醒脑益髓汤配合针刺督脉四穴为主治疗脑梗死后血管性痴呆临床研究
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摘要
目的:观察醒脑益髓汤配合针刺督脉四穴治疗脑梗死后血管性痴呆(Vascular dementia,VD)临床影响。方法:选取2012年12月～2017年12月间在本院接受治疗的肾虚血瘀型VD患者86例,随机数字表法将其分成两组,对照组(43例)行针刺治疗,观察组(43例)在对照组基础上行醒脑益髓汤;观察患者临床疗效,使用日常生活活动能力量表(ADL)、简易智能状态评价量表(MMSE)检测患者智力和日常生活能力改善状况,ELISA法检测血清γ-干扰素(IFN-γ)、白细胞介素-18(IL-18)、血管内皮生长因子(VEGF)及Livin含量。结果:治疗后观察组总的有效率为83.72%,对照组为60.47%,差异有统计学意义(P<0.05);治疗后两组患者MMSE及ALD评分较治疗前显著升高,差异有统计学意义(P<0.05),且观察组效果更优,治疗后观察组MMSE及ALD评分均高于对照组,差异有统计学意义(P<0.05);治疗后观察组血清IFN-γ、IL-18含量较治疗前、对照组显著降低,Livin、VEGF含量较治疗前、对照组显著升高,差异有统计学意义(P<0.05)。结论:针刺督脉四穴结合醒脑益髓汤可提升患者日常生活能力和智力水平,降低血清炎性因子含量,改善其临床症状。
Objective:To analyze the clinical effect of Xingnao Yijie Decoction combined with acupuncture at four points of Du meridians in the treatment of vascular dementia(VD) after cerebral infarction.Methods:86 patients with kidney-deficiency and blood-stasis type VD who were treated in our hospital from December 2012 to December 2017 were randomly divided into two groups by means of random number table method.The controlled group(43 cases) was treated by acupuncture.The observation group(43 cases) was treated by Xingnao Yijie Decoction on the basis of the controlled group.Observation of clinical efficacy,use of the ADL,MMSE to detect the intelligence and improvement of daily living ability of the patients.Serum levels of interferon-γ(IFN-γ),interleukin-18(IL-18),vascular endothelial growth factor(VEGF) and Livin were detected by ELISA.Results:The total effective rate was 83.72% in the observation group and 60.47% in the controlled group after treatment(P < 0.05).After the treatment,the MMSE and ALD scores of the two groups were significantly higher than those before the treatment.The differences were statistically significant.Significance(P < 0.05),and the observation group had better results.After treatment,the MMSE and ALD scores in the observation group were higher than those in the controlled group(P < 0.05).Serum IFN-γ and IL-18 of the observation group was significantly lower than that before treatment and the controlled group.The levels of Livin and VEGF were significantly higher than those before treatment and the controlled group.The difference was statistically significant(P < 0.05).Conclusion:Acupuncture at Dumai combined with Xingnao Yijie Decoction can improve the ability of daily living and intelligence,reduce the content of serum inflammatory factors,and improve the clinical symptoms.
Objective:To analyze the clinical effect of Xingnao Yijie Decoction combined with acupuncture at four points of Du meridians in the treatment of vascular dementia(VD) after cerebral infarction.Methods:86 patients with kidney-deficiency and blood-stasis type VD who were treated in our hospital from December 2012 to December 2017 were randomly divided into two groups by means of random number table method.The controlled group(43 cases) was treated by acupuncture.The observation group(43 cases) was treated by Xingnao Yijie Decoction on the basis of the controlled group.Observation of clinical efficacy,use of the ADL,MMSE to detect the intelligence and improvement of daily living ability of the patients.Serum levels of interferon-γ(IFN-γ),interleukin-18(IL-18),vascular endothelial growth factor(VEGF) and Livin were detected by ELISA.Results:The total effective rate was 83.72% in the observation group and 60.47% in the controlled group after treatment(P < 0.05).After the treatment,the MMSE and ALD scores of the two groups were significantly higher than those before the treatment.The differences were statistically significant.Significance(P < 0.05),and the observation group had better results.After treatment,the MMSE and ALD scores in the observation group were higher than those in the controlled group(P < 0.05).Serum IFN-γ and IL-18 of the observation group was significantly lower than that before treatment and the controlled group.The levels of Livin and VEGF were significantly higher than those before treatment and the controlled group.The difference was statistically significant(P < 0.05).Conclusion:Acupuncture at Dumai combined with Xingnao Yijie Decoction can improve the ability of daily living and intelligence,reduce the content of serum inflammatory factors,and improve the clinical symptoms.
引文
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[16]刘倩,冯友繁,葛力.丁苯酞治疗血管性痴呆的临床疗效及其对氧化应激反应的影响[J].实用心脑肺血管病杂志,2017,7(4):214~218
[2]李雪岩,刘刚,井哲,等.头项针治疗血管性痴呆的临床疗效观察[J].针灸临床杂志,2016,32(3):24~26
[3]彭小莲,邝云航,朱小苑,等.多奈哌齐联合奥氮平在精神行为异常症状血管性痴呆中认知恢复情况研究[J].热带医学杂志,2015,15(6):773~776
[4]韩丽,李鹏超,张志敏,等.血府逐瘀胶囊联合脑苷肌肽治疗血管性痴呆的疗效观察[J].现代药物与临床,2016,31(10):1591~1594
[5]田金洲,韩明向,涂晋文,等.血管性痴呆诊断、辨证及疗效评定标准(研究用)[C]//全国老年性痴呆发病机理和药物作用靶位研讨会,2003:16~65
[6]邱纪方.护理日常生活活动能力量表的效度分析[J].中华物理医学与康复杂志,2000,22(4):234~236
[7]王征宇,张明园.中文版简易智能状态检查(MMSE)的应用[J].上海精神医学,1989,2(3):108~111
[8]赵欢,杨东东,郭强,等.基于“精-血-髓一体论”观察当归补血汤治疗血管性痴呆临床研究[J].陕西中医,2016,37(10):1314~1315
[9]王银妹,张贺敏,刘莉菲,等.盐酸美金刚与喹硫平联合治疗血管性痴呆患者行为心理症状的效果观察[J].中国医药,2016,11(3):371~373
[10]李惠,邹立华,曾庆祥,等.高压氧联合活血填精补肾汤治疗血管性痴呆的临床疗效及其对乙酰胆碱酯酶活性的影响研究[J].实用心脑肺血管病杂志,2015,7(8):111~113
[11]曹银洲,赵敏.祛痰逐瘀法治疗血管性痴呆临床研究[J].中医学报,2015,4(1):127~129
[12]张丹丹,罗勇,张祖余,等.盐酸多奈哌齐联合尼莫地平治疗血管性痴呆效果观察[J].山东医药,2018,5(2):64~66
[13]王洲羿,黄虎翔,肖展翅,等.丹红注射液联合尼莫地平治疗血管性痴呆的临床疗效及其对血清VEGF、E2、Livin、β-Ap的影响[J].成都中医药大学学报,2017,3(2):53~55
[14]王晋平,唐农,古联,等.益肺宣肺降浊胶囊治疗轻中度血管性痴呆的临床研究[J].中医药导报,2016,4(6):71~73
[15]韩永强,付军.奥拉西坦联合天智颗粒治疗血管性痴呆的疗效观察[J].卒中与神经疾病,2017,24(5):464~466
[16]刘倩,冯友繁,葛力.丁苯酞治疗血管性痴呆的临床疗效及其对氧化应激反应的影响[J].实用心脑肺血管病杂志,2017,7(4):214~218