奥卡西平与卡马西平治疗伴激越行为老年痴呆患者的疗效及安全性比较  

Comparison of efficacy and safety between oxcarbazepine and carbamazepine as mood stabilizer in treating dementia patients with agitation

作　　者：昌盛[1] 濮正平 费玉娥[1] CHANG Sheng;PU Zheng-ping;FEI Yu-e(Department of Psychiatry,Kangci Hospital of Jiaxing, Jiaxing 314500,China)

机构地区：[1]浙江嘉兴市康慈医院精神科,314500

出　　处：《临床精神医学杂志》2019年第1期45-48,共4页Journal of Clinical Psychiatry

基　　金：浙江省桐乡市科技计划项目(2012-03159)

摘　　要：目的:探讨奥卡西平(OXC)与卡马西平(CBZ)作为心境稳定剂治疗痴呆患者激越行为的疗效及安全性。方法:将83例伴有激越行为的痴呆患者随机分为OXC组(41例)和CBZ组(42例);两组在服用增智药物的基础上,分别给予OXC及CBZ治疗8周;治疗前及治疗2、4、8周末给予简易痴呆筛选量表(BSSD)、痴呆行为量表(BEHAVE-AD)、日常生活能力量表(ADL)评估,以BEHAVE-AD减分率评价疗效,记录不良反应。结果:两组各有40例完成观察;与治疗前相比,两组BEHAVE-AD评分明显下降(P均<0. 05);两组间治疗前后BEHAVE-AD评分及其中攻击行为因子分、BEHAVE-AD减分率比较差异无统计学意义;治疗8周后OXC组BSSD评分明显高于CBZ组,ADL评分明显低于CBZ组(P均<0. 05)。治疗中CBZ组加重激越、心动过缓和(或)传导阻滞及认知功能下降发生率明显高于OXC组,体质量增加的发生率明显低于OXC组(P均<0. 05)。结论:OXC与CBZ对痴呆患者的激越行为疗效相当,但CBZ不良反应较多,OXC更适用于处于生理衰退期的老年患者。Objective:To compare the efficacy and safety between oxcarbazepine(OXC)and carbamazepine(CBZ)as mood stabilizer in treating dementia patients with agitation.Method:Eighty-three dementia patients with agitation were randomly assigned to the OXC group(41 cases)and the CBZ group(42 cases),and were treated for 8 weeks.Before and after treated at the end of the 2nd,4th and 8th week,the patients of the two groups were assessed by brief screening scale for dementia(BSSD),behavioral rating scale(BEHAVE-AD)and activity of daily living schedule(ADL),respectively.The efficacy was evaluated by the reduction rate of BEAVE-AD.The adverse reactions were recorded through the treatment.Results:There were 40 patients in each group completed the trial.After treatment,the scores of BEHAVE-AD in the two groups were significantly reduced than those of before treatment(all P<0.05);but the scores of BEHAVE-AD,aggressive behavior factor and reduction rate of BEAVE-AD between the two groups showed no significant difference.At the end of the 8th week after treatment,the BSSD score in OXC group was significantly higher than that in the CBZ group,while the ADL score was significantly lower than that in CBZ group(all P<0.05).The incidence rates of increased agitation,bradycardia/conduction block and cognitive impairment in CBZ group were significantly higher and incidence rate of weight gain was significantly lower than that in OXC group(all P<0.05).Conclusion:OXC and CBZ have similar efficacy in treating dementia patients with agitation.But CBZ has higher incidence rates of adverse action.OXC is more suitable for elderly patients.

关 键 词：奥卡西平 卡马西平 痴呆 激越行为 

分 类 号：R749.1[医药卫生—神经病学与精神病学]