目的 探讨甘露特钠联合多奈哌齐治疗阿尔茨海默病的临床疗效。方法 选取2020年3月—2021年11月在常熟市第二人民医院治疗的82例阿尔茨海默病患者，按照随机数字表法分为对照组（41例）和治疗组（41例）。对照组每日睡前口服盐酸多奈哌齐片，5 mg/次，持续治疗4周后调整剂量，最大剂量10 mg/d。治疗组在对照组基础上口服甘露特纳胶囊，450 mg/次，2次/d。两组患者持续治疗3个月。观察两组患者临床疗效，比较治疗前后两组患者日常生活能力量表（ADL）、简易智力状态检查量表（MMSE）和阿尔茨海默病评定量表–认知量表（ADAS-cog）评分，及血清肠道菌群代谢标志物短链脂肪酸（SCFA）、γ-氨基丁酸（GABA）和苯丙氨酸（Phe）水平。结果 治疗后，治疗组总有效率明显高于对照组（92.68% vs 75.61%，P＜0.05）。治疗后，两组患者ADL评分、MMSE评分均高于治疗前，ADAS-cog评分低于治疗前（P＜0.05），治疗组患者ADL、MMSE和ADAS-cog评分明显好于对照组（P＜0.05）。治疗后，两组患者血清SCFA和GABA水平高于治疗前，Phe低于治疗前（P＜0.05），治疗组患者血清SCFA、GABA和Phe水平明显好于对照组（P＜0.05）。结论 甘露特钠联合多奈哌齐可提高阿尔茨海默病患者日常生活能力及智力水平，调节肠道菌群代谢标志物平衡，且其安全性较高。

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

常熟市卫生和计划生育委员会科技项目(csws201804)