纳洛酮联合喹硫平治疗血管性痴呆叠加谵妄的对照研究  

A control study of delirium superimposed on vascular dementia treatment between Naloxone joint Quetiapine and Quetiapine alone

作　　者：莫新[1] 胡耀祖[1] 高丽娟[1] 

机构地区：[1]广东省佛山市第三人民医院,528000

出　　处：《齐齐哈尔医学院学报》2011年第13期2067-2069,共3页Journal of Qiqihar Medical University

基　　金：佛山市卫生局科研基金项目(项目编号2009075)

摘　　要：目的探讨洛酮联合喹硫平与单用喹硫平治疗血管性痴呆叠加谵妄的疗效与疗效指数。方法符合DSM-4血管性痴呆叠加谵妄诊断标准的住院患者,随机分成治疗组(纳洛酮联合喹硫平)和对照组(喹硫平),前瞻性观察治疗15d,采用谵妄量表(DSS)在治疗前及治疗3d、6d、9d、12d、15d进行评分。采用简易智力状态量表(MMSE)、日常生活评定量表(ADL)及临床疗效总评量表(CGI)在治疗前和治疗15d后进行评分。结果治疗组与对照组对治疗血管性痴呆叠加谵妄均有效、疗效指数高(CGI-GI分别为1.45±0.51、1.80±0.41,CGI-EI分别为3.32±0.48、2.95±0.22)。两组对比,治疗组的DSS增分在治疗3d、6d、9d、12d有显著差异(P<0.01)、在治疗15d时差异有统计学意义(P<0.05),治疗后MMSE增分、CGI-SI减分和CGI-GI的差异有统计学意义(P<0.05),CGI-EI有显著差异(P<0.01),ADL减分的差异没有统计学意义(P>0.05)。结论在治疗血管性痴呆叠加谵妄时,纳洛酮联合喹硫平较单用喹硫平控制谵妄症状快,疗效和疗效指数更高,还能提高认知功能。Objective To explore the efficacy and efficacy index of delirium superimposed on vascular dementia treatment with Naloxone joint Quetiapine and Quetiapine alone.Methods 42 patients with delirium superimposed on vascular dementia were randomly divided into Quetiapine group（n=20） and Naloxone joint Quetiapine group（n=22）,prospective observation treatment continued for 15 days.before and after treatment,DSS,MMSE,ADL and CGI were respectively used to evulate.Results Both Naloxone joint Quetiapine and Quetiapine alone to therapy delirium superimposed on vascular dementia are effective and their efficacy index are high（CGI-GI：1.45±0.51、1.80±0.41,CGI-EI：3.32±0.48、2.95±0.22）.Comparing two groups,after treatment for 3 days,6 days,9 days,12 days,the Dss increase points of Naloxone joint Quetiapine group was significant statistically（P0.01）.After treatment for 15 days,Dss increase points was significant statistically（P0.05）,after treatment,MMSE increase points、CGI-SI deduction and CGI-GI have statistically significance（P0.05）,CGI-EI was significant statistically（P0.01）,ADL deduction have no statistical significance（P0.05）.Conclusions Comparing to Quetiapine alone,Naloxone join Quetiapine to treat delirium superimposed on vascular dementia can control delirium faster,has a higher efficacy and efficacy index,and can improve cognitive function.

关 键 词：纳洛酮 喹硫平 血管性痴呆 谵妄 疗效 疗效指数 

分 类 号：R749.13[医药卫生—神经病学与精神病学]