调补脾胃法对老年痴呆患者生活质量和认知功能改善的效果分析
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摘要
目的观察调补脾胃法对老年痴呆患者生活质量和认知功能改善的效果。方法选取脾虚证老年痴呆患者64例,随机分为两组,每组32例。对照组按照一般西医常规治疗,治疗组在对照组治疗的基础上加用调补脾胃法,方选强脾益智汤加减,连续治疗10 d为1个疗程,分别在治疗后第4周、第12周、第24周对治疗效果进行评估,选用简易精神状态评价量表(MMSE)及日常生活活动能力量表(ADL)对患者的认知功能、记忆功能、日常生活能力等进行评估,对评估结果进行组间及组内比较。结果治疗4周后,两组患者MMSE及ADL评分与本组治疗前比较差异有统计学意义(P <0. 05)。治疗4周后两组患者MMSE评分比较差异无统计学意义(P> 0. 05),而ADL评分比较差异有统计学意义(P <0. 05)。治疗12周后,两组患者MMSE及ADL评分均较本组治疗前明显升高(P <0. 01),且两组患者治疗12周后组间比较差异有统计学意义(P <0. 05)。治疗24周后,两组患者MMSE及ADL评分与本组治疗前比较差异有统计学意义(P <0. 001,P <0. 01),两组患者治疗24周后MMES、ADL评分比较差异有统计学意义(P <0. 001,P <0. 01)。治疗4周后,两组患者总有效率比较差异无统计学意义(P>0. 05),治疗12周、24周后治疗组疗效明显优于对照组(P <0. 05)。结论调补脾胃法辨治老年痴呆,能够明显提高患者的认知能力、生活能力和社会功能,提高病人的生活质量,一定程度上可延缓痴呆的进展。
Objective Observe the effect of regulating spleen and stomach on quality of life and cognitive function improvement in patients with Alzheimer' s disease. Methods Sixty-four patients with Alzheimer' s disease with spleen deficiency were divided into observation group and control group,32 cases in each group. The control group was treated with the general western medicine. The observation group was supplemented with the method of regulating the spleen and stomach. The prescription of Jianjianpi Yizhi Decoction was selected for 10 days as a course of treatment. The therapeutic effect was evaluated at the 4 th,12 th and 24 th weeks after the treatment respectively. The cognitive function,memory function and daily living ability of the patients were assessed by MMSE and ADL and the evaluation results were compared. Results After 4 weeks of treatment,there were significant differences in MMSE and ADL scores between the two groups before and after treatment( P < 0. 05). After 4 weeks of treatment,there was no significant difference in MMSE score between the two groups( P > 0. 05),while there was significant difference in ADL score( P < 0. 05). After 12 weeks of treatment,the scores of MMSE and ADL in both groups were significantly increased( P < 0. 01),and there was significant difference between the two groups after 12 weeks of treatment( P < 0. 05). After 24 weeks of treatment,there were significant differences in MMSE and ADL scores between the two groups before and after treatment( P < 0. 001,P < 0. 01).There were significant differences in MMES and ADL scores between the two groups after 24 weeks of treatment( P <0. 001,P < 0. 01). After 4 weeks of treatment,there was no significant difference in the total effective rate between the two groups( P > 0. 05). After 12 and 24 weeks of treatment,the curative effect of the treatment group was significantly better than that of the control group( P < 0. 05). Conclusion Regulating spleen and stomach in the treatment of senile dementia can significantly improve the patients' cognitive ability,living ability and social function,and improve the patient's quality of life. To a certain extent,it can delay the progress of dementia.
Objective Observe the effect of regulating spleen and stomach on quality of life and cognitive function improvement in patients with Alzheimer' s disease. Methods Sixty-four patients with Alzheimer' s disease with spleen deficiency were divided into observation group and control group,32 cases in each group. The control group was treated with the general western medicine. The observation group was supplemented with the method of regulating the spleen and stomach. The prescription of Jianjianpi Yizhi Decoction was selected for 10 days as a course of treatment. The therapeutic effect was evaluated at the 4 th,12 th and 24 th weeks after the treatment respectively. The cognitive function,memory function and daily living ability of the patients were assessed by MMSE and ADL and the evaluation results were compared. Results After 4 weeks of treatment,there were significant differences in MMSE and ADL scores between the two groups before and after treatment( P < 0. 05). After 4 weeks of treatment,there was no significant difference in MMSE score between the two groups( P > 0. 05),while there was significant difference in ADL score( P < 0. 05). After 12 weeks of treatment,the scores of MMSE and ADL in both groups were significantly increased( P < 0. 01),and there was significant difference between the two groups after 12 weeks of treatment( P < 0. 05). After 24 weeks of treatment,there were significant differences in MMSE and ADL scores between the two groups before and after treatment( P < 0. 001,P < 0. 01).There were significant differences in MMES and ADL scores between the two groups after 24 weeks of treatment( P <0. 001,P < 0. 01). After 4 weeks of treatment,there was no significant difference in the total effective rate between the two groups( P > 0. 05). After 12 and 24 weeks of treatment,the curative effect of the treatment group was significantly better than that of the control group( P < 0. 05). Conclusion Regulating spleen and stomach in the treatment of senile dementia can significantly improve the patients' cognitive ability,living ability and social function,and improve the patient's quality of life. To a certain extent,it can delay the progress of dementia.
