针刺心包经联合活血通络合剂治疗梗塞后血管性痴呆的临床研究

发布时间：2018-05-03 03:25

本文选题：心包经 + 活血通络合剂　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：通过观察简易精神状态评价量表(MMSE量表)、日常生活能力量表(ADL量表)及血管性痴呆中医辨证量表(SDSVD量表)的评分变化,评价针刺心包经联合活血通络合剂治疗梗塞后气虚血瘀型血管性痴呆的临床疗效。方法：筛选2014年2月至2016年2月期间,在徐州市中医院针灸脑病科门诊及病房就诊的60例梗塞后气虚血瘀型血管性痴呆患者。所有病例均符合纳入标准,采用随机单盲对照的设计方法,将其分为常规治疗组、肾经对照组、心包经试验组,每组各20例,以4周为一个疗程,共观察2个疗程。治疗前后分别记录MMSE、ADL、SDSVD量表的评分变化,进行统计学分析,以评价针刺心包经联合活血通络合剂治疗梗塞后气虚血瘀型血管性痴呆的临床疗效。结果：(1)三组治疗后MMSE评分较前均有所升高,肾经组、心包经组较常规组升高明显(P0.05),肾经组与心包经组相当(P0.05)；心包经组MMSE有效率优于常规治疗组(P0.017),肾经组与常规治疗组、肾经组与心包经组MMSE疗效相当(P0.017)； (2)三组治疗后ADL评分均下降,肾经组、心包经组较常规治疗组下降明显(P0.05),肾经组与心包经组程度相当(P0.05)；心包经组ADL疗效优于常规治疗组(P0.017),肾经组与常规治疗组、肾经组与心包经组ADL疗效无统计学意义(P0.017)；(3)三组治疗后SDSVD评分均下降(P0.05),组间比较差异无统计学意义(P0.05)；肾经组及心包经组治疗后SDSVD疗效均较常规治疗组为优(P0.017),肾经组与心包经组疗效相当(P0.017)； (4)安全性指标较前变化不明显。结论：针刺心包经联合活血通络合剂治疗对于改善梗塞后气虚血瘀型血管性痴呆患者的认知功能、日常生活能力及中医症候行之有效,且临床应用尚未发现明显不良反应及不良事件,值得临床推广以改善血管性痴呆患者的临床症状,降低致残率,提高患者的生活质量。
[Abstract]:Objective: To evaluate the clinical effect of acupuncture pericardium combined with Huoxue Tongluo mixture on vascular dementia after infarction in the treatment of qi deficiency and blood stasis type by observing the simple mental state evaluation scale (MMSE scale), the daily living capacity scale (ADL scale) and the TCM syndrome differentiation scale of vascular dementia (SDSVD scale). During February 2016, 60 patients with Qi deficiency and blood stasis type vascular dementia were treated in the clinic and ward of acupuncture and moxibustion in Xuzhou Hospital of Traditional Chinese Medicine. All cases were in accordance with the inclusion criteria. The randomized, single blind control design method was used to divide them into routine treatment group, renal meridian control group, pericardial test group, 20 cases in each group, with 4 weeks as one. A total of 2 courses of treatment were observed. The scores of the MMSE, ADL and SDSVD scales were recorded before and after the treatment, and the clinical efficacy of the acupuncture pericardium combined with Huoxue Tongluo mixture for the treatment of qi deficiency and blood stasis type vascular dementia after infarction was evaluated. Results: (1) the three groups had higher MMSE scores than before, the renal meridian group and the pericardium group. Compared with the conventional group (P0.05), the renal meridian group was equivalent to the pericardium group (P0.05), the effective rate of MMSE in the pericardium group was better than that of the conventional treatment group (P0.017). The curative effect of MMSE in the renal meridian group and the routine treatment group was equivalent (P0.017). (2) the ADL scores of the three groups were all decreased, the renal meridian group and the pericardium group were significantly lower than those in the conventional treatment group (P0). .05), the degree of renal meridian group and pericardium group was similar (P0.05); ADL in pericardium group was better than the conventional treatment group (P0.017). There was no significant difference between the renal meridian group and the conventional treatment group, the renal meridian group and the pericardial group ADL had no statistical significance (P0.017). (3) the SDSVD scores in the three groups were decreased (P0.05), and there was no statistical difference between the groups (P0.05); the renal meridian group and the heart were not statistically significant (P0.05). The effect of SDSVD in the treatment group was better than that of the conventional treatment group (P0.017), the effect of the renal meridian group and the pericardium group was equal (P0.017); (4) the safety indexes were not obvious compared with the previous changes. Conclusion: the acupuncture pericardium meridian combined with Huoxue Tongluo mixture can improve the cognitive function and daily living ability of the patients with Qi deficiency and blood stasis type vascular dementia after infarction. And TCM syndrome is effective, and clinical application has not found obvious adverse reactions and adverse events. It is worthy of clinical promotion to improve the clinical symptoms of vascular dementia patients, reduce the rate of disability and improve the quality of life of the patients.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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