| 摘要: |
| 目的：探讨薯蓣健脾益智合剂联合艾司西酞普兰治疗脾肾两虚、痰瘀互结型中度阿尔茨海默病（Alzheimers disease，AD）伴痴呆行为和精神症状(behavioral and psychological symptoms of dementia，BPSD）的临床疗效。方法：将90 例脾肾两虚、痰瘀互结型中度AD伴BPSD患者按随机数字表法分为治疗组和对照组，每组各45 例。对照组口服多奈哌齐和艾司西酞普兰治疗，治疗组在对照组基础上加用薯蓣健脾益智合剂治疗，疗程均为12周。比较2组简易精神状态检查（Mini-Mental State Examination，MMSE）、神经精神量表（Neuropsychiatric Inventory，NPI）、日常生活能力评定量表（activity of daily living，ADL）、康奈尔痴呆抑郁量表（Cornell Scale for Depression in Dementia，CSDD）、汉密尔顿焦虑量表（Hamilton Anxiety Scale，HAMA）及不良反应发生情况。结果：最终完成临床研究者83 例，其中治疗组41 例，对照组42 例。治疗后2组MMSE评分均较治疗前增加，NPI、ADL、CSDD、HAMA评分均较治疗前降低(P＜0.05），且治疗组NPI、ADL、CSDD、HAMA评分降低幅度大于对照组(P＜0.05）;不良反应发生率治疗组为4.88%（2/41），对照组为7.14%（3/42），2组比较，差异无统计学意义（P＞0.05）。结论：薯蓣健脾益智合剂联合艾司西酞普兰治疗脾肾两虚、痰瘀互结型AD伴BPSD患者临床疗效较好，可改善其认知功能、精神行为症状、日常生活能力，且安全性高。 |
| 关键词: 阿尔茨海默病 精神行为症状 脾肾两虚型 痰瘀互结型 薯蓣健脾益智合剂 艾司西酞普兰 认知功能 |
| DOI： |
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| Clinical effect of Shuyu Jianpi Yizhi mixture combined with escitalopram in treatment of behavioral and psychological symptoms in moderate Alzheimers disease with dementia: An analysis of 45 cases |
| LOU Boya,ZHANG Peng,LIU Yingjie |
| (Hubei University of Chinese Medicine，Wuhan 430065，Hubei，China) |
| Abstract: |
| Objective: To investigate the clinical effect of Shuyu Jianpi Yizhi mixture combined with escitalopram in the treatment of behavioral and psychological symptoms of dementia (BPSD） in moderate Alzheimers disease (AD） with the syndrome of deficiency of spleen and kidney and intermingled phlegm and blood stasis.Methods: A total of 90 patients with moderate AD and BPSD who had the syndrome of deficiency of spleen and kidney and intermingled phlegm and blood stasis were divided into treatment group and control group using a random number table，with 45 patients in each group.The patients in the control group were given oral administration of donepezil and escitalopram，while those in the treatment group were given Shuyu Jianpi Yizhi mixture in addition to the treatment in the control group;the course of treatment was 12 weeks for both groups.The two groups were compared in terms of Mini-Mental State Examination (MMSE），Neuropsychiatric Inventory (NPI），activities of daily living (ADL），Cornell Scale for Depression in Dementia (CSDD），Hamilton Anxiety Scale (HAMA），and adverse reactions.Results: A total of 83 patients completed the study finally，with 41 in the treatment group and 42 in the control group.After treatment，both groups had a significant increase in MMSE score and significant reductions in NPI，ADL，CSDD，and HAMA scores (P＜0.05），and compared with the control group，the treatment group had significantly greater reductions in NPI，ADL，CSDD，and HAMA scores (P＜0.05）.There was no significant difference in the incidence rate of adverse reactions between the treatment group and the control group ［4.88% (2/41）vs 7.14% (3/42），P＞0.05］.Conclusion: Shuyu Jianpi Yizhi mixture combined with escitalopram has a good clinical effect in the treatment of patients with AD and BPSD who have the syndrome of deficiency of spleen and kidney and intermingled phlegm and blood stasis，and it can improve cognitive function，behavioral and psychological symptoms，and activities of daily living，with a favorable safety profile. |
| Key words: Alzheimers disease behavioral and psychological symptoms deficiency of spleen and kidney intermingled phlegm and blood stasis Shuyu Jianpi Yizhi mixture escitalopram cognitive function |
