【摘要】：目的:探討補(bǔ)腎法聯(lián)合丁苯酞軟膠囊以及單藥丁苯酞軟膠囊治療血管性癡呆患者的臨床療效。方法:在廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院神經(jīng)內(nèi)科門診及病房收集2014年10月到2016年10月的血管性癡呆患者78例病例,根據(jù)隨機(jī)數(shù)字表法按1:1:1隨機(jī)分配到治療組1、治療組2和對(duì)照組,治療組1、治療組2和對(duì)照組分別為26例、26例和26例。治療組1給予補(bǔ)腎益智中藥聯(lián)合丁苯酞軟膠囊口服以及內(nèi)科基礎(chǔ)治療,治療組2給予丁苯酞軟膠囊以及內(nèi)科基礎(chǔ)治療,對(duì)照組單純給予內(nèi)科基礎(chǔ)治療,三組治療療程均為90天。治療前分別予治療組和對(duì)照組測(cè)試簡(jiǎn)易智能狀態(tài)檢查量表(MMSE)、長(zhǎng)谷川智能量表(HDS)、日常生活能力評(píng)定量表(ADL)、事件相關(guān)電位(P300)、中醫(yī)證候療效積分,治療后3個(gè)月分別再次測(cè)量上述量表。將采集到的資料數(shù)據(jù)使用SPSS19.0統(tǒng)計(jì)分析軟件進(jìn)行匯總、分析。計(jì)量資料采用t檢驗(yàn),計(jì)數(shù)資料采用X2檢驗(yàn)。最后對(duì)匯總結(jié)果進(jìn)行歸納、總結(jié)。結(jié)果:(1)納入78例病例,無(wú)脫落及剔除病例,均能全程完成臨床實(shí)驗(yàn);(2)三組受試對(duì)象治療前后分別測(cè)試MMSE、HDS、ADL評(píng)分并進(jìn)行兩兩比較,結(jié)果提示治療組1較治療組2、對(duì)照組上述評(píng)分改善效果最佳(p值均0.05),其次治療組2對(duì)改善MMSE、HDS、ADL評(píng)分療效較對(duì)照組好(p值0.05),對(duì)照組對(duì)改善MMSE、HDS、ADL評(píng)分無(wú)明顯療效(p值0.05)。(3)三組治療后中醫(yī)證候療效比較:治療組1顯效5例、好轉(zhuǎn)15例、無(wú)效6例,總有效率為76.92%;治療組2顯效1例、好轉(zhuǎn)5例、無(wú)效20例,總有效率為23.07%;對(duì)照組顯效0例、好轉(zhuǎn)4例、無(wú)效22例,總有效率為15.38%。從表6數(shù)據(jù)結(jié)果顯示治療組1比治療組2和對(duì)照組改善中醫(yī)證候療效積分效果均好(P值0.05),治療組2與對(duì)照組無(wú)改善中醫(yī)證候療效積分效果(P值0.05)。(4)三組治療前后事件相關(guān)電位比較,治療組1均較治療組2、對(duì)照組潛伏期和波幅改善最佳(P值均0.05),其次治療組2對(duì)于事件相關(guān)電位改善效果較對(duì)照組好(P值0.05),對(duì)照組無(wú)明顯改善事件相關(guān)電位療效。結(jié)論:(1)補(bǔ)腎法聯(lián)合丁苯酞軟膠囊對(duì)改善血管性癡呆患者的認(rèn)知功能有一定的臨床療效,療效優(yōu)于單藥丁苯酞軟膠囊。(2)補(bǔ)腎法可能可以改善呆病腎精不足患者的中醫(yī)證候療效積分。(3)補(bǔ)腎法聯(lián)合丁苯酞軟膠囊治療血管性癡呆的過程中未發(fā)現(xiàn)明顯毒副作用,安全有效,值得進(jìn)一步深入研究。
[Abstract]:Objective: to investigate the clinical effect of tonifying kidney method combined with butyphthalide soft capsule and single drug butyphthalide soft capsule in the treatment of vascular dementia. Methods: 78 cases of vascular dementia were collected from outpatient and ward of Department of Neurology, Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine from October 2014 to October 2016. According to the method of random number table, 26 cases were randomly assigned to treatment group 1, treatment group 2 and control group, treatment group 1, treatment group 2 and control group 26 cases and 26 cases respectively. The treatment group 1 was given Bushen Yizhi Chinese medicine combined with butyphthalide soft capsule orally and basic medical treatment, the treatment group 2 was given butyphthalide soft capsule and basic medical treatment, the control group was given only internal medicine basic treatment, the three groups were treated for 90 days. Before treatment, the patients in the treatment group and the control group were given the simple Intelligent State examination scale (MMSE),) and the (MMSE), Hasegawa Intelligent scale (HDS),) before treatment. The (ADL), event-related potential (P300) was evaluated by the activity of Daily living scale (ADL), and the curative effect score of TCM syndrome was scored. The above scale was measured again 3 months after treatment. The collected data will be collected using SPSS19.0 statistical analysis software for summary, analysis. T test was used for measuring data and X 2 test was used for counting data. Finally, the summary results are summarized and summarized. Results: (1) 78 cases were included in the study, all of them were able to complete the whole clinical trial, and (2) before and after treatment, the MMSE,HDS,ADL scores of the three groups were measured and compared. The results suggest that the treatment group 1 is better than the treatment group 2, the control group has the best improvement effect on the above score (p all 0. 05), the treatment group 2 is better than the control group in improving the MMSE,HDS,ADL score (p 0. 05), and the control group has no obvious effect on improving the MMSE,HDS,ADL score (p 0. 05). (3). Comparison of TCM syndromes after treatment in the treatment group: 5 cases in the treatment group 1, 15 cases were improved, 6 cases were ineffective, the total effective rate was 76.92; in the treatment group, there were 1 case of remarkable effect, 5 cases of improvement and 20 cases of ineffectiveness, the total effective rate was 23.07, while in the control group, there were 0 cases of marked effect, 4 cases of improvement, 22 cases of ineffectiveness, and 15.38% of total effective rate. From the data of table 6, the results show that the treatment group 1 is better than the treatment group 2 and the control group in improving the integral effect of TCM syndromes (P0. 05), while the treatment group 2 and the control group have no effect of improving the curative effect of TCM syndromes (P0. 05). (4) before and after treatment. Part related potential comparison, Treatment group 1 was better than treatment group 2, the latency and amplitude of wave in control group were the best (P 0.05), the effect of treatment group 2 was better than that of control group (P 0.05), but no significant improvement of event-related potential was found in control group. Conclusion: (1) Bushen method combined with butyphthalide soft capsule can improve the cognitive function of vascular dementia patients. The curative effect was better than that of butyphthalide soft capsule. (2) Renal tonifying method may improve TCM syndromes of patients with deficiency of kidney essence. (3) Bushen method combined with Buphthalide soft capsule in the treatment of vascular dementia has no obvious toxic side effects and is safe and effective. It is worth further study.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R749.13

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