本文選題：心腎論治　切入點(diǎn)：輕度認(rèn)知損害　出處：《長春中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評(píng)價(jià)基于從心腎論治輕度認(rèn)知損害理論的中醫(yī)綜合療法治療輕度認(rèn)知損害的臨床療效和安全性,為中醫(yī)藥治療輕度認(rèn)知損害及預(yù)防老年癡呆的發(fā)生提供新途徑。方法:應(yīng)用隨機(jī)數(shù)字表法將符合納入標(biāo)準(zhǔn)的90例患者隨機(jī)分為單純中藥組(30例)、綜合療法組(30例)及對(duì)照組(30例),三組均給予控制高血壓、高血糖、高血脂等原發(fā)病的基礎(chǔ)治療,同時(shí)單純中藥組辨證采用中藥(心氣虛腎精不足型-調(diào)補(bǔ)心腎方、腎陽虛心火旺型-交通心腎方)治療,綜合療法組辨證采用中藥配合針刺、推拿、中藥熏蒸等中醫(yī)特色療法,分別比較治療前、治療第6周及第12周中醫(yī)證候積分、簡易精神狀態(tài)檢查(MMSE)、ADAS-Cog量表延遲詞語回憶(ADAS-COG-DVR)及工具性日常生活活動(dòng)(IADL)等多個(gè)認(rèn)知量表分值變化,治療后隨訪6個(gè)月觀察其遠(yuǎn)期療效及安全性。結(jié)果:(一)治療第6周1.單純中藥組與綜合療法組較本組治療前中醫(yī)證候積分、MMSE及ADAS-COG-DVR均有改善,綜合療法組差異有統(tǒng)計(jì)學(xué)意義(P0.05),單純中藥組差異無統(tǒng)計(jì)學(xué)意義(P0.05);2.綜合療法組較單純中藥組、對(duì)照組中醫(yī)證候積分、MMSE及ADAS-COG-DVR有所改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05);3.三組IADL評(píng)分均無明顯改善;(二)治療第12周1.單純中藥組與綜合療法組較本組治療前中醫(yī)證候積分、MMSE及ADAS-COG-DVR改善明顯,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),且均優(yōu)于對(duì)照組(P0.05);2.綜合療法組與單純中藥組比較中醫(yī)證候積分、MMSE及ADAS-COG-DVR評(píng)分差異無統(tǒng)計(jì)學(xué)意義(P0.05);3.三組中僅綜合療法組IADL評(píng)分有改善,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);結(jié)論:從心腎論治輕度認(rèn)知損害中醫(yī)綜合治療方案臨床療效優(yōu)勢顯著,選擇適宜的中醫(yī)綜合治療方案可以明顯改善臨床癥狀,縮短治療周期,提高M(jìn)MSE積分及降低ADAS-COG-DVR積分,療效肯定,值得臨床進(jìn)一步推廣應(yīng)用。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of TCM combined therapy for mild cognitive impairment based on the theory of heart and kidney. To provide a new approach for the treatment of mild cognitive impairment and the prevention of Alzheimer's disease with traditional Chinese medicine methods: 90 patients with mild cognitive impairment were randomly divided into two groups: 30 cases in Chinese medicine group and 30 cases in comprehensive therapy group. ) and control group (30 cases). Basic treatment of primary diseases such as hyperglycemia and hyperlipidemia, while the traditional Chinese medicine group was treated with traditional Chinese medicine (deficiency of heart and qi, deficiency of kidney essence-regulating heart and kidney prescription, kidney yang deficiency and heart fire flourishing type-communicating heart and kidney prescription). The syndromes of the combined therapy group were treated with traditional Chinese medicine combined with acupuncture, massage, Chinese medicine fumigation and so on. The scores of TCM syndromes at the 6th week and 12th week before treatment were compared respectively. The scores of ADAS-COG-DVR and ADAS-COG-DVR (ADAS-COG-DVR) and ADAS-COG-DVR (ADAS-COG-DVR) as well as the scores of ADAS-Cog and IADLwere changed. After 6 months of follow-up, the long-term efficacy and safety were observed. Results (1) in the sixth week of treatment, 1. The traditional Chinese medicine group and the combined therapy group were better than the traditional Chinese medicine syndrome score and ADAS-COG-DVR before treatment. There was significant difference between the combined therapy group and the traditional Chinese medicine group, but there was no significant difference between the traditional Chinese medicine group and the traditional Chinese medicine group. The combined therapy group was better than the traditional Chinese medicine group and the control group was improved in TCM syndromes score and ADAS-COG-DVR. The difference was statistically significant (P < 0.05). The scores of IADL in the three groups were not significantly improved. (2) at the 12th week of treatment, 1. The scores of TCM syndromes and ADAS-COG-DVR were significantly improved in the traditional Chinese medicine group and the combined therapy group. The difference was statistically significant (P 0.05) and was better than that of the control group (P 0.05). There was no significant difference in the scores of TCM syndromes and ADAS-COG-DVR between the combined therapy group and the traditional Chinese medicine group. The IADL score of the three groups was improved only in the combined therapy group. But the difference was not statistically significant (P 0.05). Conclusion: the comprehensive treatment of mild cognitive impairment based on heart and kidney has a significant clinical curative effect, and the selection of suitable comprehensive treatment can obviously improve the clinical symptoms and shorten the treatment period. To increase MMSE score and reduce ADAS-COG-DVR score is effective and worthy of further clinical application.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R277.7

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