交通心肾法治疗肾阴亏虚型血管性痴呆的临床疗效研究

发布时间：2018-04-23 02:10

本文选题：血管性痴呆 + 交通心肾法　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:通过观察血管性痴呆(vascular dementia,简称VD)患者治疗前后的简易智能精神状态检查(MMSE)量表评分、日常生活活动能力(ADL)量表评分和中医证候量表评分变化情况,评估交通心肾法治疗肾阴亏虚型VD的临床疗效。方法:选取2014年09月至2015年11月期间,广西中医药大学第一附属医院脑病科门诊就诊的VD患者60例,所有患者均符合VD的诊断标准,且中医辨证为肾阴亏虚的患者。按照患者门诊就诊的先后顺序进行编号,采用随机数字表法的分组方法分为治疗组与对照组各30例。对照组给予盐酸多奈哌齐片5mg,每晚睡前口服,治疗组则在对照组治疗的基础上,予加服交通心肾法中药(药物包括:黄连9g,肉桂3g,黄芩10g,阿胶6g,白芍10g,熟地黄24g,山药10g,枸杞10g,鹿角胶6g,菟丝子10g,龟板胶10g,川牛膝10g,山茱萸12g,新鲜鸡子黄1枚)治疗,对两组中合并有高血糖、高血压、冠心病、高脂血症等患者予控制血糖、控制血压、调脂稳斑、抗血小板聚集等基础药物治疗。以1个月为1个疗程,连服3个疗程。记录治疗组和对照组患者治疗前后的MMSE量表评分、ADL量表评分和中医证候量表评分变化情况,使用SPSS 16.0软件进行统计学分析,对治疗效果进行评价。结果:(1)MMSE评分:与治疗前比较,治疗组分别在治疗1个月后、2个月后、3个月后的MMSE评分均明显升高(P0.01),对照组也在治疗1个月后、2个月后、3个月后的MMSE评分均有升高(P0.05)。两组各治疗时间点的MMSE评分比较,差异具有统计学意义(P0.05)。(2)ADL评分:与治疗前比较,治疗组分别在治疗1个月后、2个月后、3个月后的ADL评分均有明显升高(P0.01),对照组在治疗1个月后、2个月后、3个月后的ADL评分均有升高(P0.05)。两组各治疗时间点的ADL评分比较,差异具有统计学意义(P0.05)。(3)中医证候评分:与治疗前比较,治疗组分别在治疗1个月后、2个月后、3个月后的中医证候评分均有明显降低(P0.01),对照组在治疗1个月后、2个月后、3个月后的中医证候评分也均有降低(P0.05),两组各治疗时间点的中医证候评分比较,差异均具有统计学意义(P0.05)。(4)中医证候疗效:治疗组总有效率为90.00%,对照组总有效率为66.67%,治疗组和对照组间的总有效率比较具有显著性差异(P0.05)。(5)安全性评价:两组治疗前后的血、尿常规及肝、肾功能均无明显改变,两组治疗前后比较差异均无统计学意义(P0.05)。结论:(1)交通心肾法治疗肾阴亏虚型VD具有确切临床疗效;(2)本法在治疗VD的临床疗效及改善VD患者的MMSE、ADL、中医证候评分方面均优于单用盐酸多奈哌齐治疗。
[Abstract]:Objective: to observe the changes of MMSE scale, ADL scale and TCM syndrome scale in patients with vascular dementia before and after treatment. To evaluate the clinical effect of the method of communicating heart and kidney in treating VD with deficiency of kidney yin. Methods: from September 2014 to November 2015, 60 VD patients in the Department of Encephalopathy of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine were selected. All the patients met the diagnostic criteria of VD, and the TCM syndrome differentiation was the deficiency of kidney yin. According to the order of outpatient visits, the patients were divided into treatment group (n = 30) and control group (n = 30). The control group was given 5 mg of Donepezil hydrochloride and taken orally before bedtime every night, while the treatment group was treated on the basis of the control group. They were treated with Chinese medicine (including Huanglian 9g, cinnamon 3g, Scutellaria 10g, Ejiao 6g, Paeoniae Alba 10g, cooked Rehmannia 24g, yam 10g, Lycium barbarum 10g, antler gum 6g, dodder 10g, glans gel 10g, Achyranthes bidentata 10g, doggy 12g, fresh chicken yellow). Patients with hyperglycemia, hypertension, coronary heart disease and hyperlipidemia were treated with basic drugs such as controlling blood glucose, controlling blood pressure, regulating lipid and stabilizing plaque, and anti-platelet aggregation. Take 1 month as a course of treatment, and take 3 courses of treatment. The changes of MMSE scale and TCM syndrome scale were recorded before and after treatment in the treatment group and the control group. SPSS 16.0 software was used for statistical analysis to evaluate the therapeutic effect. Results: compared with before treatment, the MMSE scores of the treatment group increased significantly after 1 month, 2 months and 3 months respectively, while the MMSE scores of the control group also increased after 1 month, 2 months and 3 months respectively. There were significant differences in MMSE scores between the two groups at each time point of treatment. After 1 month, 2 months and 3 months after treatment, the ADL scores in the treatment group were significantly higher than those in the control group. The ADL scores in the control group were increased after 1 month, 2 months and 3 months, respectively. The difference of ADL score between the two groups at each treatment time point was statistically significant (P 0.05. 0. 0. 3) TCM syndromes score: compared with before treatment, After 1 month, 2 months and 3 months after treatment, the TCM syndrome scores in the treatment group were significantly lower than those in the control group after 1 month, 2 months and 3 months, respectively, and the scores of TCM syndromes in the control group were also decreased after 1 month, 2 months and 3 months, respectively. Comparison of TCM syndromes score at time points, The difference was statistically significant (P 0.05, P 0.05, P < 0.05).) the total effective rate of the treatment group was 90.00.The total effective rate of the control group was 66.67.The total effective rate between the treatment group and the control group was significantly different (P0.05. 5) the safety evaluation: the blood before and after treatment in the two groups, the total effective rate of the treatment group was 90.005, the total effective rate of the control group was 66.67, and the total effective rate was significantly different between the two groups. Urine routine and liver and renal function were not significantly changed, and there was no significant difference between the two groups before and after treatment (P 0.05). Conclusion (1) the method of communicating heart and kidney is effective in treating VD with deficiency of kidney yin. This method is superior to Donepezil hydrochloride in the treatment of VD and the improvement of MMSE ADL in VD patients.
【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

【参考文献】