化浊通络汤治疗血管性痴呆的临床观察
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摘要
目的:探讨化浊通络汤防治血管性痴呆的临床疗效。方法:选取符合血管性痴呆纳入标准的患者160例,随机分为治疗组和对照组各80例。两组患者基础治疗基本相同,治疗组联用中药化浊通络汤,疗程3个月,观察两组患者治疗前后简易智能量表(MMSE)、日常生活能力(ADL)、临床疗效及中医证候积分的变化以及该药的安全性。结果:治疗后治疗组各项积分及总积分均较治疗前提高,差异有统计学意义(P <0.05);对照组回忆、定向、语言积分及总积分较治疗前提高,差异有统计学意义(P <0.05),计算和识记积分与治疗前比较差异无统计学意义(P> 0.05)。两组治疗后计算、回忆和总积分比较差异有统计学意义(P <0.05)。治疗组总有效率为87.5%,对照组为72.5%,治疗组疗效优于对照组(P <0.05)。两组中医证候积分治疗后较治疗前降低,差异有统计学意义(P <0.05),治疗组评分显著低于对照组(P <0.05)。两组患者治疗后较本组治疗前ADL评分降低,治疗组治疗后ADL评分显著低于对照组(P <0.05)。结论:化浊通络汤能有效改善VD患者的MMSE、ADL及临床疗效,提高患者的日常生活自理能力,有肯定的临床疗效,且安全可靠,值得临床推广及进一步深化研究。
Objective: To investigate the clinical efficacy of the Huazhuo Tongluo decoction( 化浊通络汤) on vascular dementia.Methods: 160 cases were randomly divided into the treatment group and control group. The basic treatment was same basically in two groups. The treatment group was treated with the Huazhuo Tongluo decoction more, for 3 months. The MMSE, ADL, clinical efficacy and TCM symptoms in groups were observed before and after treatment. Results: After treatment, the scores and total score in the treatment group were higher(P<0.05). The recall, orientation, language scores and total score in the control group were higher than those before treatment, with statistically significant differences(P<0.05); the calculation and memorization scores were not statistically significant(P>0.05). There were significant differences in the calculation, recall and total scores between two groups after treatment(P<0.05). The total effective rate was 87.5% in the treatment group, better than 72.5% in the control group, P<0.05. The TCM syndrome scores in two groups were lower than before treatment; the difference was statistically significant(P<0.05). The score in the treatment group was significantly lower than the control group(P<0.05). The ADL scores in two groups were lower than before treatment, and the ADL scores in the treatment group were significantly lower than the control group(P<0.05). Conclusion: The Huazhuo Tongluo decoction shows a positive clinical effect, can effectively improve the MMSE, ADL and clinical efficacy of patients with VD, improve their daily living ability,is safe and reliable, worthy of clinical promotion and further research.
Objective: To investigate the clinical efficacy of the Huazhuo Tongluo decoction( 化浊通络汤) on vascular dementia.Methods: 160 cases were randomly divided into the treatment group and control group. The basic treatment was same basically in two groups. The treatment group was treated with the Huazhuo Tongluo decoction more, for 3 months. The MMSE, ADL, clinical efficacy and TCM symptoms in groups were observed before and after treatment. Results: After treatment, the scores and total score in the treatment group were higher(P<0.05). The recall, orientation, language scores and total score in the control group were higher than those before treatment, with statistically significant differences(P<0.05); the calculation and memorization scores were not statistically significant(P>0.05). There were significant differences in the calculation, recall and total scores between two groups after treatment(P<0.05). The total effective rate was 87.5% in the treatment group, better than 72.5% in the control group, P<0.05. The TCM syndrome scores in two groups were lower than before treatment; the difference was statistically significant(P<0.05). The score in the treatment group was significantly lower than the control group(P<0.05). The ADL scores in two groups were lower than before treatment, and the ADL scores in the treatment group were significantly lower than the control group(P<0.05). Conclusion: The Huazhuo Tongluo decoction shows a positive clinical effect, can effectively improve the MMSE, ADL and clinical efficacy of patients with VD, improve their daily living ability,is safe and reliable, worthy of clinical promotion and further research.
引文
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[2]American Psychiatric Association.Diagnostic and Statistical Manual of mental Disorders[M].4th ed.American Psychiatric Association,1994:143-147.
[3]John C,Morris MD.The Clinical Dementia Rating(CDR):Current Version and Scoring Rules[J].Neurology,1993,43(11):2412.
[4]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:91-98.
[5]石苗茜,刘卫平.血管性痴呆发病机制研究进展[J].第四军医大学学报,2007,28(9):861-862.
[6]O’neill D,Gerrard J,Surmon D,et al.Variability in scoring the Hachinski ischaemic score[J].Age and Aging,1995,24(3):242-246.
[7]Roman GC,Tatemichi TK,Erkinjuntti T,et al.Vascular dementia:diagnostic criteria for research studies,Report of the NINDS-AIRENinternational workshop[J].Neurology,1993,43(2):250-260.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:10-11
[9]王洲羿,夏光明,周刚,等.何首乌对血管性认知障碍大鼠学习记忆功能的影响[J].中西医结合心脑血管病杂志,2016,14(9):960-962.
[10]易传安,汪冶,胡祥上,等.何首乌提取物对血管性痴呆大鼠5-HT受体及生化指标的影响[J].中国老年学杂志,2014,34(2):945-947.
[11]朱妍,徐畅.熟地黄活性成分药理作用研究进展[J].亚太传统医药,2011,11(7):173-175.
[12]张慧云,欧阳蓉.丹参对中枢神经系统的抑制作用[J].药学学报,1979,14(5):288-292.
[13]范录平,张宾辉,等.补肾益气法、活血祛瘀法治疗血管性痴呆的实验研究[J].疑难病杂志,2003,5(2):260-262