化瘀通络中药改善血管性痴呆认知功能的临床观察

发布时间：2019-04-30 18:34

【摘要】：目的:探讨化瘀通络法中药改善血管性痴呆认知功能的临床疗效。方法:收集2014年10月—2016年10月在广西中医药大学附属瑞康医院神经内科、康复科门诊及住院治疗的血管性痴呆患者64例,中医证型符合瘀血阻络证,按照随机数字表法,随机分为2组,治疗组和对照组各32例。对照组予常规西医治疗,如抗血小板聚集,调脂稳定斑块,降血压、降血脂、降血糖治疗,戒烟戒酒等,治疗组在对照组基础上加用化瘀通络的中药,连续服用3个月。分别比较两组治疗前、治疗1个月后及治疗3个月后简易智能状态检查量表(MMSE)、长谷川智能量表(HDS)、日常生活自理能力量表(ADL)、P300及中医证候积分的变化,所有数据均采用SPSS19.0统计分析软件进行分析。计量资料采用t检验,计数资料采用X~2检验。结果:(1)治疗前两组间比较均无显著差异(P0.05),两组具有可比性;(2)对照组及治疗组治疗后1个月的MMSE、HDS、ADL量表评分较治疗前均稍有改善,但是在统计学上无差异(P0.05);治疗后1个月组间比较无统计学意义(P0.05);(3)对照组治疗后3个月MMSE、HDS、ADL评分及P300较治疗前均稍有改善,但是无统计学差异(P0.05),治疗组治疗后3个月MMSE、HDS、ADL量表评分及P300较治疗前均有显著差异(P0.05);(4)临床疗效:治疗组治疗后的总有效率为84.38%,显著高于对照组的59.38%,差异有统计学意义。提示治疗组的疗效较对照组的疗效好。(5)治疗过程中未出现与化瘀通络法有关影响治疗的不良反应。结论:化瘀通络法结合西医基础治疗对改善血管性痴呆的认知功能有一定疗效,可明显改善血管性痴呆患者临床症状,提高认知功能,提高认知功能量表评分,提高患者及患者家属的生活质量,值得进一步深入研究。
[Abstract]:Objective: to explore the clinical effect of Huayu Tongluo method on improving cognitive function of vascular dementia. Methods: from October 2014 to October 2016, 64 patients with vascular dementia were collected from Department of Neurology, Rehabilitation Clinic and inpatient treatment in Ruikang Hospital of Guangxi University of traditional Chinese Medicine. They were randomly divided into two groups: treatment group (32 cases) and control group (32 cases). The control group was treated with conventional western medicine, such as anti-platelet aggregation, regulating lipid and stabilizing plaque, lowering blood pressure, lowering blood lipid, lowering blood sugar, giving up smoking and alcohol, etc. The treatment group added traditional Chinese medicine to remove blood stasis and clear collaterals on the basis of control group, and took it continuously for 3 months. Before treatment, 1 month after treatment and 3 months after treatment, the changes of (ADL), P300 and TCM syndrome score of (MMSE), Hasegawa Intelligence scale (HDS), daily life self-care ability scale and TCM syndrome score were compared between the two groups. All data were analyzed by SPSS19.0 statistical analysis software. T-test was used to measure the data, and X-2 test was used to count the data. Results: (1) there was no significant difference between the two groups before treatment (P0.05). (2) 1 month after treatment, the MMSE,HDS,ADL scale scores of the control group and the treatment group were slightly improved compared with those before treatment, but there was no statistical difference (P0.05); there was no significant difference between the two groups 1 month after treatment (P0.05); (3) the MMSE,HDS,ADL score and P300 in the control group improved slightly after 3 months treatment compared with those before treatment, but there was no statistical difference (P0.05). In the treatment group, the MMSE,HDS, at 3 months after treatment was slightly improved (P0.05). The scores of ADL scale and P300 were significantly different from those before treatment (P0.05). (4) Clinical efficacy: the total effective rate of the treatment group was 84.38%, which was significantly higher than that of the control group (59.38%). It was suggested that the therapeutic effect of the treatment group was better than that of the control group. (5) there was no adverse reaction related to Huayu Tongluo method in the course of treatment. Conclusion: Huayu Tongluo method combined with basic treatment of western medicine can improve the cognitive function of vascular dementia, improve the clinical symptoms of vascular dementia patients and improve the score of cognitive function scale. It is worth further study to improve the quality of life of patients and their families.
【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】：2017
【分类号】：R277.7

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