良反应发生率、治疗总有效率比较差异均不显著,无统计学意义(P>0.05)。结论:多奈哌齐联合抗精神病药物奥氮平比单独使用多奈哌齐,可有效改善老年痴呆症患者行为障碍尤其是生活自理能力,并且也不增加药物不良反应发生率,值得在临床上推广。
关键词:老年痴呆症;多奈哌齐;奥氮平;行为障碍
【Abstract】Objective: To investigate the effect of donepezil combined with antipsychotic olanzapine on behavior disorder in patients with senile dementia. Methods: A retrospective analysis of 76 elderly patients with dementia treated in the elderly psychiatric ward from December 2015 to December 2017 was performed and divided into two groups by random number method. 38 patients in group A were treated with donepezil The level of nitrogen was remained, and the remaining 38 cases were treated with donepezil alone in group B. To compare the behavioral pathology scores, daily life ability scores, and adverse drug reactions between the two groups before treatment, at 4 weeks, 6 weeks, and 8 weeks after treatment in patients with Alzheimer's disease. Results: The BEHAVE-AD score and ADL score were significantly lower at the 6th and 8th week after treatment in both groups than before treatment. The ADL scores in group A were significantly higher than those in group B at the 6th and 8th weeks of treatment. All have statistical significance (P<0.05). The total effective rate was 92.1% in group A and 84.2% in group B. The incidence of adverse reactions in group A was 26.32% (10/38), and the incidence of adverse reactions in group B was 21.05% (8/18). There was no significant difference in the incidence of adverse reactions and total effective treatment between the two groups (P>0.05). Conclusion : Donepezil combined with the antipsychotic olanzapine alone can improve the behavioral disorders, especially the self-care ability, of Alzheimer's disease patients, and does not increase the incidence of adverse drug reactions. It is worthy of promotion in clinical practice.
Key words: Alzheimer's disease; donepezil; olanzapine; behavior disorder