本文選題：補陽還五湯　切入點：血管性癡呆　出處：《湖北中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的：觀察補陽還五湯加味聯(lián)合西醫(yī)療法治療血管性癡呆的臨床療效及安全性。為運用中醫(yī)內(nèi)治法聯(lián)合西醫(yī)療法治療血管性癡呆提供一些臨床參考價值,并以期探索一種經(jīng)濟安全、療效可靠、適宜治療血管性癡呆的新方法。 方法：入選60例病例均來自武漢市一醫(yī)院神經(jīng)內(nèi)科門診及住院部,納入?yún)⒄?002年中華醫(yī)學(xué)會神經(jīng)病學(xué)分會血管性癡呆診斷標(biāo)準(zhǔn)草案及2000年中國中醫(yī)藥學(xué)會內(nèi)科腦病專業(yè)委員會通過的《血管性癡呆診斷、辯證及療效判定標(biāo)準(zhǔn)》。癡呆分度及療效根據(jù)臨床癡呆評定量表(CDR),簡易精神狀態(tài)檢查(MMSE),Blessed行為量表(BBS),血管性癡呆辯證量表(SDSVD),日常行為量表(ADL)等進(jìn)行評定。試驗采用隨機、單盲對照法,將60病例分為治療組與對照組,每組30例；對照組口服西藥尼莫地平片、石杉堿甲片、奧拉西坦片并進(jìn)行康復(fù)訓(xùn)練；治療組在對照組的基礎(chǔ)上加用補陽還五湯加減方。治療8周后對患者治療前、后的認(rèn)知功能,中醫(yī)癥候,日常行為能力,神經(jīng)精神癥狀進(jìn)行療效評價。并定期進(jìn)行三大常規(guī),肝、腎功能及心電圖檢測以評價試驗安全性。 結(jié)果：(1)經(jīng)過8周治療,60例患者無脫落和剔除病例,均按方案配合完成臨床試驗。(2)經(jīng)過8周治療,在改善認(rèn)知功能方面進(jìn)行臨床療效評價,發(fā)現(xiàn)兩組均有效的改善了患者的臨床癥狀(P0.05),治療組的總有效率明顯高于對照組(P0.05),具有統(tǒng)計學(xué)意義。(3)治療8周后,兩組治療前后的中醫(yī)癥候積分(SDSVD)以及BBS量表的評定均顯現(xiàn)有顯著的差異(P0.01),且兩組組間比較即治療組與對照組比較差異有統(tǒng)計學(xué)意義(P0.05),說明治療組較對照組改善認(rèn)知功能障礙效果更為顯著。(4)經(jīng)過8周治療,兩組治療后MMSE、ADL量表評分比較P0.05,顯示兩組間無明顯差異,但治療組總體有效率均高于對照組。(5)在安全性方面,中藥方和西醫(yī)內(nèi)服藥均未發(fā)現(xiàn)對人體存在明顯的毒副作用。 結(jié)論：通過本次試驗觀察,在運用西醫(yī)藥物治療的基礎(chǔ)上,聯(lián)合中藥補陽還五湯并配合康復(fù)訓(xùn)練治療血管性癡呆,具有確切療效。不僅可以較為有效的改善患者認(rèn)知功能障礙,還可以提高患者的生活質(zhì)量,且無明顯不良反應(yīng)。不僅體現(xiàn)了中西醫(yī)結(jié)合治療血管性癡呆的優(yōu)勢,也為臨床上治療血管性癡呆開拓了一個新的思路。
[Abstract]:Objective: to observe the clinical efficacy and safety of Buyang Huanwu decoction combined with western medicine in the treatment of vascular dementia.To provide some clinical reference value for the treatment of vascular dementia by internal treatment of traditional Chinese medicine combined with western medicine, and to explore a new method for the treatment of vascular dementia, which is economical and safe, reliable in curative effect and suitable for treatment of vascular dementia.Methods: all 60 cases were selected from Department of Neurology, Department of Neurology, first Hospital of Wuhan.According to the draft criteria for the diagnosis of vascular dementia adopted by the Chinese Medical Association Neurology Branch in 2002 and the diagnosis, Dialectical and Therapeutic criteria of Vascular dementia adopted by the Professional Committee on Encephalopathy of the Chinese Academy of traditional Chinese Medicine in 2000.The classification and efficacy of dementia were evaluated according to the clinical dementia rating scale (CDR), the simple mental state examination (MMSE) and the Blessed behavior scale (BBSN), the vascular dementia dialectical scale (SDSVD), and the daily behavior scale (ADL).60 cases were randomly divided into treatment group (n = 30) and control group (n = 30). The control group was treated with nimodipine tablet, Huperzine A tablet, oxacitam tablet and rehabilitation training.Treatment group on the basis of the control group plus Buyang Huanwu decoction.After 8 weeks of treatment, the patients' cognitive function, TCM symptoms, daily behavior ability and neuropsychiatric symptoms were evaluated before and after treatment.Three routine, liver, renal and electrocardiogram tests were performed regularly to evaluate the safety of the test.Results (1) after 8 weeks of treatment, 60 cases of patients without abscission or elimination were treated in accordance with the plan and completed the clinical trial. 2) after 8 weeks of treatment, the clinical effect of improving cognitive function was evaluated.The effect of cognitive dysfunction was more significant. 4) after 8 weeks of treatment,Conclusion: on the basis of western medicine treatment, combined with Buyang Huanwu decoction and rehabilitation training, it is effective to treat vascular dementia.It can not only improve the cognitive dysfunction, but also improve the quality of life.It not only reflects the advantages of integrated traditional Chinese and western medicine in the treatment of vascular dementia, but also opens up a new idea for clinical treatment of vascular dementia.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749.13

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