补阳还五汤加味联合西医疗法治疗血管性痴呆的临床疗效观察

发布时间：2018-04-01 20:28

本文选题：补阳还五汤　切入点：血管性痴呆　出处：《湖北中医药大学》2012年硕士论文

【摘要】：目的：观察补阳还五汤加味联合西医疗法治疗血管性痴呆的临床疗效及安全性。为运用中医内治法联合西医疗法治疗血管性痴呆提供一些临床参考价值,并以期探索一种经济安全、疗效可靠、适宜治疗血管性痴呆的新方法。方法：入选60例病例均来自武汉市一医院神经内科门诊及住院部,纳入参照2002年中华医学会神经病学分会血管性痴呆诊断标准草案及2000年中国中医药学会内科脑病专业委员会通过的《血管性痴呆诊断、辩证及疗效判定标准》。痴呆分度及疗效根据临床痴呆评定量表(CDR),简易精神状态检查(MMSE),Blessed行为量表(BBS),血管性痴呆辩证量表(SDSVD),日常行为量表(ADL)等进行评定。试验采用随机、单盲对照法,将60病例分为治疗组与对照组,每组30例；对照组口服西药尼莫地平片、石杉碱甲片、奥拉西坦片并进行康复训练；治疗组在对照组的基础上加用补阳还五汤加减方。治疗8周后对患者治疗前、后的认知功能,中医症候,日常行为能力,神经精神症状进行疗效评价。并定期进行三大常规,肝、肾功能及心电图检测以评价试验安全性。结果：(1)经过8周治疗,60例患者无脱落和剔除病例,均按方案配合完成临床试验。(2)经过8周治疗,在改善认知功能方面进行临床疗效评价,发现两组均有效的改善了患者的临床症状(P0.05),治疗组的总有效率明显高于对照组(P0.05),具有统计学意义。(3)治疗8周后,两组治疗前后的中医症候积分(SDSVD)以及BBS量表的评定均显现有显著的差异(P0.01),且两组组间比较即治疗组与对照组比较差异有统计学意义(P0.05),说明治疗组较对照组改善认知功能障碍效果更为显著。(4)经过8周治疗,两组治疗后MMSE、ADL量表评分比较P0.05,显示两组间无明显差异,但治疗组总体有效率均高于对照组。(5)在安全性方面,中药方和西医内服药均未发现对人体存在明显的毒副作用。结论：通过本次试验观察,在运用西医药物治疗的基础上,联合中药补阳还五汤并配合康复训练治疗血管性痴呆,具有确切疗效。不仅可以较为有效的改善患者认知功能障碍,还可以提高患者的生活质量,且无明显不良反应。不仅体现了中西医结合治疗血管性痴呆的优势,也为临床上治疗血管性痴呆开拓了一个新的思路。
[Abstract]:Objective: to observe the clinical efficacy and safety of Buyang Huanwu decoction combined with western medicine in the treatment of vascular dementia.To provide some clinical reference value for the treatment of vascular dementia by internal treatment of traditional Chinese medicine combined with western medicine, and to explore a new method for the treatment of vascular dementia, which is economical and safe, reliable in curative effect and suitable for treatment of vascular dementia.Methods: all 60 cases were selected from Department of Neurology, Department of Neurology, first Hospital of Wuhan.According to the draft criteria for the diagnosis of vascular dementia adopted by the Chinese Medical Association Neurology Branch in 2002 and the diagnosis, Dialectical and Therapeutic criteria of Vascular dementia adopted by the Professional Committee on Encephalopathy of the Chinese Academy of traditional Chinese Medicine in 2000.The classification and efficacy of dementia were evaluated according to the clinical dementia rating scale (CDR), the simple mental state examination (MMSE) and the Blessed behavior scale (BBSN), the vascular dementia dialectical scale (SDSVD), and the daily behavior scale (ADL).60 cases were randomly divided into treatment group (n = 30) and control group (n = 30). The control group was treated with nimodipine tablet, Huperzine A tablet, oxacitam tablet and rehabilitation training.Treatment group on the basis of the control group plus Buyang Huanwu decoction.After 8 weeks of treatment, the patients' cognitive function, TCM symptoms, daily behavior ability and neuropsychiatric symptoms were evaluated before and after treatment.Three routine, liver, renal and electrocardiogram tests were performed regularly to evaluate the safety of the test.Results (1) after 8 weeks of treatment, 60 cases of patients without abscission or elimination were treated in accordance with the plan and completed the clinical trial. 2) after 8 weeks of treatment, the clinical effect of improving cognitive function was evaluated.The effect of cognitive dysfunction was more significant. 4) after 8 weeks of treatment,Conclusion: on the basis of western medicine treatment, combined with Buyang Huanwu decoction and rehabilitation training, it is effective to treat vascular dementia.It can not only improve the cognitive dysfunction, but also improve the quality of life.It not only reflects the advantages of integrated traditional Chinese and western medicine in the treatment of vascular dementia, but also opens up a new idea for clinical treatment of vascular dementia.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.13

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