引文
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[12]Lotte Gerritsen,Wang HX,Chandra A,et al.Influence of negative life events and widowhood on risk for dementia[J]. The American Journal of Geriatric Psychiatry,2017,25(7):766-778.
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[14]郑卫莉,郑静.中医治疗老年痴呆患者对其日常生活能力改善效果观察[J].中国现代药物应用,2016,10(5):252-253.
[15]王枫,刘敬霞,顾玉宝,等.血管性痴呆的中医研究进展和治疗现状[J].辽宁中医杂志,2016,43(9):1997-2000.
[16]于佳佳,孙西庆.从脾胃论治老年呆病探析[J].中国中医药信息杂志,2015,22(8):106-107.
[17]张洁,张海滨.中医传承与创新论坛论文汇编[C]. 2015:76-77.
[18]陈旺琨,冯方俊.试述脾胃与老年性痴呆[J].实用中医药杂志,2012,28(10):875.
[19]王一洲,刘宇,赵强.中医药治疗血管性痴呆的研究进展[J].四川中医,2013,31(1):144-146.
[2]冯丽君,张楠,程焱,等.阿尔茨海默病和血管性痴呆患者的认知功能和精神行为症状[J].中国心理卫生杂志,2011,25(5):334-338.
[3]李瑞,胡玉萍,袁德培,等.从脾胃论治老年性痴呆[J].中医杂志,2017,58(5):384-386,393.
[4]曹静,李秀琴.李秀琴教授从脾胃论治脑病经验[J].中西医结合心脑血管病杂志,2016,14(3):332-336.
[5]夏永良,王彩霞,李德新.脾胃虚弱与老年性痴呆发病机制探讨[J].山东中医杂志,2001(12):709-710.
[6]中华医学会精神分会. CCMD-3-中国精神障碍分类与诊断标准[M]. 3版.济南:山东科学技术出版社,2001.
[7]傅仁杰.老年呆病(老年痴呆)的中医临床诊断及疗效评定标准(试行)[A]∥全国中医药防治老年病学术交流会学术论文集[C],2011.
[8]沈渔邨.精神病学[M]. 4版.北京:人民卫生出版社,2003:212-213.
[9]吴春城.早期康复治疗对脑梗死偏瘫患者功能恢复的影响[J].中国处方药,2017,15(4):124-125.
[10]周贤刚,钟渠.脑蛋白水解物注射液治疗老年性痴呆疗效研究的系统评价[J].循证医学,2005,5(6):271-272.
[11]朱圆,余小萍.老年痴呆患者安全管理的研究进展[J].重庆医科大学学报,2017,42(6):743-748.
[12]Lotte Gerritsen,Wang HX,Chandra A,et al.Influence of negative life events and widowhood on risk for dementia[J]. The American Journal of Geriatric Psychiatry,2017,25(7):766-778.
[13]任建刚.中西医结合治疗血管性痴呆临床观察[J].中国实用医药,2012,27(7):184-185.
[14]郑卫莉,郑静.中医治疗老年痴呆患者对其日常生活能力改善效果观察[J].中国现代药物应用,2016,10(5):252-253.
[15]王枫,刘敬霞,顾玉宝,等.血管性痴呆的中医研究进展和治疗现状[J].辽宁中医杂志,2016,43(9):1997-2000.
[16]于佳佳,孙西庆.从脾胃论治老年呆病探析[J].中国中医药信息杂志,2015,22(8):106-107.
[17]张洁,张海滨.中医传承与创新论坛论文汇编[C]. 2015:76-77.
[18]陈旺琨,冯方俊.试述脾胃与老年性痴呆[J].实用中医药杂志,2012,28(10):875.
[19]王一洲,刘宇,赵强.中医药治疗血管性痴呆的研究进展[J].四川中医,2013,31(1):144-146.