于氏头针联合电针治疗非痴呆型血管性认知障碍的临床疗效观察

发布时间：2018-08-28 13:25

【摘要】：目的:基于功能代偿学说,通过于氏头针联合电针与长留针所选头区的不同对VCIND的疗效探讨,为临床提供更加有效的治疗方法和临床依据及理论基础。方法:将144例符合纳入标准的VCIND的患者随机分为三组:A组、B组、C组,每组48例患者。三组患者中,A组选取于氏头针额区、顶前区、颞区(双),电针;B组选取于氏头针额区、顶前区、颞区(双),长留针,间断行针;C组选取于氏头针额区、顶前区、颡区(患侧),长留针,间断行针。额区针刺六针,顶前区针刺八针,两侧颞区各针刺三针。A组采用KWD-808-I型脉冲电针仪,使用疏密波,每次通电30min,额区(+)与顶前区(-)、顶前区(+)与颞区(-);B、C两组长留针8h,每2h捻转行针一次,每针行针10s,转速200r/min。体针均为针刺30min后出针。A组每日两次,B、C两组每日一次,六天为一疗程,每疗程结束后休息一日,共治疗四周。使用蒙特利尔认知评估量表(MoCA)、日常生活量表(ADL)量表、事件相关电位P300和血同型半胱氨酸(Hcy)评定认知功能损伤程度和疗效。利用SPSS 20.0统计软件对数据进行处理与分析。结果:1.治疗后三组患者的MoCA量表评分较疗前有明显提高,治疗前后有显著差异(p0.01),且A组与B、C两组间有显著差异(p(A、B 组)0.01,p(A、C 组)0.01),B 组、C 组两者间无明显差异(p0.05)。2.治疗后三组患者的ADL量表评分较疗前有明显提高,治疗前后有显著差异(p0.01),且A组与B、C两组间有显著差异(p(A、B 组)0.01,p(A、C 组)0.01),B 组、C 组两者间无明显差异(p0.05)。3.治疗后三组患者的事件相关电位P300Q潜伏期较疗前明显缩短,治疗前后有显著差异(p0.01),且A组与B、C两组间有显著差异(p(A、B 组)0.01,p(A、C 组)0.01),B 组、C 组两者间有明显差异(p0.01)。波幅较疗前明显增高,治疗前后有显著差异(p0.01),且A组与B、C两组间有显著差异(p(A、B组)0.01,(A、C组)0.01),B组、C组两者间有明显差异(p0.01)。4.治疗后三组患者的Hcy较疗前有明显降低,治疗前后有显著差异(p0.01),且A组与B、C两组间有显著差异(p(A、B组)0.01,p(A、C组)0.01),B组、C组两者间无明显差异(p0.05)。结论:1.于氏头针能够有效地提高VCIND患者的MoCA、ADL的量表评分,可以有效缩短其事件相关电位P300的潜伏期且增加其波幅,并能够明显降低VCIND患者的危险因素Hcy水平,说明于氏头针可以有效地改善VCIND患者的认知功能障碍。2.于氏头针双侧颞区和单侧颞区长留针的临床疗效基本一致,均能有效地改善患者的认知力和生活自理能力等。3.于氏头针(双侧颞区)联合电针较双侧颞区和单侧颞区长留针对VCIND患者的疗效更好。
[Abstract]:Objective: based on the theory of functional compensation, the curative effect of VCIND was discussed by the difference of the head area of Yu's scalp acupuncture combined with long retention needle, so as to provide more effective treatment method, clinical basis and theoretical basis for clinical treatment. Methods: one hundred and forty-four patients with VCIND were randomly divided into three groups: group A: group B and group C, with 48 patients in each group. Among the three groups, group A selected frontal area of scalp acupuncture, preparietal area, temporal region (double area), electroacupuncture group B selected frontal area of scalp acupuncture, preparietal region, temporal region (double area), long needle retention, intermittent acupuncture group C selected in frontal area of scalp acupuncture, preparietal region, preparietal area. Perteobagrus fulvidraco (affected side), long needle retention, intermittent needle. The frontal region was needled with six needles, the preparietal region with eight needles, and the two sides of the temporal region with three needles. Group A was treated with KWD-808-I type pulse electroacupuncture instrument, with dense waves. For 30 minutes, the frontal area () and the preparietal area (-), the preparietal area () and the temporal region (-) kept the needle for 8 hours. The needle was twirled once every 2 hours. The needle was rotated at a rotational speed of 200 r / min. All the body acupuncture groups were treated by acupuncture after 30min. Group A was treated twice a day with six days as a course of treatment. After each course of treatment, the patients were given a rest day for four weeks. The Montreal Cognitive Assessment scale (MoCA), the (ADL) scale of Daily living scale (ADL), the event-related potential (P300) and the plasma homocysteine (Hcy) were used to evaluate the degree and efficacy of cognitive impairment. The data are processed and analyzed by SPSS 20.0 software. The result is 1: 1. After treatment, the scores of MoCA scale in the three groups were significantly higher than those before and after treatment (p0.01), and there was a significant difference between group A and group B (0.01). There was no significant difference between group B and group B (p0.05) .2.There was no significant difference between group B and group C (p0.05). After treatment, the scores of ADL scale in the three groups were significantly higher than those before and after treatment (p0.01), and there was significant difference between group A and group B (0.01). There was no significant difference between group B and group B (p0.05). After treatment, the latency of P300Q in the three groups was significantly shorter than that before treatment (p0.01), and there was significant difference between group A and group B (P 0.01). There was a significant difference between group A and group B (P < 0.01). The amplitude of wave was significantly higher than that before and after treatment (p0.01), and there was significant difference between group A and group B (P 0.01) and between group A (group A) and group B (group C). There was a significant difference between group C (P 0.01) and group C (P 0.01). After treatment, the Hcy of the three groups was significantly lower than that of before and after treatment (p0.01), and there was a significant difference between group A and group B (0.01). There was no significant difference between group B and group C (p0.05). Conclusion 1. Yu's scalp acupuncture can effectively improve the score of MoCA,ADL in patients with VCIND, shorten the latency and increase the amplitude of P300, and decrease the Hcy level of risk factors in VCIND patients. It shows that Yu's scalp acupuncture can effectively improve the cognitive dysfunction of patients with VCIND. 2. 2. The clinical curative effect of bilateral temporal area and unilateral temporal area retention needle of Yu's scalp acupuncture is basically the same, which can effectively improve the cognitive ability and life self-care ability of patients. 3. The curative effect of Yu's scalp acupuncture (bilateral temporal region) combined with electroacupuncture on VCIND patients was better than that of bilateral temporal area and unilateral temporal area.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

【参考文献】