补肾平肝方联合盐酸多奈哌齐治疗阿尔茨海默病精神行为症状的有效性观察

Effectiveness of notifying kidney and calming liver recipe combined with donepezil in the treatment of Alzheimer's disease with behavioral and psychological symptoms

关键词:  补肾平肝方  阿尔茨海默病  痴呆  呆病  MMSE量表  NPI问卷

Key words:  notifying kidney and calming liver  Alzheimer's disease  behavioral and psychological symptoms  MMSE scale  NPI questionnaire

摘要:

[目的]观察补肾平肝方联合盐酸多奈哌齐治疗阿尔茨海默病（AD）精神行为症状（BPSD）的疗效。[方法]采用回顾性研究的方法，纳入2016年9月—2018年6月期间就诊于本院记忆门诊的轻、中度AD伴精神行为症状患者92例，根据疗法分组，观察组50例，采用补肾平肝方联合盐酸多奈哌齐治疗，对照组42例，单纯采用盐酸多奈哌齐治疗，疗程均为12周。治疗前、后以简易精神状态检查量表（MMSE）评估总体认知功能，以神经精神问卷（NPI）评估精神行为症状。[结果]观察组治疗后的MMSE评分较治疗前有显著升高（P<0.05），且MMSE分数改善情况优于对照组（P<0.05）；两组患者治疗后NPI总分均较治疗前降低，且观察组较对照组分数下降更明显（P<0.05）；观察组治疗后幻觉和易怒/易激惹次数较治疗前显著减少（P<0.05），幻觉和易怒/易激惹发生次数改善情况优于对照组（P<0.05）。[结论]补肾平肝方联合盐酸多奈哌齐治疗AD伴BPSD在改善认知、控制精神行为症状方面，效果优于单用盐酸多奈哌齐。

Abstract:

[Objective] To observe the efficacy of notifying kidney and calming liver recipe combined with donepezil on Alzheimer's disease (AD) with behavioral and psychological symptoms(BPSD).[Methods] A retrospective cohort study was conducted,and 92 patients with mild and moderate AD with behavioral and psychological symptoms who were admitted to the memory clinic of our hospital from September 2016 to June 2018 were enrolled. The patients were divided into the observation group and control group according to different treatment methods. The 50 patients in the observation group were treated with notifying kidney and calming liver drugs combined with donepezil,while,the control group was treated with donepezil in 42 cases. The course of treatment was 12 weeks. Behavioral and psychological symptoms were assessed using the Neuropsychiatric Inventory scale (NPI) before and after treatment,and overall cognitive function was evaluated with the Mini-Mental State Examination scale (MMSE).[Results] The MMSE scores in the observation group were significantly higher than those before treatment (P<0.05),and the improvement of MMSE score was better than that of control group (P<0.05). The NPI total scores in both groups were lower than those before treatment,and the observation group decreased more significantly than the control group (P<0.05). The frequency of hallucination and irritability in the observation group was significantly decreased after treatment (P<0.05),moreover,compared with the control group,the frequency of hallucinations and irritability decreased significantly in the observation group (P<0.05).[Conclusion] Treatment of AD with BPSD with notifying kidney and calming liver drugs combined with donepezil is better than simple treatment with donepezil in improving cognition and behavioral and psychological symptoms.