多奈哌齐联合奥氮平对老年痴呆患者行为障碍的影响观察  

Effect of donepezil combined with olanzapine on behavioral disorder in elderly patients with dementia

作　　者：刘向阳[1] 张慧敏 尹慧丽 刘家梅[1] 史建新[1] LIU Xiangyang;ZHANG Huimin;YIN Huili(Geriatric psychiatry,Zhumadian psychosis hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市精神病医院老年精神科

出　　处：《国际精神病学杂志》2019年第6期1020-1023,共4页Journal Of International Psychiatry

摘　　要：目的探讨多奈哌齐联合奥氮平治疗老年痴呆患者行为障碍的效果。方法回顾性分析院老年精神科病区2015年12月~2017年12月收治的老年痴呆症患者76例,采用随机数法将其平均分为两组,其中A组38例采用多奈哌齐联合奥氮平,剩余38例为B组仅采用多奈哌齐治疗。比较在治疗前,治疗后4周、6周、8周两组患者老年痴呆行为病理评分(BEHAVE-AD),日常生活能力评分(ALD)和药物不良反应发生情况。结果两组患者在治疗后第6周和第8周BEHAVE-AD评分和ALD评分较治疗前明显降低,并且A组ALD评分在治疗第6周和第8周均明显高于B组,差异均具有统计学意义(P<0.05)。其中A组治疗总有效率为92.1%,B组治疗后总有效率为84.2%,A组不良反应发生率为26.32%(10/38),B组不良反应发生率为21.05%(8/18),两组不良反应发生率、治疗总有效率比较差异均不显著,无统计学意义(P>0.05)。结论多奈哌齐联合奥氮平比单独使用多奈哌齐,可有效改善老年痴呆症患者行为障碍尤其是生活自理能力,并且也不增加药物不良反应发生率,值得在临床上推广。Objective To investigate the effect of donepezil combined with olanzapine in the treatment of behavioral disorders in elderly patients with dementia.Methods Retrospective analysis of 76 elderly patients with dementia admitted from December 2015 to December 2017 in the elderly psychiatric ward.They were divided into two groups by random number method.Among them,38 patients in group A were treated with donepezil and olanzapine.The remaining 38 patients in group B were treated with donepezil.The pathological scores of Alzheimer's disease,daily living ability scores and adverse drug reactions were compared between the two groups before treatment,4 weeks,6 weeks,and 8 weeks after treatment.Results The BEHAVE-AD score and ALD score of the two groups before treatment were significantly lower than those at the 6th week and the 8th week after treatment,and the ALD scores of the group A were significantly higher than those of the B group at the 6th and 8th week after treatment.,statistical significance(P<0.05).The total effective rate was 92.1%in group A and 84.2%in group B.The incidence of adverse reactions in group A was 26.32%(10/38),and the incidence of adverse reactions in group B was 21.05%(8/18).There was no significant difference in the incidence of adverse reactions and total effective treatment between the two groups(P>0.05).Conclusion Donepezil combined with olanzapine can improve the behavioral disorder,especially the self-care ability of patients with Alzheimer's disease,and does not increase the incidence of adverse drug reactions,which is worthy of clinical promotion.

关 键 词：老年痴呆症 多奈哌齐 奥氮平 行为障碍 

分 类 号：R749.053[医药卫生—神经病学与精神病学]