五脏温阳化瘀汤治疗阳虚型血管性痴呆的临床疗效观察

发布时间：2018-08-06 13:22

【摘要】：目的:通过观察五脏温阳化瘀方治疗阳虚型血管性痴呆患者的临床疗效,评价该方治疗阳虚型VD的有效性,为其更好的应用临床及新药开发提供基础。方法:根据VD的诊断标准,将符合纳入标准的90例患者随机分为治疗组与对照组,每组45人。治疗组予五脏温阳化瘀方颗粒剂,冲服,200ml/次,2次/日;对照组给予盐酸多奈哌齐片口服,1片/次,1次/日,两组均是12周为一个疗程。观察两组患者治疗前后的认知功能积分、日常行为能力积分、中医证候积分的变化情况,并对药物的安全性和临床愈显率、总有效率进行分析和评价。结果:(1)临床疗效:治疗组患者43例,显效率37.21%,总有效率90.69%,对照组44例,显效率27.27%,总有效率84.09%,两组比较有明显差异(P0.05),说明治疗组明显优于对照组。(2)MMSE积分和ADL积分:治疗组和对照组治疗后,认知功能积分和日常行为能力积分均有不同程度提高,两组治疗前后组内比较均有显著差异(P0.05),提示两组患者认知功能、日常生活能力明显改善。治疗后,治疗组的认知功能积分和日常行为能力积分与对照组比较无明显差异(P0.05),说明五脏温阳化瘀方在阳虚型VD患者的认知功能及日常生活能力方面与盐酸多奈哌齐的改善效果大致相同。(3)中医证候积分:两组中医证候评分治疗前后进行组内及组间比较,治疗组明显优于对照组(P0.05),说明五脏温阳化瘀方在轻中度肾阳虚型血管性痴呆患者的中医证候积分方面改善情况明显优于盐酸多奈哌齐。(4)安全性评价:治疗后两组患者血常规尿常规大便常规、心电图及肝肾功能均未出现明显改变,P值都0.05;且用药过程中均未发现患者出现过敏等不良反应。说明五脏温阳化瘀方和盐酸多奈哌齐均无毒副作用,安全可靠。结论:五脏温阳化瘀方对于阳虚型血管性痴呆疗效确切,疗效明显优于对照组,无毒副作用及不良反应,具有较好的临床运用价值。
[Abstract]:Objective: to observe the clinical effect of Wuzangwenyang Huayu recipe in treating vascular dementia of Yang deficiency type, and evaluate its efficacy in treating VD of yang deficiency type, so as to provide a basis for its better clinical application and new drug development. Methods: according to the diagnostic criteria of VD, 90 patients with VD were randomly divided into treatment group and control group with 45 patients in each group. The treatment group was treated with Wuzangwenyang Huayu granule (200ml / d) and the control group (control group) was given one tablet of Donepezil Hydrochloride once a day for 12 weeks as a course of treatment. To observe the changes of cognitive function score, daily behavior score and TCM syndrome score before and after treatment, and to analyze and evaluate the drug safety, clinical recovery rate and total effective rate. Results: (1) Clinical efficacy: 43 patients in the treatment group, the effective rate was 37.21, the total effective rate was 90.69 and the control group was 44. The effective rate was 27.27% and the total effective rate was 84.09. The difference between the two groups was significant (P0.05), which indicated that the treatment group was superior to the control group. (2) MMSE score and ADL score: after treatment, the cognitive function score and the daily behavior ability score of the treatment group and the control group were improved to some extent. There were significant differences between the two groups before and after treatment (P0.05), indicating that the cognitive function and ADL of the two groups were significantly improved. After treatment, There was no significant difference in the scores of cognitive function and ADL between the treatment group and the control group (P0.05), which indicated that the cognitive function and daily living ability of VD patients with WZQ warming Yang and removing Blood stasis Formula were improved with Donepezil Hydrochloride. (3) TCM syndromes score: two groups of TCM syndrome score before and after treatment were compared within the group and between groups, The treatment group was significantly better than the control group (P0.05), indicating that Wuzangwenyang Huayu prescription in mild and moderate kidney yang deficiency type vascular dementia patients improved the situation of TCM syndromes significantly better than Donepezil hydrochloride. (4) Safety evaluation: two groups of patients after treatment blood routine? Urine routine? Defecation routine, electrocardiogram and liver and kidney function were not significantly changed (P = 0.05), and no adverse reactions such as allergies were found in the course of medication. It shows that both Wuzang Wenyang Huayu recipe and Donepezil Hydrochloride have no toxic side effects and are safe and reliable. Conclusion: Wuzangwenyang Huayu prescription is effective in treating vascular dementia with deficiency of Yang, and is superior to the control group. It has no toxic side effects and adverse reactions, so it has good clinical application value.
【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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