丙戊酸镁联合多奈哌齐治疗老年痴呆患者的临床效果研究  

Clinical effect of magnesium valproate combined with donepezil on senile dementia

作　　者：王金东[1] 周田田[1] 陈晓芹 曾波涛[3] 王百灵[1] Wang Jindong;Zhou Tiantian;Chen Xiaoqin;Zeng Botao;Wang Bailing(Department of Geriatrics,Qingdao Mental Health Center,Shandong Province,Qingdao 266034,China;Department of Substance Dependence,Qingdao Mental Health Center,Shandong Province,Qingdao 266034,China;Department of Clinical Psychology,Qingdao Mental Health Center,Shandong Province,Qingdao 266034,China)

机构地区：[1]山东省青岛市精神卫生中心老年科,266034 [2]山东省青岛市精神卫生中心物质依赖科,266034 [3]山东省青岛市精神卫生中心临床心理科,266034

出　　处：《中国医药》2020年第5期699-703,共5页China Medicine

基　　金：山东省医药卫生科技发展计划(2017WS115)。

摘　　要：目的探讨丙戊酸镁联合多奈哌齐治疗老年痴呆患者的临床效果。方法选取2015年1月至2019年1月山东省青岛市精神卫生中心接收的90例老年痴呆患者,根据随机数字表法将患者分为观察组和对照组,每组45例。对照组服用多奈哌齐治疗,观察组服用丙戊酸镁联合多奈哌齐治疗。比较2组患者相关量表评分、炎性因子水平、临床疗效及治疗期间不良反应发生情况。结果治疗3个月后,观察组简易精神状态检查量表评分明显高于对照组[(22.9±4.3)分比(16.5±3.3)分],日常活动能力量表、汉密尔顿抑郁量表、阿尔茨海默病评定量表认知部分评分明显低于对照组[(16±5)分比(23±6)分、(7.2±1.7)分比(11.8±1.9)分、(21.3±4.2)分比(27.3±3.6)分],白细胞介素1β、白细胞介素6、肿瘤坏死因子α水平均明显低于对照组[(0.25±0.09)ng/L比(0.43±0.11)ng/L、(84±19)ng/L比(138±38)ng/L、(107±23)μg/L比(164±25)μg/L],差异均有统计学意义(均P<0.05)。观察组的临床总有效率明显高于对照组[88.9%(40/45)比64.4%(29/45)],差异有统计学意义(P=0.006)。2组不良反应发生率比较差异无统计学意义(P=0.581)。结论丙戊酸镁联合多奈哌齐治疗老年痴呆患者效果明显,可有效改善临床症状,并降低炎性因子水平,安全性较好。Objective To investigate the clinical efficacy of magnesium valproate combined with donepezil in treatment of senile dementia. Methods A total of 90 senile patients with dementia who were admitted to Qingdao Mental Health Center,Shandong Province from January 2015 to January 2019 were randomly divided into observation group and control group,with 45 cases in each group. The control group took donepezil,while the observation group took magnesium valproate and donepezil. Assessment scale scores,inflammatory factors,clinical efficacy and adverse reactions were analyzed. Results After 3 months of treatment,Mini-Mental State Examination score in the observation group was significantly higher than that in the control group [( 22. 9 ± 4. 3) vs( 16. 5 ± 3. 3) ],scores of Activity of Daily Living,Hamilton Depression Scale and Alzheimer Disease Assessment Scale-cognitive in the observation group were significantly lower than those in the control group [( 16 ± 5) vs( 23 ± 6),( 7. 2 ± 1. 7) vs( 11. 8 ± 1. 9),( 21. 3 ± 4. 2) vs( 27. 3 ± 3. 6) ];serum levels of interleukin-1β,interleukin-6,tumor necrosis factor-α in the observation group were significantly lower than those in the control group[( 0. 25 ± 0. 09) ng/L vs( 0. 43 ± 0. 11) ng/L,( 84 ± 19) ng/L vs( 138 ± 38) ng/L,( 107 ± 23) μg/L vs( 164 ± 25) μg/L]( all P < 0. 05). Total clinical effective rate in the observation group was significantly higher than that in the control group[88. 9%( 40/45) vs 64. 4%( 29/45) ]( P = 0. 006). There was no significant difference in the incidence of adverse reactions between groups( P = 0. 581). Conclusion Magnesium valproate combined with donepezil treating senile dementia can effectively improve clinical symptoms and reduce inflammatory factors with good safety.

关 键 词：痴呆 丙戊酸镁 多奈哌齐 

分 类 号：R749.16[医药卫生—神经病学与精神病学]