多奈哌齐合并奥氮平治疗老年痴呆精神行为症状的疗效和安全性对照研究

目的 探讨多奈哌齐合并奥氮平治疗老年痴呆精神行为症状的疗效和安全性。方法 103例伴精神行为症状的痴呆病人随机分为多奈哌齐合并奥氮平组与单用奥氮平组。治疗前和研究结束时进行简易智力状态检查(MMSE)评分,在治疗2、4、6、8周末以痴呆病理行为评定量表(BEHAVE-AD)减分率评定疗效:≥60%为显效,≥30%为有效,<30%为无效。以副反应量表(TESS)评定记录治疗中各项药物不良反应。结果 多奈哌齐合并奥氮平组MMSE评分较治疗前提高2分以上,治疗结束后组内比较差异有统计学意义 (t=2.060,P<0.05)。治疗前后BEHAVE-AD量表评分两组组内比较,至第4周末时均明显下降,差异有显著统计学意义(P<0.01 或P<0.05)。多奈哌齐合并奥氮平组有效率为 88.46%,显效率为 67.31%;单用奥氮平组有效率 70.59%,显效率为 45.10%,两组比较有效率和显效率差异均有统计学意义(χ²=5.067,P<0.05; χ²=5.701, P<0.05)。两组均无不能耐受的不良药物反应。结论 多奈哌齐合并奥氮平治疗老年痴呆精神行为症状安全有效且优于单用奥氮平。

Efficacy and safety study of the donepezil combined olanzapine flow in the treatment of behavioral and psychological symptoms of dementia

AIM: To investigate the efficacy and safety of donepezil combined olanzapine or single olanzapine in the treatment of behavioral and psychological symptoms. METHODS: 103 dementia patients with behavioral and psychological symptoms were randomly divided into donepezil combined olanzapine group and the single olanzapine group. The mini-mental state examination (MMSE) score were evaluated before treatment and the end of the study. The efficacies were evaluated in 2,4,6,8 weekend of the treatment by reduced rate of the behavioral pathology in Alzheimer's Disease Scale (BEHAVE-AD), ≥60% was markedly effective, ≥ 30% was effective, <30% was not effective. The treatment emergent symptom scale (TESS) assessment record treatment of the adverse drug reactions. RESULTS: The MMSE scores of donepezil combined olanzapine group increased more than two scores after the end than before treatment, it was statistically significant differences(t=2.060,P<0.05). The BEHAVE-AD scale scores of two groups before and after treatment compared to the fourth weekend were significantly decreased, there were statistically significant (P<0.01 or P<0.05). The effective rate was 88.46% and the markedly effective rate was 67.31% in donepezil combined olanzapine group.The effective rate was 70.59%, and the markedly effective rate was 45.10% in alone olanzapine group .There were statistically significant (χ²=5.067, P<0.05; χ²=5.701, P<0.05). There were no adverse drug reactions that can not tolerate. CONCLUSION: It is safe and effective that donepezil combined olanzapine treat behavioral and psychological symptoms of dementia patients, and better than single olanzapine.