盐酸多奈哌齐联合重复经颅磁刺激对阿尔茨海默病患者的临床效果

摘要/Abstract

摘要： 目的探讨盐酸多奈哌齐联合重复经颅磁刺激对阿尔茨海默病患者的临床效果。方法选取2021年1月—2022年10月临沂市精神卫生中心收治的96例阿尔茨海默病患者作为研究对象,按照随机数表法分为对照组和试验组,每组48例。对照组采用口服盐酸多奈哌齐治疗,试验组在对照组的基础上联合重复经颅磁刺激治疗。比较两组患者治疗前后的认知功能、日常生活活动能力和睡眠质量情况。结果干预前,两组患者简易精神状态检查表（MMSE）比较,差异无统计学意义（P>0.05）;干预后,两组患者MMSE评分均高于干预前,且试验组MMSE评分高于对照组,差异有统计学意义（P<0.05）。干预前,两组患者日常生活能力量表（ADL）评分、匹茨堡睡眠质量指数（PSQI）评分比较,差异无统计学意义（P>0.05）;干预后,两组患者ADL评分、PSQI评分均低于干预前,且试验组ADL评分、PSQI评分低于对照组,差异有统计学意义（P<0.05）。结论对阿尔茨海默病患者应用盐酸多奈哌齐联合重复经颅磁刺激治疗可有效改善患者的精神状态、日常生活能力以及睡眠质量,值得临床应用。

关键词: 盐酸多奈哌齐, 重复经颅磁刺激, 阿尔茨海默病

Abstract: Objective To explore the clinical effect of donepezil hydrochloride combined with repetitive transcranial magnetic stimulation on patients with Alzheimer disease. Methods 96 patients with Alzheimer disease who were treated in Linyi Mental Health Center from January 2021 to October 2022 were selected as the subjects of this study. They were randomly divided into two groups with 48 patients each. The control group was treated with oral donepezil hydrochloride, and the experimental group was treated with repeated transcranial magnetic stimulation on the basis of the control group. The cognitive function, activities of daily living (ADL) and sleep quality of the two groups were observed before and after treatment. Results Mini-mental State Examination (MMSE) of the two groups before intervention was compared (P>0.05); after the intervention, the MMSE score of patients in the two groups was higher than that before the intervention, and the MMSE score in the experimental group was higher than that in the control group (P<0.05). ADL score and Pittsburgh Sleep Quality Index (PSQI) score between the two groups were compared before intervention, with no significant difference (P>0.05); after the intervention, the ADL score and PSQI score of the two groups were lower than those before the intervention, and the ADL score and PSQI score of the experimental group were lower than those of the control group (P<0.05). Conclusion The application of donepezil hydrochloride combined with repetitive transcranial magnetic stimulation in patients with Alzheimer disease can effectively improve the mental state, daily living ability and sleep quality of patients, which is worthy of clinical application.

Key words: donepezil hydrochloride, repetitive transcranial magnetic stimulation, Alzheimer disease

中图分类号:

R749

耿静. 盐酸多奈哌齐联合重复经颅磁刺激对阿尔茨海默病患者的临床效果[J]. 中华养生保健, 2023, 41(14): 17-20.

GENG Jing. Clinical Effect of Donepezil Hydrochloride Combined with Repetitive Transcranial Magnetic Stimulation on Patients with Alzheimer Disease[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(14): 17-20.

