Observationof the Clinical Efficacy of Probiotic Preparation Combined with Donepezil in Patients withMild-moderate Cognitive Impairment andFrailty/YU Yifeng，RUANWenjing，ZHOU Zhun. // Medical Innovation of China，2025，22（16）： 022-026

[Abstract]Objective：To observe the efficacy of probiotic preparation combined with Donepezil in patients with mild-moderatecognitive impairmentand frailty.Method： A totalof 8Opatients with mild-moderatecognitive impairment and frailtyAlzheimer'sdisease （AD） treated in Shangrao People's Hospital from January 2O22 to January 2024 were selected and divided into study group and control group according to random number table method， with 40 cases in each group.Both groups were given nutritional support，the control group was treated with Donepezil， and the study group was treated with probiotic preparation based on the control group.The clinical effcacy，the score of mini-mental state examination （MMSE），Barthel index，prealbumin （PA），transferin （TRF），albumin （ALB）， interleukin-6 （IL-6），hypersensitive C reactive protein （hs-CRP）and serum neurofilament light chain protein （Nf-L） and neuron-specific enolase （NSE）levels were evaluated in both groups before treatment and 6 months after treatment. Result： After6 months of treatment， MMSE score and Barthel index in two groups were higher than those before treatment，and MMSE score in study group was higher than that in control group，the diferences were statistically significant（ P lt;0.05）; there was no significant difference in Barthel index between the two groups （ P gt;0.05）. The clinical effect of the study group was higher than that of the control group （ P lt;0.05）.After 6 months of treatment， thelevels of PA，TRF and ALB in two groups were higher thanthose before treatment，and those inthe study group were higher than those in the control group （ P lt;0.05）. The levels of IL-6， hs-CRP，Nf-L and NSE in both groups werelower than those before treatment，and those in the study group were lower than those in the control group 0 P lt;0.05）. Conclusion： Probiotic preparation combined with Donepezil can improve the cognitive level and living activity abilityofAD patients with mild-moderatecognitive impairmentand frailty，and improve the nutritional status， serum neuroinflammatory indexes and neuronal injury indexes of patients.

[Key words]Mild-moderate cognitive impairmentFrailtyDonepezil Probiotic preparation

First-author'saddress：Department of General Medicine，Shangrao People'sHospital，Shangrao 334000， China

doi：10.3969/j.issn.1674-4985.2025.16.006

认知障碍包含感情、记忆和思维障碍，引起认知障碍的原因较多，但除了器质性损伤外，大多认知障碍患者是由精神疾病所致，如神经衰弱、阿尔茨海默病、精神分裂症、抑郁症等[1-2]。衰弱是指人体的储备和功能下降，与年龄高度相关，是一种复杂的临床综合征，严重影响老年人的健康状态，也是老年医学中的重要研究方向[3。诸多研究发现，与年龄相关的衰弱会引起的大脑功能损伤会影响认知功能，造成认知功能障碍，而阿尔茨海默病（AD）即为老年人认知障碍的最后阶段[4-5]。在老年AD 患者中认知障碍和衰弱共存的现象普遍存在，多奈哌齐是治疗轻中度AD的常见药物，可以改善患者的认知功能及受损的脑血流，阻止神经元变性和坏死[6-7。近年来许多研究发现肠道菌群与神经系统疾病存在关联，补充益生菌维持肠道菌群稳态已成为干预神经系统疾病的新型措施[8-9]。但目前关于益生菌制剂干预认知障碍伴衰弱AD患者的报道较少，疗效有待探究。因此，本研究采用益生菌制剂联合多奈哌齐治疗轻中度认知障碍伴衰弱AD患者，观察其疗效，以期为认知障碍伴衰弱患者的治疗提供一种新的方案。

1资料与方法

1.1一般资料

选取2022年1月—2024年1月上饶市人民医院收治的80例轻中度认知障碍伴衰弱的AD患者作为研究对象。纳入标准：（1）符合AD诊断标准[1];（2）简易精神状态检查量表（MMSE）评分11＼～24分（小学及以下文化程度患者11＼～20分）[};（3）年龄60＼～85岁，Fried衰弱评分3＼～5分[2}；（4）具备一定的文化素养，能够配合相关量表的完成；……