美金刚联合脑电磁治疗阿尔茨海默病痴呆的行为精神症状的疗效观察*

Memantine combined with brain electromagnetic therapy in the treatment of Alzheimer's disease with behavioral and psychological symptoms of dementia*

摘要:

目的 探讨美金刚联合脑电磁治疗阿尔茨海默病（AD） 痴呆的行为精神症状（BPSD） 的研究。 方法 选取2017 年1 月—2020 年1 月在浙江省人民医院就诊的AD 伴BPSD 患者122 例，按照随机表法分为观 察组和对照组，各61例。对照组口服美金刚片；观察组在对照组基础上结合脑电磁治疗。两组疗程均为12周。 比较两组疗效，以及治疗前后简易精神状态检查（MMSE）、日常生活活动（ADL）、AD 病理行为症状量表 （BEHAVE-AD）、神经精神量表（NPI） 评分及脑源性神经营养因子（BDNF）、多巴胺（DA）、5-羟色胺 （5-HT） 水平变化。结果 观察组治疗后总有效率高于对照组（P <0.05）。观察组治疗前后MMSE 评分、 ADL 评分、BEHAVE-AD 评分、NPI 总分和NPI 苦恼因子评分的差值高于对照组（P <0.05）。观察组治疗前 后血清BDNF、DA 和5-HT 水平的差值高于对照组（P <0.05）。结论 美金刚联合脑电磁治疗AD 患者 BPSD 临床疗效较好，值得临床借鉴。

Abstract:

Objective To investigate the effect of memantine combined with brain electromagnetic therapy on Alzheimer's disease (AD) with behavioral and psychological symptoms of dementia (BPSD). Methods The 122 patients with AD and BPSD in Zhejiang Provincial People's Hospital from January 2017 to January 2020 were randomly divided into observation group (61 cases) and control group (61 cases). The control group was treated with memantine tablets, while the observation group was treated with brain electromagnetic therapy on the basis of memantine. The course of treatment was 12 weeks in both groups. Before and after treatment, Mini-Mental State Examination (MMSE) score, Activities of Daily Living (ADL) score, Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) score, Neuropsychiatric Inventory (NPI) score, brain-derived neurotrophic factor (BDNF), dopamine (DA) and 5-hydroxytryptamine (5-HT) levels were compared between the two groups. Results After treatment, the overall effective rate in the observation group was higher than that in control group (P < 0.05). The differences of MMSE score, ADL score, BEHAVE-AD score, total NPI score and the score of caregivers' distress before and after treatment in the observation group were higher than those in control group (P < 0.05). The differences of serum BDNF, DA and 5-HT levels before and after the treatment in the observation group were higher than those in the control group (P < 0.05). Conclusions Memantine combined with brain electromagnetic therapy for AD patients with BPSD shows great clinical efficacy, which is worthy of clinical reference.