目的 探讨复方活脑舒胶囊联合重酒石酸卡巴拉汀胶囊治疗阿尔茨海默病的临床疗效。方法 选取2020年1月—2023年2月在空军军医大学唐都医院进行治疗的96例阿尔茨海默病患者，采用随机数表法将96例阿尔茨海默病患者分为对照组和治疗组，每组各48例。对照组患者口服重酒石酸卡巴拉汀胶囊，起始剂量为3 mg/d，于早晚餐时分2次服用，用药4周后无不可耐受情况可将剂量调整至6 mg/d，若耐受良好，可继续增加直至最大耐受剂量，但每日剂量不能超过12 mg。治疗组在对照组的基础上口服复方活脑舒胶囊，3粒/次，2次/d。两组患者均连续治疗6个月。观察两组患者的临床疗效，比较治疗前后阿尔茨海默病评价量表-认知分表（ADAS-cog）评分、日常生活能力评估量表（ADL）评分、中医症状积分以及血清丙二醛、还原型谷胱甘肽（GSH）的水平。结果 治疗后，治疗组的总有效率为93.75%，比对照组的总有效率79.17%更高（P＜0.05）。治疗后，两组ADAS-cog评分、ADL评分均低于治疗前（P＜0.05）；且治疗后治疗组ADAS-cog评分、ADL评分低于对照组（P＜0.05）。治疗后，两组神疲倦怠评分、智力减退评分、心悸等评分均低于治疗前（P＜0.05）；且治疗后治疗组中医症状评分低于对照组（P＜0.05）。治疗后，两组血清丙二醛水平低于治疗前，而血清GSH水平高于治疗前（P＜0.05）；且治疗后治疗组血清丙二醛水平低于对照组，血清GSH水平高于对照组（P＜0.05）。结论 复方活脑舒胶囊联合卡巴拉汀治疗阿尔茨海默病可获得较为满意的疗效，对患者的各项中医症状、认知功能以及自理生活的能力有较明显的改善作用，并可降低氧化应激水平，且具有较好的安全性。

Objective To investigate the therapeutic effect of Compound Huonaoshu Capsules combined with Rivastigmine Hydrogen Tartrate Capsules in treatment of Alzheimer’s disease. Methods A total of 96 patients with Alzheimer’s disease treated in Tangdu Hospital of Air Force Military Medical University from January 2020 to February 2023 were selected and divided into control group and treatment group by random number table method, with 48 patients in each group. Patients in the control group were po administered with Rivastigmine Hydrogen Tartrate Capsules, the initial dosage was 3 mg/d, taken twice at breakfast and dinner. After 4 weeks, the dosage could be adjusted to 6 mg/d if no intolerance occurs. If the tolerance was good, the dosage could be continued to the maximum tolerated dosage, but the daily dosage should not exceed 12 mg. Patients in treatment group were po administered with Compound Huonaoshu Capsules on the basis of the control group, 3 grain/time, twice daily. Both groups were treated continuously for 6 months. The clinical effects of the two groups were observed, and the scores of Alzheimer’s Disease Assessment Scale-Cognitive Scale (ADAS-cog), Daily Living Ability Assessment Scale (ADL), TCM symptom score and serum malondialdehyde and reduced glutathione (GSH) before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 93.75%, which was higher than that of control group 79.17% (P < 0.05). After treatment, the ADAS-cog scores and ADL scores in both groups were lower than before treatment (P < 0.05). After treatment, ADAS-cog scores and ADL scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, the scores of mental fatigue, mental impairment and heart palpitation were lower than before treatment (P < 0.05). After treatment, the symptom score of the treatment group was lower than that of the control group (P < 0.05). After treatment, serum malondialdehyde level was lower than before treatment, but serum GSH level was higher than before treatment (P < 0.05). After treatment, the serum malondialdehyde level in the treatment group was lower than that in the control group, and the serum GSH level was higher than that in the control group (P < 0.05). Conclusion Compound Huonaoshu Capsules combined with Rivastigmine Hydrogen Tartrate Capsules can obtain satisfactory curative effect in treatment of Alzheimer’s disease, and can significantly improve the symptoms of Chinese medicine, cognitive function and self-care ability of patients, which can reduce the level of oxidative stress with good safety.

R971

陕西省重点研发计划项目(2019SF-009)