回医烙灸督脉联合针刺治疗血管性痴呆的临床疗效观察

发布时间：2018-01-04 16:44

本文关键词：回医烙灸督脉联合针刺治疗血管性痴呆的临床疗效观察　出处：《宁夏医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的观察烙灸督脉联合针刺与单纯运用烙灸、针刺治疗血管性痴呆的临床疗效差异。方法按照随机、对照的临床研究方法,选择符合纳入标准的血管性痴呆患者120例,按就诊顺序以1:1:1比例随机分为烙灸针刺组、督脉烙灸组、常规针刺组,每组各40例。烙灸针刺组给予烙灸联合针刺治疗,针刺每天1次,每次30min,每周连续治疗5次,周末休息,烙灸每周一、周五治疗,每周2次。督脉烙灸组的治疗同烙灸针刺组中的烙灸治疗,常规针刺组的治疗同烙灸针刺组中的针刺治疗。1周为1个疗程,共治疗4周。分别在治疗前、治疗4周、12周后随访采用血管性痴呆辩证量表(SDSVD)、简易精神状态量表(MMSE)、修订长谷川痴呆量表(HDS)、日常生活活动量表(ADL)进行评分,评定临床疗效。结果1.总体疗效:采用全分析集方法(FAS分析法):治疗4周后烙灸针刺组总有效率为90.00%(36/40)、督脉烙灸组70.00%(28/40)、针刺组65.00%(26/40)。12周后随访,烙灸针刺组、督脉烙灸组和常规针刺组的总有效率分别为85.00%(34/40)、65.00%(26/40)和60.00%(24/40)。治疗4周、12周后随访各组的总有效率不全相同,差异有统计学意义(P0.05);烙灸针刺组与督脉烙灸组、常规针刺组比较,差异均有统计学意义(P10.05,P20.05);督脉烙灸组与常规针刺组疗效比较,差异无统计学意义(P0.05);利用符合方案集分析(PP分析法):治疗4周后烙灸针刺组总有效率为89.47%(34/38)、督脉烙灸组65.79%(25/38)、常规针刺组63.16%(24/38)。12周后随访烙灸针刺组、督脉烙灸组和常规针刺组的总有效率分别为86.84(33/38)%、60.52%(25/38)和57.89%(22/38)。治疗4周、12周后随访各组的总有效率不全相同,差异有统计学意义(P0.05);烙灸针刺组与督脉烙灸组、常规针刺组比较,差异均有统计学意义(P10.05,P20.05);督脉烙灸组与常规针刺组疗效比较,差异无统计学意义(P0.05)。2.各项评价指标比较:采用全分析集方法(FAS分析法)及符合方案集分析(PP分析法):治疗4周后3组各项评分较治疗前均有显著变化(均P0.01);烙灸针刺组SDSVD、MMSE、HDS、ADL评分改善优于督脉烙灸组和常规针刺组(均P0.05);督脉烙灸组与常规针刺组治疗后的各项指标评分差异无统计学意义(P0.05)。12周后随访,采用全分析集方法(FAS分析法)及符合方案集分析(PP分析法):烙灸针刺组SDSVD、MMSE、HDS、ADL评分改善优于督脉烙灸组和常规针刺组(均P0.05);督脉烙灸组与常规针刺组各项指标评分差异无统计学意义(P0.05)。结论1.回医烙灸督脉联合针刺治疗血管性痴呆在总体疗效方面优于单纯督脉烙灸和常规针刺治疗;2.回医烙灸督脉联合针刺治疗血管性痴呆在改善患者的中医证候积分、认知功能,恢复日常活动能力方面优于单纯督脉烙灸和常规针刺治疗;3.督脉烙灸和常规针刺治疗血管性痴呆在临床疗效、改善各项评价指标方面疗效相近,但督脉烙灸组在耗材、省时和节约医疗费用等方面优于常规针刺组。
[Abstract]:Objective to observe the difference of clinical effect between cauterized moxibustion combined with acupuncture and simple cauterization moxibustion and acupuncture in treating vascular dementia. One hundred and twenty patients with vascular dementia according to the inclusive criteria were selected and randomly divided into four groups according to the proportion of 1: 1: 1: 1: 1: 1: 1: 1: 1: 1: 1: 1: 1: 1: 1: 1: 1, 1: 1, 1: 1, respectively. 40 cases in each group were treated with cauterized moxibustion combined with acupuncture, acupuncture once a day for 30 minutes, 5 times a week, rest on the weekend, cautery moxibustion every Monday, Friday treatment. Two times a week. The treatment of du meridian cauterization moxibustion group is the same as the cauterization moxibustion treatment in the cautery moxibustion group, and the acupuncture treatment in the routine acupuncture group and the cauterized moxibustion group is a course of treatment for a period of 4 weeks, respectively before the treatment. After 4 weeks and 12 weeks of treatment, the patients were followed up with Vascular dementia Dialectic scale (SDSVD), simple Mental State scale (MMSE), and modified Hasegawa dementia scale (HDS). Activity of daily living (ADL) was evaluated. Evaluation of clinical efficacy. 1. Overall efficacy: the total effective rate of the cauterized moxibustion acupuncture group was 90.0036 / 40 after 4 weeks of treatment. 2. The moxibustion group was followed up by 26 / 40 / 12 weeks, and the moxibustion group was followed up by cautery moxibustion for 28 / 40%, and the acupuncture group was followed up by 65.00% of 26 / 40. 