盐酸美金刚联合用药治疗帕金森痴呆的疗效分析  

Analysis of memantine curative effect for the treatment of Parkinson's disease dementia

作　　者：姚胜旗[1] 陆学胜[1] 许敏[1] 张燕[1] 张允[1] 丁冀[1] 

机构地区：[1]上海市同仁医院上海交通大学医学院附属同仁医院神经内科,上海200336

出　　处：《临床和实验医学杂志》2016年第9期875-878,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨盐酸美金刚联合用药治疗帕金森痴呆的疗效和安全性。方法选取2013年1月至2015年12月符合随访标准的帕金森痴呆患者270例,随机分为4组。A组采用多巴丝肼治疗,B组采用多巴丝肼+盐酸美金刚,C组多巴丝肼+盐酸多奈哌齐,D组采用盐酸多奈哌齐+盐酸美金刚。统计观察4组简易智能状态检查量表(MMSE)、蒙特利尔认知评估量表(Mo CA)、日常生活能力(ADL)、神经精神症状问卷(NPI)以及不良反应。结果 A组MMSE、Mo CA、NPI、ADL与治疗前差异无统计学意义(P>0.05)。B组、C组、D组各项指标均较治疗前好转,且与A组比较,差异也具有统计学意义(P<0.05)。B组和C组经治疗6个月后,虽然B组各项指标较C组恢复的好,但差异无统计学意义(P>0.05)。D组将盐酸美金刚与盐酸多奈哌齐联合应用,显示出较好的效果,与其他组比较,差异均具有统计学意义(P<0.05)。A组不良反应发生率较高(P<0.05),D组最低(P<0.05),其余各组间无统计学差异(P<0.05)。结论治疗帕金森痴呆盐酸美金刚具备一线用药价值,不良反应较少,与盐酸多奈哌齐联合效果更佳。Objective To analyze the curative effect of Memantine for the treatment of Parkinson＇s disease dementia. Methods Between January 2013 and December 2015,according to the standard of follow- up,270 patients with Parkinson＇s disease dementia were randomly divided into 4 groups. All these patients were treated with group A treated with Levodopa and Benserazide Hydrochlo- ride,group B treated with Levodopa and Benserazide Hydrochlo- ride and memantine hydrochloride,group C treated with Levodopa and Benserazide Hydrochlo- ride and donepezil,group D treated with donepezil and memantine hydrochloride. The simple intelligent state examination（ MMSE）,Montreal cognitive assessment scale（ MoCA）,ability of daily life（ ADL）,nerve mental symptoms questionnaire（ NPI） and adverse reactions were observed and compared. Results MMSE,MoCA,NPI,ADL of group A did not show significant difference compared with pre- treatment（ P〈0. 05）. Each index of Group A,B,C,D group improved compared with group A（ P〉0. 05）. Although the indicators of group B had good recovery compared with group C,but P〉0. 05. Patients in group D were treated with donepezil and memantine hydrochloride. The patients of group D had good effect compared with other groups（ P〈0. 05）. Group A had higher incidence of adverse reactions（ P〈0. 05）,group D the lowest（ P〈0. 05）,no statistical difference was found among groups（ P〈0. 05）. Conclusion Memantine hydrochloride had good effect,with less adverse reaction,the joint effect of donepezil HCL is better.

关 键 词：帕金森痴呆 盐酸美金刚 疗效 

分 类 号：R742.5[医药卫生—神经病学与精神病学]