补肾法联合丁苯酞治疗血管性痴呆的临床研究

发布时间：2018-08-26 20:25

【摘要】：目的:探讨补肾法联合丁苯酞软胶囊以及单药丁苯酞软胶囊治疗血管性痴呆患者的临床疗效。方法:在广西中医药大学附属瑞康医院神经内科门诊及病房收集2014年10月到2016年10月的血管性痴呆患者78例病例,根据随机数字表法按1:1:1随机分配到治疗组1、治疗组2和对照组,治疗组1、治疗组2和对照组分别为26例、26例和26例。治疗组1给予补肾益智中药联合丁苯酞软胶囊口服以及内科基础治疗,治疗组2给予丁苯酞软胶囊以及内科基础治疗,对照组单纯给予内科基础治疗,三组治疗疗程均为90天。治疗前分别予治疗组和对照组测试简易智能状态检查量表(MMSE)、长谷川智能量表(HDS)、日常生活能力评定量表(ADL)、事件相关电位(P300)、中医证候疗效积分,治疗后3个月分别再次测量上述量表。将采集到的资料数据使用SPSS19.0统计分析软件进行汇总、分析。计量资料采用t检验,计数资料采用X2检验。最后对汇总结果进行归纳、总结。结果:(1)纳入78例病例,无脱落及剔除病例,均能全程完成临床实验;(2)三组受试对象治疗前后分别测试MMSE、HDS、ADL评分并进行两两比较,结果提示治疗组1较治疗组2、对照组上述评分改善效果最佳(p值均0.05),其次治疗组2对改善MMSE、HDS、ADL评分疗效较对照组好(p值0.05),对照组对改善MMSE、HDS、ADL评分无明显疗效(p值0.05)。(3)三组治疗后中医证候疗效比较:治疗组1显效5例、好转15例、无效6例,总有效率为76.92%;治疗组2显效1例、好转5例、无效20例,总有效率为23.07%;对照组显效0例、好转4例、无效22例,总有效率为15.38%。从表6数据结果显示治疗组1比治疗组2和对照组改善中医证候疗效积分效果均好(P值0.05),治疗组2与对照组无改善中医证候疗效积分效果(P值0.05)。(4)三组治疗前后事件相关电位比较,治疗组1均较治疗组2、对照组潜伏期和波幅改善最佳(P值均0.05),其次治疗组2对于事件相关电位改善效果较对照组好(P值0.05),对照组无明显改善事件相关电位疗效。结论:(1)补肾法联合丁苯酞软胶囊对改善血管性痴呆患者的认知功能有一定的临床疗效,疗效优于单药丁苯酞软胶囊。(2)补肾法可能可以改善呆病肾精不足患者的中医证候疗效积分。(3)补肾法联合丁苯酞软胶囊治疗血管性痴呆的过程中未发现明显毒副作用,安全有效,值得进一步深入研究。
[Abstract]:Objective: to investigate the clinical effect of tonifying kidney method combined with butyphthalide soft capsule and single drug butyphthalide soft capsule in the treatment of vascular dementia. Methods: 78 cases of vascular dementia were collected from outpatient and ward of Department of Neurology, Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine from October 2014 to October 2016. According to the method of random number table, 26 cases were randomly assigned to treatment group 1, treatment group 2 and control group, treatment group 1, treatment group 2 and control group 26 cases and 26 cases respectively. The treatment group 1 was given Bushen Yizhi Chinese medicine combined with butyphthalide soft capsule orally and basic medical treatment, the treatment group 2 was given butyphthalide soft capsule and basic medical treatment, the control group was given only internal medicine basic treatment, the three groups were treated for 90 days. Before treatment, the patients in the treatment group and the control group were given the simple Intelligent State examination scale (MMSE),) and the (MMSE), Hasegawa Intelligent scale (HDS),) before treatment. The (ADL), event-related potential (P300) was evaluated by the activity of Daily living scale (ADL), and the curative effect score of TCM syndrome was scored. The above scale was measured again 3 months after treatment. The collected data will be collected using SPSS19.0 statistical analysis software for summary, analysis. T test was used for measuring data and X 2 test was used for counting data. Finally, the summary results are summarized and summarized. Results: (1) 78 cases were included in the study, all of them were able to complete the whole clinical trial, and (2) before and after treatment, the MMSE,HDS,ADL scores of the three groups were measured and compared. The results suggest that the treatment group 1 is better than the treatment group 2, the control group has the best improvement effect on the above score (p all 0. 05), the treatment group 2 is better than the control group in improving the MMSE,HDS,ADL score (p 0. 05), and the control group has no obvious effect on improving the MMSE,HDS,ADL score (p 0. 05). (3). Comparison of TCM syndromes after treatment in the treatment group: 5 cases in the treatment group 1, 15 cases were improved, 6 cases were ineffective, the total effective rate was 76.92; in the treatment group, there were 1 case of remarkable effect, 5 cases of improvement and 20 cases of ineffectiveness, the total effective rate was 23.07, while in the control group, there were 0 cases of marked effect, 4 cases of improvement, 22 cases of ineffectiveness, and 15.38% of total effective rate. From the data of table 6, the results show that the treatment group 1 is better than the treatment group 2 and the control group in improving the integral effect of TCM syndromes (P0. 05), while the treatment group 2 and the control group have no effect of improving the curative effect of TCM syndromes (P0. 05). (4) before and after treatment. Part related potential comparison, Treatment group 1 was better than treatment group 2, the latency and amplitude of wave in control group were the best (P 0.05), the effect of treatment group 2 was better than that of control group (P 0.05), but no significant improvement of event-related potential was found in control group. Conclusion: (1) Bushen method combined with butyphthalide soft capsule can improve the cognitive function of vascular dementia patients. The curative effect was better than that of butyphthalide soft capsule. (2) Renal tonifying method may improve TCM syndromes of patients with deficiency of kidney essence. (3) Bushen method combined with Buphthalide soft capsule in the treatment of vascular dementia has no obvious toxic side effects and is safe and effective. It is worth further study.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.13

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