目的 探討復(fù)方活腦舒膠囊聯(lián)合重酒石酸卡巴拉汀膠囊治療阿爾茨海默病的臨床療效。方法 選取2020年1月—2023年2月在空軍軍醫(yī)大學(xué)唐都醫(yī)院進(jìn)行治療的96例阿爾茨海默病患者，采用隨機(jī)數(shù)表法將96例阿爾茨海默病患者分為對照組和治療組，每組各48例。對照組患者口服重酒石酸卡巴拉汀膠囊，起始劑量為3 mg/d，于早晚餐時分2次服用，用藥4周后無不可耐受情況可將劑量調(diào)整至6 mg/d，若耐受良好，可繼續(xù)增加直至最大耐受劑量，但每日劑量不能超過12 mg。治療組在對照組的基礎(chǔ)上口服復(fù)方活腦舒膠囊，3粒/次，2次/d。兩組患者均連續(xù)治療6個月。觀察兩組患者的臨床療效，比較治療前后阿爾茨海默病評價量表-認(rèn)知分表（ADAS-cog）評分、日常生活能力評估量表（ADL）評分、中醫(yī)癥狀積分以及血清丙二醛、還原型谷胱甘肽（GSH）的水平。結(jié)果 治療后，治療組的總有效率為93.75%，比對照組的總有效率79.17%更高（P＜0.05）。治療后，兩組ADAS-cog評分、ADL評分均低于治療前（P＜0.05）；且治療后治療組ADAS-cog評分、ADL評分低于對照組（P＜0.05）。治療后，兩組神疲倦怠評分、智力減退評分、心悸等評分均低于治療前（P＜0.05）；且治療后治療組中醫(yī)癥狀評分低于對照組（P＜0.05）。治療后，兩組血清丙二醛水平低于治療前，而血清GSH水平高于治療前（P＜0.05）；且治療后治療組血清丙二醛水平低于對照組，血清GSH水平高于對照組（P＜0.05）。結(jié)論 復(fù)方活腦舒膠囊聯(lián)合卡巴拉汀治療阿爾茨海默病可獲得較為滿意的療效，對患者的各項中醫(yī)癥狀、認(rèn)知功能以及自理生活的能力有較明顯的改善作用，并可降低氧化應(yīng)激水平，且具有較好的安全性。

Objective To investigate the therapeutic effect of Compound Huonaoshu Capsules combined with Rivastigmine Hydrogen Tartrate Capsules in treatment of Alzheimer’s disease. Methods A total of 96 patients with Alzheimer’s disease treated in Tangdu Hospital of Air Force Military Medical University from January 2020 to February 2023 were selected and divided into control group and treatment group by random number table method, with 48 patients in each group. Patients in the control group were po administered with Rivastigmine Hydrogen Tartrate Capsules, the initial dosage was 3 mg/d, taken twice at breakfast and dinner. After 4 weeks, the dosage could be adjusted to 6 mg/d if no intolerance occurs. If the tolerance was good, the dosage could be continued to the maximum tolerated dosage, but the daily dosage should not exceed 12 mg. Patients in treatment group were po administered with Compound Huonaoshu Capsules on the basis of the control group, 3 grain/time, twice daily. Both groups were treated continuously for 6 months. The clinical effects of the two groups were observed, and the scores of Alzheimer’s Disease Assessment Scale-Cognitive Scale (ADAS-cog), Daily Living Ability Assessment Scale (ADL), TCM symptom score and serum malondialdehyde and reduced glutathione (GSH) before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 93.75%, which was higher than that of control group 79.17% (P < 0.05). After treatment, the ADAS-cog scores and ADL scores in both groups were lower than before treatment (P < 0.05). After treatment, ADAS-cog scores and ADL scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, the scores of mental fatigue, mental impairment and heart palpitation were lower than before treatment (P < 0.05). After treatment, the symptom score of the treatment group was lower than that of the control group (P < 0.05). After treatment, serum malondialdehyde level was lower than before treatment, but serum GSH level was higher than before treatment (P < 0.05). After treatment, the serum malondialdehyde level in the treatment group was lower than that in the control group, and the serum GSH level was higher than that in the control group (P < 0.05). Conclusion Compound Huonaoshu Capsules combined with Rivastigmine Hydrogen Tartrate Capsules can obtain satisfactory curative effect in treatment of Alzheimer’s disease, and can significantly improve the symptoms of Chinese medicine, cognitive function and self-care ability of patients, which can reduce the level of oxidative stress with good safety.

R971

陜西省重點(diǎn)研發(fā)計劃項目(2019SF-009)