目的 研究利培酮或者喹硫平與多奈哌齊聯(lián)合使用對老年癡呆患者精神行為癥狀的治療效果。方法 選擇2015年1月-2017年12月許昌市第二人民醫(yī)院的198例老年癡呆患者，隨機(jī)分為利培酮組以及喹硫平組。利培酮組采用利培酮聯(lián)合多奈哌齊治療，喹硫平組采用喹硫平聯(lián)合多奈哌齊治療。兩組治療2個(gè)月后，比較MMSE評分、BEHAVE-AD評分以及TESS評分。結(jié)果 利培酮組與喹硫平組的有效率相比無明顯差異。兩組治療后的認(rèn)知功能MMSE評分均明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），但兩組間相比無明顯差異。兩組治療后的幻覺、偏執(zhí)妄想、行為紊亂、晝夜節(jié)律紊亂、攻擊行為、焦慮恐懼以及情感障礙評分值均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），但兩組間相比無明顯差異。喹硫平組治療1個(gè)月和2個(gè)月后的TESS評分均明顯低于利培酮組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 利培酮或者喹硫平與多奈哌齊聯(lián)合使用均可以有效改善老年癡呆患者的精神行為癥狀，但與利培酮相比，喹硫平的不良反應(yīng)更少，更適合用于老年癡呆患者的治療。

Objective To investigate the clinical effect of risperidone or quetiapine combined with donepezil in the treatment of psycho behavioral symptoms in Alzheimer's patients.Methods Selected 198 cases of Alzheimer's patients who were treated in our hospital from January 2015 to December 2016,divided into two groups randomly.The risperidone group was treated with risperidone combined with donepezil,the quetiapine group was treated with quetiapine combined with donepezil.After two months of treatment,the MMSE score,BEHAVE-AD score and TESS score of the two groups were compared.Results There was no significant difference in the efficiency of the risperidone group and the quetiapine group.The cognitive function MMSE scores in the two groups were significantly increased (P< 0.05),but there was no significant difference between the two groups.The scores of hallucinations,paranoid delusions,behavioral disorders,circadian rhythm disorders,aggressive behaviors,anxiety and fear,and affective disorders in the two groups decreased significantly (P< 0.05),but there was no significant difference between the two groups.The TESS score of the quetiapine group was significantly lower than risperidone group (P< 0.05).Conclusion Risperidone or quetiapine combined with donepezil can effectively improve the mental and behavioral symptoms of Alzheimer's disease,but compared with risperidone,quetiapine has fewer side effects and is more suitable for the treatment of Alzheimer's disease.