从心肾论治轻度认知损害中医综合治疗方案的临床疗效研究

发布时间：2018-03-07 06:29

本文选题：心肾论治　切入点：轻度认知损害　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:评价基于从心肾论治轻度认知损害理论的中医综合疗法治疗轻度认知损害的临床疗效和安全性,为中医药治疗轻度认知损害及预防老年痴呆的发生提供新途径。方法:应用随机数字表法将符合纳入标准的90例患者随机分为单纯中药组(30例)、综合疗法组(30例)及对照组(30例),三组均给予控制高血压、高血糖、高血脂等原发病的基础治疗,同时单纯中药组辨证采用中药(心气虚肾精不足型-调补心肾方、肾阳虚心火旺型-交通心肾方)治疗,综合疗法组辨证采用中药配合针刺、推拿、中药熏蒸等中医特色疗法,分别比较治疗前、治疗第6周及第12周中医证候积分、简易精神状态检查(MMSE)、ADAS-Cog量表延迟词语回忆(ADAS-COG-DVR)及工具性日常生活活动(IADL)等多个认知量表分值变化,治疗后随访6个月观察其远期疗效及安全性。结果:(一)治疗第6周1.单纯中药组与综合疗法组较本组治疗前中医证候积分、MMSE及ADAS-COG-DVR均有改善,综合疗法组差异有统计学意义(P0.05),单纯中药组差异无统计学意义(P0.05);2.综合疗法组较单纯中药组、对照组中医证候积分、MMSE及ADAS-COG-DVR有所改善,差异有统计学意义(P0.05);3.三组IADL评分均无明显改善;(二)治疗第12周1.单纯中药组与综合疗法组较本组治疗前中医证候积分、MMSE及ADAS-COG-DVR改善明显,差异均有统计学意义(P0.05),且均优于对照组(P0.05);2.综合疗法组与单纯中药组比较中医证候积分、MMSE及ADAS-COG-DVR评分差异无统计学意义(P0.05);3.三组中仅综合疗法组IADL评分有改善,但差异无统计学意义(P0.05);结论:从心肾论治轻度认知损害中医综合治疗方案临床疗效优势显著,选择适宜的中医综合治疗方案可以明显改善临床症状,缩短治疗周期,提高MMSE积分及降低ADAS-COG-DVR积分,疗效肯定,值得临床进一步推广应用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of TCM combined therapy for mild cognitive impairment based on the theory of heart and kidney. To provide a new approach for the treatment of mild cognitive impairment and the prevention of Alzheimer's disease with traditional Chinese medicine methods: 90 patients with mild cognitive impairment were randomly divided into two groups: 30 cases in Chinese medicine group and 30 cases in comprehensive therapy group. ) and control group (30 cases). Basic treatment of primary diseases such as hyperglycemia and hyperlipidemia, while the traditional Chinese medicine group was treated with traditional Chinese medicine (deficiency of heart and qi, deficiency of kidney essence-regulating heart and kidney prescription, kidney yang deficiency and heart fire flourishing type-communicating heart and kidney prescription). The syndromes of the combined therapy group were treated with traditional Chinese medicine combined with acupuncture, massage, Chinese medicine fumigation and so on. The scores of TCM syndromes at the 6th week and 12th week before treatment were compared respectively. The scores of ADAS-COG-DVR and ADAS-COG-DVR (ADAS-COG-DVR) and ADAS-COG-DVR (ADAS-COG-DVR) as well as the scores of ADAS-Cog and IADLwere changed. After 6 months of follow-up, the long-term efficacy and safety were observed. Results (1) in the sixth week of treatment, 1. The traditional Chinese medicine group and the combined therapy group were better than the traditional Chinese medicine syndrome score and ADAS-COG-DVR before treatment. There was significant difference between the combined therapy group and the traditional Chinese medicine group, but there was no significant difference between the traditional Chinese medicine group and the traditional Chinese medicine group. The combined therapy group was better than the traditional Chinese medicine group and the control group was improved in TCM syndromes score and ADAS-COG-DVR. The difference was statistically significant (P < 0.05). The scores of IADL in the three groups were not significantly improved. (2) at the 12th week of treatment, 1. The scores of TCM syndromes and ADAS-COG-DVR were significantly improved in the traditional Chinese medicine group and the combined therapy group. The difference was statistically significant (P 0.05) and was better than that of the control group (P 0.05). There was no significant difference in the scores of TCM syndromes and ADAS-COG-DVR between the combined therapy group and the traditional Chinese medicine group. The IADL score of the three groups was improved only in the combined therapy group. But the difference was not statistically significant (P 0.05). Conclusion: the comprehensive treatment of mild cognitive impairment based on heart and kidney has a significant clinical curative effect, and the selection of suitable comprehensive treatment can obviously improve the clinical symptoms and shorten the treatment period. To increase MMSE score and reduce ADAS-COG-DVR score is effective and worthy of further clinical application.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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