本文選題：心包經(jīng) + 活血通絡(luò)合劑��； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：通過觀察簡(jiǎn)易精神狀態(tài)評(píng)價(jià)量表(MMSE量表)、日常生活能力量表(ADL量表)及血管性癡呆中醫(yī)辨證量表(SDSVD量表)的評(píng)分變化,評(píng)價(jià)針刺心包經(jīng)聯(lián)合活血通絡(luò)合劑治療梗塞后氣虛血瘀型血管性癡呆的臨床療效。方法：篩選2014年2月至2016年2月期間,在徐州市中醫(yī)院針灸腦病科門診及病房就診的60例梗塞后氣虛血瘀型血管性癡呆患者。所有病例均符合納入標(biāo)準(zhǔn),采用隨機(jī)單盲對(duì)照的設(shè)計(jì)方法,將其分為常規(guī)治療組、腎經(jīng)對(duì)照組、心包經(jīng)試驗(yàn)組,每組各20例,以4周為一個(gè)療程,共觀察2個(gè)療程。治療前后分別記錄MMSE、ADL、SDSVD量表的評(píng)分變化,進(jìn)行統(tǒng)計(jì)學(xué)分析,以評(píng)價(jià)針刺心包經(jīng)聯(lián)合活血通絡(luò)合劑治療梗塞后氣虛血瘀型血管性癡呆的臨床療效。結(jié)果：(1)三組治療后MMSE評(píng)分較前均有所升高,腎經(jīng)組、心包經(jīng)組較常規(guī)組升高明顯(P0.05),腎經(jīng)組與心包經(jīng)組相當(dāng)(P0.05)；心包經(jīng)組MMSE有效率優(yōu)于常規(guī)治療組(P0.017),腎經(jīng)組與常規(guī)治療組、腎經(jīng)組與心包經(jīng)組MMSE療效相當(dāng)(P0.017)； (2)三組治療后ADL評(píng)分均下降,腎經(jīng)組、心包經(jīng)組較常規(guī)治療組下降明顯(P0.05),腎經(jīng)組與心包經(jīng)組程度相當(dāng)(P0.05)；心包經(jīng)組ADL療效優(yōu)于常規(guī)治療組(P0.017),腎經(jīng)組與常規(guī)治療組、腎經(jīng)組與心包經(jīng)組ADL療效無統(tǒng)計(jì)學(xué)意義(P0.017)；(3)三組治療后SDSVD評(píng)分均下降(P0.05),組間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)；腎經(jīng)組及心包經(jīng)組治療后SDSVD療效均較常規(guī)治療組為優(yōu)(P0.017),腎經(jīng)組與心包經(jīng)組療效相當(dāng)(P0.017)； (4)安全性指標(biāo)較前變化不明顯。結(jié)論：針刺心包經(jīng)聯(lián)合活血通絡(luò)合劑治療對(duì)于改善梗塞后氣虛血瘀型血管性癡呆患者的認(rèn)知功能、日常生活能力及中醫(yī)癥候行之有效,且臨床應(yīng)用尚未發(fā)現(xiàn)明顯不良反應(yīng)及不良事件,值得臨床推廣以改善血管性癡呆患者的臨床癥狀,降低致殘率,提高患者的生活質(zhì)量。
[Abstract]:Objective: To evaluate the clinical effect of acupuncture pericardium combined with Huoxue Tongluo mixture on vascular dementia after infarction in the treatment of qi deficiency and blood stasis type by observing the simple mental state evaluation scale (MMSE scale), the daily living capacity scale (ADL scale) and the TCM syndrome differentiation scale of vascular dementia (SDSVD scale). During February 2016, 60 patients with Qi deficiency and blood stasis type vascular dementia were treated in the clinic and ward of acupuncture and moxibustion in Xuzhou Hospital of Traditional Chinese Medicine. All cases were in accordance with the inclusion criteria. The randomized, single blind control design method was used to divide them into routine treatment group, renal meridian control group, pericardial test group, 20 cases in each group, with 4 weeks as one. A total of 2 courses of treatment were observed. The scores of the MMSE, ADL and SDSVD scales were recorded before and after the treatment, and the clinical efficacy of the acupuncture pericardium combined with Huoxue Tongluo mixture for the treatment of qi deficiency and blood stasis type vascular dementia after infarction was evaluated. Results: (1) the three groups had higher MMSE scores than before, the renal meridian group and the pericardium group. Compared with the conventional group (P0.05), the renal meridian group was equivalent to the pericardium group (P0.05), the effective rate of MMSE in the pericardium group was better than that of the conventional treatment group (P0.017). The curative effect of MMSE in the renal meridian group and the routine treatment group was equivalent (P0.017). (2) the ADL scores of the three groups were all decreased, the renal meridian group and the pericardium group were significantly lower than those in the conventional treatment group (P0). .05), the degree of renal meridian group and pericardium group was similar (P0.05); ADL in pericardium group was better than the conventional treatment group (P0.017). There was no significant difference between the renal meridian group and the conventional treatment group, the renal meridian group and the pericardial group ADL had no statistical significance (P0.017). (3) the SDSVD scores in the three groups were decreased (P0.05), and there was no statistical difference between the groups (P0.05); the renal meridian group and the heart were not statistically significant (P0.05). The effect of SDSVD in the treatment group was better than that of the conventional treatment group (P0.017), the effect of the renal meridian group and the pericardium group was equal (P0.017); (4) the safety indexes were not obvious compared with the previous changes. Conclusion: the acupuncture pericardium meridian combined with Huoxue Tongluo mixture can improve the cognitive function and daily living ability of the patients with Qi deficiency and blood stasis type vascular dementia after infarction. And TCM syndrome is effective, and clinical application has not found obvious adverse reactions and adverse events. It is worthy of clinical promotion to improve the clinical symptoms of vascular dementia patients, reduce the rate of disability and improve the quality of life of the patients.

【學(xué)位授予單位】：南京中醫(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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