益气聪明汤加味治疗气虚痰瘀型血管性痴呆的临床研究

发布时间：2018-03-31 01:22

本文选题：益气聪明汤加味　切入点：血管性痴呆　出处：《广西中医药大学》2016年硕士论文

【摘要】：目的:家师根据自己多年临床经验,以益气聪明汤加味治疗血管性痴呆。家师认为,血管性痴呆中医的主要病机为气虚为本,痰瘀为标,由痰致瘀,以痰为主,其病位虽在脑,而根本却在脾,所以治疗的关键在于益气健脾,并主张在痰瘀同治的基础上重在化痰。此次在整理古今中医文献的基础上,拟中药益气聪明汤加味治疗气虚痰瘀型血管性痴呆患者,观察其临床疗效和安全性。方法:根据西医诊断标准和中医诊断及中医辨证分型标准,采取随机分组法,将所收集自2015年5月至2015年12月广西中医药大学第一附属医院神经内科二病区门诊和住院62例血管性痴呆患者随机分为2组,治疗组32例,予益气聪明汤加味治疗,对照组30例,予盐酸多奈哌齐片治疗,4周为1疗程,治疗3个疗程。采用简易智能精神状态检查量表(MMSE)评价患者的认知功能及痴呆的严重程度,采用日常生活能力量表(ADL)评价患者的日常生活自理能力,采用AD评定量表的认知次级量表(ADAS-cog)评价患者认知功能及精神行为。治疗前后分别由专业人员进行简易智能量表(MMSE)、日常生活活动量表(ADL)、ADAS-Cog量表积分评定,中医证候和安全性积分分布评分标准进行疗效评价并对结果进行统计学分析,得出相应的治疗结论。结果:1、益气聪明汤治疗老年性痴呆临床总有效率为78.12%,治疗后治疗组与对照组的MMSE量表、ADL量表、ADAS-cog量表评分都较治疗前有所改善(p0.05),治疗后两组各积分比较无统计学差异(p0.05),中医临床症状积分方面治疗组治疗后在智能减退,善忘,神疲乏力,嗜睡,咳嗽咯痰,自汗出,耳鸣耳聋,二便失禁等症状都较治疗前有好转(p0.05);对照组治疗前后比较,智能减退,善忘,呆钝少言,反应迟钝,小便频数或失禁有所好转(p0.05);与对照组相比,治疗组在神疲乏力,嗜睡,咳嗽咯痰,自汗出的症状改善上有统计学差异(p0.05)。2、治疗过程中患者亦无明显不适。结论:益气聪明汤加味治疗气虚痰瘀型血管性痴呆安全有效。
[Abstract]:Objective: according to our many years clinical experience, we treat vascular dementia with Yiqi Lingtang. The main pathogenesis of vascular dementia is qi deficiency, phlegm stasis is the standard, phlegm is the main cause, phlegm is the main disease, although the disease is located in the brain, the main pathogenesis of vascular dementia is Qi deficiency, phlegm stasis is the standard, phlegm is the main cause, and the disease is located in the brain. But it is basically in the spleen, so the key to treatment is to invigorate qi and invigorate the spleen, and it is advocated to focus on resolving phlegm on the basis of simultaneous treatment of phlegm and blood stasis. This time, on the basis of sorting out the ancient and modern TCM documents, In order to treat vascular dementia with Qi deficiency and phlegm stasis, the clinical efficacy and safety were observed. Methods: according to the criteria of western medicine diagnosis, traditional Chinese medicine diagnosis and TCM syndrome differentiation, random grouping method was used to treat vascular dementia with Qi deficiency and phlegm stasis. From May 2015 to December 2015, 62 patients with vascular dementia were randomly divided into two groups, 32 patients in the treatment group, treated with Yiqi Lingtang decoction, from May 2015 to December 2015 in Department of Neurology, first affiliated Hospital of Guangxi University of traditional Chinese Medicine, and 62 patients with vascular dementia were randomly divided into two groups. 30 patients in the control group were treated with Donepezil Hydrochloride for 4 weeks and 3 courses. The cognitive function and the severity of dementia were evaluated by MMSE. ADL was used to evaluate the self-care ability of daily life of patients. The cognitive function and mental behavior of patients were evaluated by ADAS-cog. Before and after treatment, MMSE was performed by professional personnel and ADAS-Cog was evaluated by ADLL and ADAS-Cog before and after treatment. TCM syndromes and safety score were evaluated and the results were statistically analyzed. Results the total effective rate of the treatment of Alzheimer's disease was 78.12. After treatment, the scores of ADAS-cog in the treatment group and control group were improved compared with those before treatment, and the two groups after treatment improved the score of ADAS-cog scale. After treatment, the treatment group and the control group both improved the score of ADAS-cog scale, and the two groups after treatment improved the score of ADAS-cog scale. There was no statistical difference in the scores between the two groups (P 0.05). The intelligence of the treatment group was decreased after treatment in terms of clinical symptom integral of traditional Chinese medicine (TCM). The symptoms of forgetfulness, fatigue, drowsiness, cough and sputum, spontaneous sweating, tinnitus and deafness, and incontinence of the second stool were all better than those before and after treatment. Compared with the control group, the treatment group was tired, sleepy, cough and sputum. There was a statistical difference in the improvement of the symptoms of self-sweating, and there was no obvious discomfort in the treatment process. Conclusion: Yiqi Lingming decoction is safe and effective in the treatment of vascular dementia of Qi deficiency and phlegm stasis type.
【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】：2016
【分类号】：R277.7

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