摘要
目的观察盐酸美金刚与卡巴拉汀联合对比卡巴拉汀单药治疗24周后对轻、中度阿尔茨海默病患者的日常生活能力的影响。方法轻、中度AD患者共160例,选择符合纳入标准122例随机分为卡巴拉汀治疗组,美金刚联合卡巴拉汀治疗组。于治疗前、治疗12、24周末比较两组简易智能状态检查量表(MMSE)、日常生活能力量表(ADL)、AD评估量表认知分量表(ADAS-cog)、AD的相关症状量表(ROSA)、照料者负担量表(ZBI)评分;同时记录两组患者治疗时或治疗后出现的副作用和不良反应。结果 (1)两组患者治疗24周后,MMSE、ROSA、ADAS-cog、ADL、ZBI评分与入组时基线相比,差异均有显著意义(P<0.05)。(2)治疗24周后,卡巴拉汀组MMSE、ROSA评分均低于两药联合治疗组,ADL、ADAS-cog、ZBI评分均高于联合治疗组。联合治疗组各评分改善的差值均较卡巴拉汀组明显,差异有显著意义(P<0.05)(除PADL差异无统计学意义(P>0.05)。结论美金刚联合卡巴拉汀与卡巴拉汀单用对轻、中度AD治疗均具有一定的临床疗效,两药联合治疗对轻、中度AD患者日常生活能力的改善可能优于单用卡巴拉汀,并且在24周的治疗期间,联合治疗组不良反应并无明显增加。不同神经心理学量表对阿尔茨海默病的诊断及临床疗效具有一定的辅助意义。
Objective To evaluate the efficacy of memantine combined with rivastigmine initiated simultaneous versus rivastigmine mono therapy on ADL（20 item version in China） in the mild-to-moderate stage of Alzheimer＇s disease. Methods 122 patients who met the standards were randomly divided into rivastigmine group and memantine plus rivastigmine combination group. At baseline and after 12 and 24 weeks treatment,the patients were assessed by mini-mental state examination（MMSE）,activity of daily living scale（ADL）,Alzheimer＇s disease assessment scale-cognitive subscales（ADAS-cog）,the Relevant Outcome Scale for Alzheimer＇s Disease（ROSA）,Zarit caregiver burden scale（ZBI） and the scores of MMSE,ADL,ADAS-cog,ROSA and ZBI were compared respectively. Results（1）The scores of MMSE,ADL,ADAS-cog,ROSA and ZBI after 24 weeks treatment were significant difference compared with the baseline（P〈0.05）.（2）The scores of MMSE and ROSA after 24 weeks treatment were lower in rivastigmine group than in the combination group,the scores of ADL, ADAS- cog and ZBI were higher than in the combination group,the improved scores of each scales were significantly better in the combination group than in rivastigmine group（P〈0.05）,but the score of PADL had no difference（P〉0.05）,and there was no statistical significance. Conclusion Rivastigmine and memantine combined with rivastigmine may be improve the clinical effects in the treatment of mild-to-moderate AD. Memantine combined with rivastigmine to treat patients with mild-to-moderate AD may be improve daily life ability better than rivastigmine group. During theperiod of treatment, combined treatment group＇s adverse reactions do not increase.Different neuropsychological scales have an auxiliary significance to the diagnosis and the clinical effects of Alzheimer＇s disease.
出处
《中国医药科学》
2016年第19期23-27,共5页
China Medicine And Pharmacy
关键词
阿尔茨海默病
美金刚
卡巴拉汀
日常生活能力
Alzheimer＇s disease
Memantine
Rivastigmine
Activities of Daily Living
