目的 探討甘露特鈉聯(lián)合多奈哌齊治療阿爾茨海默病的臨床療效。方法 選取2020年3月—2021年11月在常熟市第二人民醫(yī)院治療的82例阿爾茨海默病患者，按照隨機(jī)數(shù)字表法分為對(duì)照組（41例）和治療組（41例）。對(duì)照組每日睡前口服鹽酸多奈哌齊片，5 mg/次，持續(xù)治療4周后調(diào)整劑量，最大劑量10 mg/d。治療組在對(duì)照組基礎(chǔ)上口服甘露特納膠囊，450 mg/次，2次/d。兩組患者持續(xù)治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者日常生活能力量表（ADL）、簡(jiǎn)易智力狀態(tài)檢查量表（MMSE）和阿爾茨海默病評(píng)定量表–認(rèn)知量表（ADAS-cog）評(píng)分，及血清腸道菌群代謝標(biāo)志物短鏈脂肪酸（SCFA）、γ-氨基丁酸（GABA）和苯丙氨酸（Phe）水平。結(jié)果 治療后，治療組總有效率明顯高于對(duì)照組（92.68% vs 75.61%，P＜0.05）。治療后，兩組患者ADL評(píng)分、MMSE評(píng)分均高于治療前，ADAS-cog評(píng)分低于治療前（P＜0.05），治療組患者ADL、MMSE和ADAS-cog評(píng)分明顯好于對(duì)照組（P＜0.05）。治療后，兩組患者血清SCFA和GABA水平高于治療前，Phe低于治療前（P＜0.05），治療組患者血清SCFA、GABA和Phe水平明顯好于對(duì)照組（P＜0.05）。結(jié)論 甘露特鈉聯(lián)合多奈哌齊可提高阿爾茨海默病患者日常生活能力及智力水平，調(diào)節(jié)腸道菌群代謝標(biāo)志物平衡，且其安全性較高。

Objective To investigate the clinical efficacy of oligomannate combined with donepezil in treatment of Alzheimer's disease.Methods Patients (82 cases) with Alzheimer's disease in Changshu Second People's Hospital from March 2020 to November 2021 were divided into control (41 cases) and treatment (41 cases) group by random number table method.Patients in the control group were po administered with Mesalazin Enteric-coated Tablets before going to bed every day,5 mg/time,adjusted the dose after continuous treatment for four weeks,and the maximum dose was 10 mg/d.Patients in the treatment group were po administered with Sodium Oligomannate Capsules on the basis of the control group,450 mg/time,twice daily.Patients in two groups were treated for 3 months.After treatment,the clinical evaluation was evaluated,the scores of ADL,MMSE,and ADAS-cog,the levels of serum intestinal flora metabolic markers SCFA,GABA and Phe in two groups before and after treatment were compared.Results After treatment,the clinical effect of the treatment group was significantly higher than that of the control group (92.68%vs 75.61%,P<0.05).After treatment,the scores of ADL and MMSE in two groups were higher than those before treatment,while the scores of ADAS-cog were lower than those before treatment (P<0.05),and the scores of ADL,MMSE,and ADAS-cog in the treatment group were significantly better than those in the control group (P<0.05).After treatment,the levels of serum SCFA and GABA in two group were higher than those before treatment,and the levels of Phe were lower than those before treatment (P<0.05),and the levels of serum SCFA,GABA,and Phe in the treatment group were significantly better than those in the control group (P<0.05).Conclusion Sodium oligomannate combined with donepezil can improve the ability of daily life and intelligence level of patients with Alzheimer's disease,regulate the balance of metabolic markers of intestinal flora,and its safety is high.

R971

常熟市衛(wèi)生和計(jì)劃生育委員會(huì)科技項(xiàng)目(csws201804)