丙戊酸钠缓释片联合利培酮治疗阿尔茨海默病伴精神行为症状的临床研究

范德康; 凌迎春; 吕娉娉; 汪海燕

doi:10.16766/j.cnki.issn.1674-4152.004421

丙戊酸钠缓释片联合利培酮治疗阿尔茨海默病伴精神行为症状的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.004421

1.
永康市第三人民医院精神科，浙江永康 321300
2.
绍兴市第七人民医院检验科，浙江绍兴 312000
3.
永康市第三人民医院老年科

基金项目:

浙江省医药卫生科技计划项目 2022KY1309

详细信息

通讯作者:
范德康，E-mail：18967917009@163.com

中图分类号: R749.1 R749.05
计量
- 文章访问数: 16
- HTML全文浏览量: 8
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2025-11-17
- 网络出版日期: 2026-06-02

Clinical study of sodium valproate sustained release tablets combined with risperidone in the treatment of mental and behavioral symptoms of Alzheimer ' s disease

1.
Department of Psychiatry, Yongkang Third People ' s Hospital, Yongkang, Zhejiang 321300, China

摘要

摘要: 目的探讨丙戊酸钠缓释片联合利培酮治疗阿尔茨海默病(AD)伴精神行为症状(BPSD)的疗效及安全性，为临床制定治疗方案提供借鉴。方法选取2023年5月—2025年4月永康市第三人民医院收治的186例AD伴BPSD患者，采用随机数表法分成A组(93例)与B组(93例)，A组予以利培酮治疗，B组予以丙戊酸钠缓释片联合利培酮治疗。观察2组患者认知功能、精神行为症状、日常生活能力、临床疗效及不良反应发生情况。结果 2组患者治疗后蒙特利尔认知评估量表(MoCA)、简易智力状态检查量表(MMSE)评分均提高(P＜0.05)，且B组治疗后MoCA、MMSE评分高于A组(P＜0.05)。2组治疗后阿尔茨海默病病理行为评定量表(BEHAVE-AD)、神经精神科问卷(NPI)评分均降低(P＜0.05)，且B组治疗后BEHAVE-AD、NPI评分低于A组(P＜0.05)。2组治疗后ADL评分均提高(P＜0.05)，且B组治疗后ADL评分高于A组(P＜0.05)。B组总有效率为86.02%(80/93)，高于A组[74.19%(69/93), χ²=4.082，P=0.043]。A组不良反应发生率为12.90%(12/93)，B组为10.75%(10/93)，2组比较差异无统计学意义(P＞0.05)。结论以丙戊酸钠缓释片联合利培酮治疗AD伴BPSD，能改善患者认知功能、精神行为相关症状以及日常生活能力，提升临床疗效，且在安全性方面表现良好，值得推广。
- 阿尔茨海默病 /
- 精神行为症状 /
- 丙戊酸钠缓释片 /
- 利培酮 /
- 认知功能 /
- 日常生活能力
Abstract: Objective To investigate the efficacy and safety of sodium valproate sustained-release tablets combined with risperidone in the treatment of Alzheimer ' s disease (AD) with psychobehavioral symptoms (BPSD), providing evidence for clinical treatment strategies. Methods A total of 186 patients with AD with BPSD admitted to Yongkang Third People ' s Hospital from May 2023 to April 2025 were randomly divided into group A and group B. 93 cases in group A were treated with risperidone, and 93 cases in group B were treated with sodium valproate sustained-release tablets combined with risperidone. The cognitive function, mental and behavioral symptoms, activities of daily living, clinical efficacy, and adverse reactions of the two groups were observed. Results The Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) scores of the two groups were improved after treatment (P < 0.05), and the MoCA and MMSE scores of group B were higher than those of group A (P < 0.05). After treatment, the behavioral pathology in the Alzheimer ' s disease rating scale (BEHAVE-AD) and neuropsychiatric inventory (NPI) scores in the two groups were decreased (P < 0.05), and the BEHAVE-AD and NPI scores in group B were lower than those in group A (P < 0.05). After treatment, the ADL scores of the two groups were improved (P < 0.05), and the ADL scores of group B were higher than those of group A (P < 0.05). The total effective rate of group B was 86.02% (80/93), which was higher than 74.19% (69/93) of group A (χ²=4.082, P=0.043). The incidence of adverse reactions was 12.90% (12/93) in group A and 10.75% (10/93) in group B, and there was no significant difference between the two groups (P>0.05). Conclusion Sodium valproate sustained-release tablets combined with risperidone in the treatment of AD with BPSD can improve the cognitive function, mental behavior-related symptoms, and the ability of daily life of patients, improve the clinical efficacy, and perform well in terms of safety, which is worthy of promotion.
- Alzheimer ' s disease /
- Behavioral and psychological symptoms /
- Sodium valproate sustained-release tablets /
- Risperidone /
- Cognitive function /
- Activities of daily living

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表 1 2组AD伴BPSD患者治疗前后认知功能比较(x±s，分)

Table 1. Comparison of cognitive function between the two groups of AD patients with BPSD (x±s, points)

组别	例数	MoCA		MMSE
组别	例数	治疗前	治疗后	治疗前	治疗后
A组	93	16.25±3.18	19.87±3.52^b	15.32±2.87	17.69±3.04^b
B组	93	16.51±3.09	23.15±3.26^b	14.93±2.79	20.32±2.97^b
统计量		0.565^a	43.474^c	0.940^a	35.622^c
P值		0.572	＜0.001	0.349	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 2 2组AD伴BPSD患者治疗前后精神行为症状比较(x±s，分)

Table 2. Comparison of psychological and behavioral symptoms between the two groups of AD patients with BPSD (x±s, points)

组别	例数	BEHAVE-AD		NPI
组别	例数	治疗前	治疗后	治疗前	治疗后
A组	93	22.58±4.36	14.23±3.81^b	32.61±5.47	19.45±4.98^b
B组	93	23.02±4.21	11.37±3.12^b	33.15±5.39	15.29±4.26^b
统计量		0.700^a	31.375^c	0.678^a	37.484^c
P值		0.485	＜0.001	0.499	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 3 2组AD伴BPSD患者治疗前后日常生活能力比较(x±s，分)

Table 3. Comparison of daily living ability between two groups of AD patients with BPSD (x±s, points)

组别	例数	ADL
组别	例数	治疗前	治疗后
A组	93	48.65±6.23	63.82±5.79^b
B组	93	47.98±5.71	68.51±4.43^b
统计量		0.765^a	38.491^c
P值		0.446	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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