奥氮平或喹硫平联合多奈哌齐治疗老年痴呆精神行为症状的疗效和安全性研究

目的探讨奥氮平或喹硫平联合多奈哌齐治疗老年痴呆精神行为症状的疗效和安全性。方法将103例伴精神行为症状的痴呆患者随机分为奥氮平联合多奈哌齐组（A组）与喹硫平联合多奈哌齐组（B组）。治疗前和研究结束时进行简易智力状态检查（MMSE）评分。在治疗后的第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,以副反应量表（TESS）记录治疗中各项药物不良反应。结果两组MMSE评分均较治疗前提高2分以上,治疗结束后两组组内比较,差异均有统计学意义（均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,差异有高度统计学意义（均P〈0.01）。A组有效率为88.46%（46/52）,显著有效率为67.31%（35/52）;B组有效率为86.27%（44/51）,显著有效率为64.71%（33/51）,两组疗效比较差异无统计学意义（P〉0.05）。两组均无不能耐受的不良药物反应。结论奥氮平或喹硫平联合多奈哌齐治疗老年痴呆精神行为症状安全有效。

Efficacy and safety study of Olanzapine or Quetiapine joint Donepezil in the treatment of behavioral and psychological symptoms of dementia

Objective To investigate the efficacy and safety of Olanzapine or Quetiapine joint Donepezil in the treatment of Alzheimer’s behavioral and psychological symptoms.Methods 103 patients with behavioral and psychological symptoms of dementia patients were randomly divided into a combination of Olanzapinewith Donepezil group(group A) and the Quetiapine with Donepezil group(group B).The mini-mental state examination(MMSE) scores 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),the treatment emergent symptom scale(TESS) was used to record the adverse reactions.Results Two sets of MMSE scores than before treatment,increased by more than two scores after the end of the treatment within the two groups were statistically significant different(all P < 0.05).BEHAVE-AD scale scores before and after treatment within the two groups compared to the fourth weekend decreased significantly,there are statistically significant differences(P < 0.01).Group A effective rate was 88.46%(46/52),markedly effective rate was 67.31%(35/52);group B effective rate was 86.27%(44/51),markedly effective rate was 64.71%(33/51),two sets of comparative efficacy differences without statistical significance(P > 0.05).There were no adverse drug reactions that can not tolerate.Conclusion Olanzapine or Quetiapine joint Donepezil is safe and sure in the treatment of Alzheimer’s behavioral and psychological symptoms.