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識多一點點 – 老年痴呆症(二)
2009-07-28

吳義銘醫生
香港老年痴呆症協會副主席(外務)


治療老人痴呆症
治療方法主要分為藥物治療及非藥物治療。

藥物治療
針對治療早期及中期痴呆症的藥物有Donepezil、Rivastigmine 和Galantamine,主要運用「乙醯膽鹼酶抑制劑」(Cholinesterase Inhibitors),防止大腦內的一種稱為「乙醯膽鹼」的化學物質被分解。很多醫學研究指出,減少「乙醯膽鹼」的流失對控制早期及中期痴呆症的病情有一定程度的功效。同時,「乙醯膽鹼酶抑制劑」亦能幫助控制因路易體痴呆症引起的幻覺、血管性痴呆症及由柏金遜症引起的痴呆症病情。當患者步入中期痴呆症階段,而上述藥物的功效亦未見十分顯著時,便會考慮加入另一種稱為memantine的藥物。這亦能穩定患者的病情,減慢進一步的衰退。不過,所有治療老年痴呆症的藥物均須由醫生處方。

非藥物治療
老年痴呆症的非藥物治療跟藥物治療同樣重要。很多學術文獻已證實多種非藥物治療的方法,包括認知訓練、現實導向、確認治療、多感官刺激及其他心理行為治療等,均能有效地改善他們的情緒和行為問題。除了尋求不同的治療方法外,照顧者亦需要相關的社區服務支援,例如日間中心、到戶/家居訓練、暫托服務和照顧者支援等。

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