吡格列酮联合双氢麦碱治疗阿尔茨海默病临床观察(1)
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2010年1月1日
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【摘要】目的:探讨吡格列酮治疗阿尔茨海默病的疗效观察。方法:治疗组30例用吡格列酮、双氢麦角碱治疗持续24周,对照组30例用双氢麦角碱、吡拉西坦治疗持续24周,分别于治疗后6周、12周、24周进行疗效评估。结果:吡格列酮、双氢麦角硷治疗24周后,用MMSE评分比治疗前有显著意义的提高,且远期评分更有意义,和对照组相比有统计学意义。结论:吡格列酮可改善阿尔茨海默病的临床症状,远期疗效优于对照组。
【关键词】吡格列酮;胰岛素抵抗;阿尔茨海默病
【中图分类号】R741.05 【文献标识码】C 【文章编号】1008-6455(2010)07-0160-02
Clinical Observation ofTreatmentEffectsofPioglitazone CombiningTopiramate alkaline on Alzheimer’s disease
Wang Zhihai1 Meng Jianhua1 Wang Lianyu2 Liu Keyu3 Li Junfeng1
【Abstract】Objective:To investigate the treatmen effects of pioglitazone combining topiramate alkaline onAlzheimer’s diseaset. Methods:The 30 patients oftreated group were continuously treatedby pioglitazone combining topiramate alkaline for 24 weeks. The 30 patients ofcontrolgroup were continuously treatedby topiramate alkaline combining piracetam for 24weeks .The therapy effects were respectively assessed in 6th week ,12th week ,24th week after treatment.Results:The treatment effcets were significantlyimproved intreated group after treating by pioglitazone combining topiramate alkaline compared with the MMSE score. In addition.The effects were more meaningfulintreated group than control group compared with the long-term score.The treatment effects were statistically significant in treatde group compared with contol group.Conclusion: Pioglitazone may improve the symptoms of Alzheimer’s disease.The long-term efficacy in treated groupwas more than contol goup.
【Key words】Pioglitazone; Insulin resistance; Alzheimer’s disease
阿尔茨海默病(AD)是一种以进行性认知障碍、记忆受损、人格改变、情感障碍等为特征的慢性进行性中枢神经系统变性疾病。临床上缺乏肯定有效的治疗方法。本研究旨在观察吡格列酮联合双氢麦角碱治疗轻中度AD的临床效果及安全性。现将结果总结如下。
1 资料和方法
1.1 临床资料:60例AD患者,男31例,女29例;年龄50-80岁,平均69.2岁。随机分为两组:治疗组30例,男16例,女14例,年龄55～80(70.3±4.9)岁;对照组30例,男15例,女15例,年龄50-79 (68.6±55.9),岁两组年龄差异无显著性(P>0.05)。入组标准:符合《中国精神疾病分类方案与诊断标准(CCMD-3)》中阿尔茨海默病诊断标准和美国精神病学第4版《精神病的诊断统计手册》中阿尔茨海默病的诊断标准,出现认知功能和日常生活能力下降至少6个月;头颅CT检查均有脑萎缩;无其他脑器质性病变;痴呆严重程度则根据DSM-IV-R诊断为轻、中度痴呆,且MMSE的评分为10～26分。排除标准:除AD以外患有其他可能导致痴呆的疾病者;严重或极轻微的痴呆MMSE<10分或>26分;HAM-D≥15分有明显抑郁症状者;有其他严重和不稳定疾病的患者;已参加过其他药物试验者。
1.2 治疗方法:治疗组予吡格列酮片15 mg qd,双氢麦角碱1mg tid。对照组服用吡拉西坦0.8g tid ,双氢麦角碱1mg tid。观察总疗程为24周。两组分别在治疗前,治疗后6、12、24周进行简易精神状态量表(MMSE)评分,MMSE检查项目包括时间定向力、地点定向力、瞬时记忆、计算力、注意力、短时记忆、语言和结构等认知功能,共30项,评分范围为0-30分,分数越高认知功能越好 ......
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