Objectives To evaluate the clinical efficacy of Memantine combined with Donepezil in the treatment of moderat to severe Moderate Alzheimer’s Disease.Methods A total of 76 patients with moderate to severe AD were randomly divided into two groups:The trial group was treated as Memantine combined with Donepezil, while the control group Donepezil only.All patients were received treatment for 52 weeks.Once every 4 weeks follow-up, The two groups were evaluated using different scales suan as Mini-Mental Status Examination subscale( MMSE) , Alzheimers′Disease Assessment Scale-cognitive subscale ( ADAS-Cog) , Activity of daily life subscale(ADL) and the Neuropsychiatric Inventory(NPI).Results 16 weeks later,there were significant differences in MMSE, ADAS-Cog, ADL and NPI scores of two groups(P<0.05);especially the scores of NPI decrease evidently (P<0.01) in the trial group at the 4th week.Patients in the trial group, as compared with those in the control group, There were not significant differences in the scores of MMSE, ADAS-Cog(P>0.05), but There were significant differences in the scores of ADL afetr 28th week(P<0.05), and there were significant differences in NPI scores afetr 4th week(P<0.05).Conclusions Donepezil can im-prove effectively the cognitive function, the daily living skills and psychological symptoms.Its combination with memantine is superi-or to its single use in improving the daily living skills and psychological symptoms.%目的：评估美金刚联合多奈哌齐治疗中、重度阿尔茨海默病（ AD）的临床疗效。方法76例中、重度AD患者随机分成2组，试验组予美金刚联合多奈哌齐，对照组单用多奈哌齐治疗52周，每4周随访1次，采用简易智能精神状态评价量表（ MMSE）、阿尔茨海默病评价量表—认知分表（ ADAS－cog）、日常生活能力量表（ ADL）、神经精神科问卷（ NPI）进行评估。结果两组治疗前后自身比较，治疗16周后MMSE、ADAS－cog、ADL、NPI评分差异有统计学意义（ P＜0．05），其中NPI评分试验组于治疗4周后即明显下降（ P＜0．01）。两组间的比较， MMSE、ADAS－cog 评分差异无统计学意义（ P＞0．05），ADL评分于治疗28周及以后差异有统计学意义（P＜0．05），NPI评分于治疗4周及以后差异有统计学意义（P＜0．01）。结论美金刚联合多奈哌齐以及单用多奈哌齐均能有效改善AD患者认知功能、日常生活能力及精神行为症状，但在改善精神行为症状和日常生活能力方面联合治疗效果优于单用多奈哌齐。
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