益气健脾养血法治疗血管性痴呆气血亏虚证的临床观察

发布时间：2018-07-06 14:53

本文选题：血管性痴呆 + 益气健脾　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：采用随机对照的研究方法,观察益气健脾养血法治疗血管性痴呆的临床疗效及其安全性,为益气健脾养血法治疗血管性痴呆提供一定的临床依据。方法：本研究按照随机、对照的原则,采用随机数字表法按照1：1的比例,将2013年12月至2015年12月期间在四川省中医院／成都中医药大学附属医院住院以及门诊的病人中符合血管性痴呆气血亏虚证诊断标准的60例患者,分为对照组、治疗组各30例。对照组服用尼莫地平片,治疗组予尼莫地平片+补中益气汤+白芍、熟地黄、水蛭,疗程12周。采用简易精神状态量表(MMSE-R)、日常生活活动能力量表(ADL-R)、中医证候量表积分评价益气健脾养血法在改善血管性痴呆认知功能、提高生活能力、中医证候等方面的影响。采用统计学软件SPSS 19.0对观察结果进行分析。结果：所有组病人均符合纳入标准,共分为两组,无剔除、脱落病例,最终纳入统计的病例共为60例。1、MMSE评分疗效：两组治疗12周结束时的评分与治疗前的MMSE进行对比,组内对比为P0.05,组间对比为P0.05,两组总有效率对比为P0.05,提示两组治疗方案在改善患者认知方面均有效,其中治疗组明显优于对照组。2、ADL评分疗效：两组治疗12周治疗结束后的评分与治疗前的ADL评分进行组内及组间对比,结果都为P0.05,提示两治疗组在提高日常生活能力方面均有效,其中治疗组疗效明显优于对照组。3、中医证候量表积分评分：对照组总有效率为56.6%,治疗组的总有效率为93.6%,两组对比存在明显差异(P0.01)。提示两组在改善中医证候方面均有效,其中治疗组疗效优于对照组。4、药物安全性方面：治疗过程中个别患者出现的不良反应主要有恶心呕吐、皮肤瘙痒、腹胀等,两组比较,其差异无统计学意义。结论：通过本研究发现在使用西医药物治疗本病的基础上,联合中药益气健脾养血的方法治疗,对血管性痴呆患者的中医证候、日常生活活动能力和认知功能改善的方面明显优于单纯使用西药,且药物不良反应不明显。
[Abstract]:Objective: to observe the clinical efficacy and safety of invigorating qi and invigorating spleen and nourishing blood in the treatment of vascular dementia, and to provide a certain clinical basis for the treatment of vascular dementia by supplementing qi and invigorating spleen and nourishing blood. Methods: in this study, according to the principle of randomness and contrast, the method of random digital table was used according to the proportion of 1:1, From December 2013 to December 2015, 60 patients who met the diagnostic criteria of deficiency of qi and blood in Sichuan Provincial Hospital of Chinese Medicine / Chengdu University of traditional Chinese Medicine were divided into control group (n = 30) and treatment group (n = 30). The control group was treated with nimodipine tablet, the treatment group was treated with Nimodipine tablet, the treatment group was treated with Nimodipine tablet, the treatment group was treated with Nimodipine tablet for 12 weeks. MMSE-R, ADL-R and TCM syndromes scale were used to evaluate the effects of Qi-Jianpi and Blood-nourishing method on improving cognitive function, improving life ability and TCM syndrome of vascular dementia. Statistical software SPSS 19.0 was used to analyze the observation results. Results: all the patients were divided into two groups, none of them were excluded or dropped out, and the final included cases were 60 patients with MMSE score. The scores at the end of 12 weeks were compared with those before treatment. The intra-group contrast was P0.05, the inter-group contrast was P0.05, and the total effective rate of the two groups was P0.05, indicating that the two groups were effective in improving patients' cognition. The therapeutic effect of the treatment group was significantly better than that of the control group. The scores after 12 weeks of treatment in the two groups were compared with the ADL scores before and after treatment. The results were both P0.05, indicating that the two groups were effective in improving the ability of daily living. The therapeutic effect of the treatment group was significantly better than that of the control group. The score of TCM syndrome scale score: the total effective rate of the control group was 56.6, the total effective rate of the treatment group was 93.60.There was a significant difference between the two groups (P0.01). The results suggest that the two groups are effective in improving TCM syndrome, and the curative effect of the treatment group is better than that of the control group. The drug safety: the adverse reactions of individual patients in the course of treatment are mainly nausea and vomiting, pruritus of skin, abdominal distension and so on, which are compared between the two groups. The difference was not statistically significant. Conclusion: on the basis of using western medicine to treat this disease, the TCM syndrome of vascular dementia patients can be treated with the combination of traditional Chinese medicine to invigorate qi and invigorate spleen and nourish blood. The improvement of ADL and cognitive function was better than that of western medicine alone, and the adverse drug reaction was not obvious.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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