参考文献

[1] 邱国真,许春燕,郭启雯,等.阿魏酸和白芷提取物对1例额叶变异型阿尔茨海默病患者的临床疗效[J].阿尔茨海默病及相关病,2022,5(2):139-142.
[2] 范彩芹,许海宁,何文杰,等.基于血管修复因子、神经递质探讨脑循环治疗仪联合美金刚治疗阿尔茨海默病机制[J].疑难病杂志,2022,21(10):1019-1023.
[3] 谢平安,廖辉,张艳敏,等.miR-146a尾静脉注射对阿尔茨海默病大鼠认知能力、Th17/Treg分布及炎症因子水平的影响[J].山东医药,2022,62(20):46-49.
[4] 王慧敏,汤其强.阿尔茨海默病患者脑脊液可溶性血小板衍生生长因子受体β与认知损害及脑脊液生物标志物的相关性研究[J].中华神经科杂志,2022,55(1):47-52.
[5] 王锋存,赵秀丽,刘军莉.阿尔茨海默病患者血清LncRNA MALAT1、LncRNA NEAT1的表达变化及临床意义[J].中国现代医学杂志,2022,32(18):77-82.
[6] 刘璐,张潇潇,赵静,等.盐酸多奈哌齐对老年阿尔茨海默病患者的治疗效果及对简易精神状态检查量表评分等指标的影响[J].中国医院用药评价与分析,2021,21(10):1188-1191.
[7] 王玉香,崔传举,李彦玲,等.脑源性神经营养因子修饰人羊膜间充质干细胞移植改善阿尔茨海默病大鼠认知功能[J].中国组织工程研究,2022,26(13):2045-2049.
[8] 中国痴呆与认知障碍写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南(二):阿尔茨海默病诊治指南[J].中华医学杂志,2018,98(13):971-977.
[9] 齐若兵,宋明芬,陈斌华,等.盐酸美金刚、多奈哌齐分别联合利培酮治疗阿尔茨海默病伴精神行为症状患者的疗效观察[J].中华全科医师杂志,2021,20(7):777-780.
[10] BLAUVELT A, LEONARDI C L, GAYLIS N, et al.Treatment with SDZ-ADL, an adalimumab biosimilar, in patients with rheumatoid arthritis, psoriasis, or psoriatic arthritis: results of patient-reported outcome measures from two phase Ⅲ studies (ADMYRA and ADACCESS)[J]. BioDrugs,2021,35(2):229-238.
[11] HO K Y, LAM K K W, XIA W, et al. Psychometric properties of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) among Hong Kong Chinese childhood cancer survivors[J]. Health and Quality of Life Outcomes,2021,19(1):1-11.
[12] MOHAMAD SAFIAI N I, AMIR N A, BASRI H, et al. Effectiveness and tolerability of repetitive transcranial magnetic stimulation for preventive treatment of episodic migraine: a single-centre, randomised, double-blind, sham-controlled phase 2 trial (Magnet-EM)[J]. Trials,2020, 21(1):1-9.
[13] 张春梅,张海燕,刘忠锦,等.Aβ25~35诱导SH-SY5Y细胞阿尔茨海默病模型的建立及鹿茸多肽对其治疗作用[J].中国老年学杂志,2022,42(10):2460-2463.
[14] FUNNELL J L, ZIEMBA A M, NOWAK J F, et al.Assessing the combination of magnetic field stimulation, iron oxide nanoparticles, and aligned electrospun fibers for promoting neurite outgrowth from dorsal root ganglia in vitro[J]. Acta Biomaterialia,2021,131:302-313.
[15] 金俊花,胡静. 5Hz重复经颅磁刺激对轻、中度阿尔茨海默病患者的精神行为症状及认知功能的影响[J]. 检验医学与临床,2020,17(13):1867-1869.
[16] CHÉTELAT G. Multimodal neuroimaging in Alzheimer's disease: early diagnosis, physiopathological mechanisms, and impact of lifestyle[J]. Journal of Alzheimer's Disease,2018,64(s1):S199-S211.
[17] 刘文邦,郑宏,周东升.重复经颅磁刺激联合多奈哌齐对阿尔茨海默病患者认知功能、精神行为症状的影响[J].中国基层医药,2021,28(2):213-217.
[18] PARNETTI L, CHIPI E, SALVADORI N, et al.Prevalence and risk of progression of preclinical Alzheimer's disease stages: a systematic review and meta-analysis[J]. Alzheimer's research & therapy,2019,11(1):1-13.
[19] 徐桥,齐钢桥.重复经颅磁刺激联合复方海蛇胶囊治疗阿尔茨海默病的疗效及对神经损伤指标的影响[J].浙江医学,2020,42(7):697-699,712.
[20] 罗英茂,谭小林,张雄,等.肝脏X受体激动剂TO901317对APP/PS1双转基因阿尔茨海默病小鼠认知功能的影响及其机制[J].中南大学学报(医学版),2022,47(10):1324-1331.