目的 探讨艾地苯醌联合石杉碱甲治疗阿尔茨海默病的疗效。方法 选取邯郸市第一医院2024年1月—2025年1月收治的100例阿尔茨海默病患者，采用随机数字序列分为对照组（n＝50）和治疗组（n＝50）。对照组患者每日口服石杉碱甲片，早、晚餐后各口服75 μg。治疗组患者在对照组基础上口服艾地苯醌片，早、中、晚餐后各口服10 mg。两组患者治疗周期均为6个月。比较组间疗效以及治疗前及治疗后3、6个月蒙特利尔认知评估量表（MoCA）、临床痴呆评定量表（CDR）、简易精神状态量表（MMSE）、简明神经精神问卷（NPI-Q）、阿尔茨海默病生活质量量表（QOL-AD）评分和血清因子超氧化物歧化酶（SOD）、肿瘤坏死因子-α（TNF-α）和脑源性神经营养因子（BDNF）水平。结果 治疗组总有效率为94.00%，对照组总有效率为80.00%，组间比较有差异有统计意义（P＜0.05）。相较于治疗前，治疗后3、6个月两组MoCA评分、MMSE评分、QOL-AD评分均升高，CDR评分、NPI-Q评分均降低（P＜0.05）。且治疗后3、6个月，治疗组MoCA评分、MMSE评分、QOL-AD评分均高于对照组，CDR评分、NPI-Q评分均低于对照组（P＜0.05）。治疗后3、6个月，两组TNF-α水平均明显低于治疗前（P＜0.05），SOD、BDNF水平均明显高于治疗前（P＜0.05），且治疗组TNF-α水平明显低于对照组，SOD、BDNF水平明显高于对照组（P＜0.05）。结论 艾地苯醌联合石杉碱甲治疗AD，效果显著，能有效改善患者的认知功能及生活能力。

Objective To explore the efficacy of idebenone combined with huperzine A in treatment of Alzheimer’s disease. Methods A total of 100 patients with Alzheimer’s disease (AD) admitted to Handan First Hospital from January 2024 to January 2025 were enrolled and randomly divided into the control group and the treatment group using the random number sequence, with 50 cases in each group. Patients in the control group were po administered with Huperzine A Tablets at a dose of 75 μg after breakfast and dinner respectively. On the basis of the control group, patients in the treatment group were po administered with Idebenone Tablets at a dose of 10 mg after breakfast, lunch and dinner respectively. The treatment course for both groups lasted 6 months. The clinical efficacy between the two groups was compared. The scores of the Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory-Questionnaire (NPI-Q) and Quality of Life-Alzheimer’s Disease (QOL-AD), as well as the serum levels of superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α) and brain-derived neurotrophic factor (BDNF) were compared between the two groups before treatment, 3 months and 6 months after treatment. Results The total effective rate of the treatment group was 94.00%, which was significantly higher than 80.00% of the control group, and the difference was statistically significant (P < 0.05). Compared with baseline levels before treatment, the MoCA, MMSE and QOL-AD scores of the two groups were significantly increased, while the CDR and NPI-Q scores were significantly decreased at 3 and 6 months after treatment (P < 0.05). At 3 and 6 months after treatment, the treatment group presented remarkably higher MoCA, MMSE and QOL-AD scores, and lower CDR and NPI-Q scores than the control group (all P < 0.05). In addition, the serum TNF-α levels of both groups were significantly decreased, while SOD and BDNF levels were significantly elevated at 3 and 6 months after treatment in contrast to those before treatment (P < 0.05). Moreover, the treatment group had lower TNF-α levels and higher SOD and BDNF levels than the control group after treatment (P < 0.05). Conclusion The combination of idebenone and huperzine A has a significant therapeutic effect on Alzheimer’s disease, which can effectively improve the cognitive function and living ability of patients.

R971

河北省医学科学研究项目（20261254）