12 weeks later, the burn moxibustion group. The total effective rates of the moxibustion group and the routine acupuncture group were 85.00% and 65.00% and 65.00% respectively. After 12 weeks of follow-up, the total effective rate of each group was not all the same, and the difference was statistically significant (P 0.05). The differences between cauterized moxibustion group and du vein cautery moxibustion group and routine acupuncture group were statistically significant (P 10.05) and P 20.05 (P < 0.05). There was no significant difference in the curative effect between the du vein cauterization moxibustion group and the routine acupuncture group (P 0.05). The total effective rate of cauterized moxibustion group was 89.47% and that of du vein cauterized moxibustion group was 65.79% / 38% after 4 weeks of treatment. The total effective rates of the routine acupuncture group and the routine acupuncture group were 86.84% 33 / 38 / 38% after follow-up for 24 / 38 / 12 weeks, respectively, in the du vein cautery moxibustion group and the routine acupuncture group. 60.52% 25 / 38) and 57.89% 22 / 38. After 4 weeks and 12 weeks of treatment, the total effective rate of each group was not all the same, and the difference was statistically significant (P 0.05). The differences between cauterized moxibustion group and du vein cautery moxibustion group and routine acupuncture group were statistically significant (P 10.05) and P 20.05 (P < 0.05). Comparison of curative effect between the moxibustion group of du vein cautery and the routine acupuncture group. There was no statistical difference (P0.05. 2.Compared with each evaluation index: the total analysis set method was used to analyze the FAS) and the consistent scheme set analysis method was used to analyze the PP). : after 4 weeks of treatment, the scores of the three groups were significantly different from those before treatment (all P 0.01). The improvement of ADL score of SDSVDX MMSE MMSE in the cautery moxibustion group was better than that in the du vein cautery moxibustion group and the routine acupuncture group (all P 0.05). There was no significant difference in the scores of the indexes between the two groups after treatment (P0.050.12 weeks later). The whole analysis set method was used to analyze MMSE HDS and the consistent scheme set analysis was used to analyze the PP method: the group of cautery moxibustion and acupuncture group were treated with MMSEN HDS. The improvement of ADL score was better than that of du vein cautery moxibustion group and routine acupuncture group (P 0.05). There was no significant difference in the scores of various indexes between the du meridian cautery moxibustion group and the routine acupuncture group (P0.05). Conclusion 1.The general curative effect of treating vascular dementia with cauterized moxibustion combined with acupuncture is superior to that of simple cauterization moxibustion of du vein and routine acupuncture treatment. 2. Traditional Chinese medicine syndromes score, cognitive function and recovery of daily activity of patients with vascular dementia were better than those of traditional Chinese medicine moxibustion and routine acupuncture treatment. 3. The curative effect on vascular dementia treated by cauterized moxibustion of du vein and routine acupuncture was similar, but the effect of cauterization moxibustion group was superior to that of routine acupuncture group in material consumption, time saving and medical expense saving.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

【参考文献】