CAJ | 학술논문

目的：探讨盐酸多奈哌齐（安理申）联合盐酸美金刚对阿尔茨海默病（AD）认知功能和精神行为的改善作用。方法将214例 AD 患者按随机数字表法分为对照组（盐酸美金刚）和观察组（安理申联合盐酸美金刚），每组107例，治疗前后进行简易智能状态检查（MMSE）和世界卫生组织-加利福尼亚洛杉矶大学听觉词语学习测验（WHO-UCLA AVLT）、阿尔茨海默病病理行为评分表（BEHAVE-AD），分别评定 AD 患者的认知功能、精神行为。用不良反应量表（TESS）和相关实验室检查评定不良反应。结果与治疗前相比，无论是对照组还是观察组治疗患者的 MMSE 总评分及其6个子项、WHO-UCLA AVLT 评测的即刻记忆、短时记忆和长时记忆都有所增加（P ＜0．01或 P ＜0．05），而精神行为症状病例数及各项得分和总评分都有不同程度的降低（P ＜0．01或 P ＜0．05）。观察组患者治疗后的 MMSE 总评分及其子项得分、WHO-UCLA AVLT 评测得分的增高程度和精神行为症状病例数、BEHAVE-AD 总评分及其子项得分降低程度均高于对照组（t ＝－1．742， t ＝－1．431、－1．626、－2．173、－1．448、－1．026，t ＝－1．016、－1．279、－1．971，χ2＝12．295、7．609、8．917，t ＝0．778、1．139、2．004、1．153、0．822、1．944，P ＜0．01或 P ＜0．05）；观察组总有效率为90．65％，显著高于对照组的71．96％（χ2＝12．299，P ＜0．01）；治疗后两组患者无严重药物不良反应。结论利用安理申联合盐酸美金刚显著改善 AD 患者认知功能和精神行为症状，疗效显著，不良反应少。
목적：탐토염산다내고제（안리신）연합염산미금강대아이자해묵병（AD）인지공능화정신행위적개선작용。방법장214례 AD 환자안수궤수자표법분위대조조（염산미금강）화관찰조（안리신연합염산미금강），매조107례，치료전후진행간역지능상태검사（MMSE）화세계위생조직-가리복니아락삼기대학은각사어학습측험（WHO-UCLA AVLT）、아이자해묵병병리행위평분표（BEHAVE-AD），분별평정 AD 환자적인지공능、정신행위。용불량반응량표（TESS）화상관실험실검사평정불량반응。결과여치료전상비，무론시대조조환시관찰조치료환자적 MMSE 총평분급기6개자항、WHO-UCLA AVLT 평측적즉각기억、단시기억화장시기억도유소증가（P ＜0．01혹 P ＜0．05），이정신행위증상병례수급각항득분화총평분도유불동정도적강저（P ＜0．01혹 P ＜0．05）。관찰조환자치료후적 MMSE 총평분급기자항득분、WHO-UCLA AVLT 평측득분적증고정도화정신행위증상병례수、BEHAVE-AD 총평분급기자항득분강저정도균고우대조조（t ＝－1．742， t ＝－1．431、－1．626、－2．173、－1．448、－1．026，t ＝－1．016、－1．279、－1．971，χ2＝12．295、7．609、8．917，t ＝0．778、1．139、2．004、1．153、0．822、1．944，P ＜0．01혹 P ＜0．05）；관찰조총유효솔위90．65％，현저고우대조조적71．96％（χ2＝12．299，P ＜0．01）；치료후량조환자무엄중약물불량반응。결론이용안리신연합염산미금강현저개선 AD 환자인지공능화정신행위증상，료효현저，불량반응소。
Objective To explore the effect of donepezil combined with memantine in ameliorating the cogni-tive function and psychological behavior of patients with Alzheimers'disease(AD).Methods 214 AD patients were randomly divided into the control groupand observation group.The control group were treated with memantine,and the observation group were treated donepezil combined with memantine.Before and after treatment,MMSE and WHO -UCLA AVLT,BEHAVE -AD were utilized to assess the cognitive function,psychological behavior,respectively.The adverse effects were observed using TESS and laboratory examination.Results The scores of MMSE and its subitem, WHO -UCLA AVLT(Immediate memory,short -term memory and long -term memory)after treatment significantly increased as compared with those before treatment in the control group and the observation group(P <0.01 or P <0.05),while the cases of psychological behavior,the score of BEHAVE -AD and its subitem decreased(P <0.01 or P <0.05).The observation group showed statistically significant difference in the increasion of the scores of MMSE and its subitem,WHO -UCLA AVLT,and the decreasion of the cases of psychological behavior,the score of BE-HAVE -AD and its subitem comparison with the control group(t =-1.742,-1.431,-1.626,-2.173,-1.448,-1.026,-1.016,-1.279,-1.971,χ2 =12.295,7.609,8.917,t =0.778,1.139,2.004,1.153,0.822,1.944, P <0.01 or P <0.05).The total effective rate of the observation group was 90.65%,and 71.96% of the control group,there was a significant difference between the two groups(χ2 =12.299,P <0.01).There was no obvious side effects during the treatment in both groups.Conclusion Donepezil combined with memantine can significantly improve the cognitive function and psychological behavior of AD patients,and there are fewer adverse events.