【摘要】：目的:基于功能代償學說,通過于氏頭針聯(lián)合電針與長留針所選頭區(qū)的不同對VCIND的療效探討,為臨床提供更加有效的治療方法和臨床依據(jù)及理論基礎。方法:將144例符合納入標準的VCIND的患者隨機分為三組:A組、B組、C組,每組48例患者。三組患者中,A組選取于氏頭針額區(qū)、頂前區(qū)、顳區(qū)(雙),電針;B組選取于氏頭針額區(qū)、頂前區(qū)、顳區(qū)(雙),長留針,間斷行針;C組選取于氏頭針額區(qū)、頂前區(qū)、顙區(qū)(患側),長留針,間斷行針。額區(qū)針刺六針,頂前區(qū)針刺八針,兩側顳區(qū)各針刺三針。A組采用KWD-808-I型脈沖電針儀,使用疏密波,每次通電30min,額區(qū)(+)與頂前區(qū)(-)、頂前區(qū)(+)與顳區(qū)(-);B、C兩組長留針8h,每2h捻轉行針一次,每針行針10s,轉速200r/min。體針均為針刺30min后出針。A組每日兩次,B、C兩組每日一次,六天為一療程,每療程結束后休息一日,共治療四周。使用蒙特利爾認知評估量表(MoCA)、日常生活量表(ADL)量表、事件相關電位P300和血同型半胱氨酸(Hcy)評定認知功能損傷程度和療效。利用SPSS 20.0統(tǒng)計軟件對數(shù)據(jù)進行處理與分析。結果:1.治療后三組患者的MoCA量表評分較療前有明顯提高,治療前后有顯著差異(p0.01),且A組與B、C兩組間有顯著差異(p(A、B 組)0.01,p(A、C 組)0.01),B 組、C 組兩者間無明顯差異(p0.05)。2.治療后三組患者的ADL量表評分較療前有明顯提高,治療前后有顯著差異(p0.01),且A組與B、C兩組間有顯著差異(p(A、B 組)0.01,p(A、C 組)0.01),B 組、C 組兩者間無明顯差異(p0.05)。3.治療后三組患者的事件相關電位P300Q潛伏期較療前明顯縮短,治療前后有顯著差異(p0.01),且A組與B、C兩組間有顯著差異(p(A、B 組)0.01,p(A、C 組)0.01),B 組、C 組兩者間有明顯差異(p0.01)。波幅較療前明顯增高,治療前后有顯著差異(p0.01),且A組與B、C兩組間有顯著差異(p(A、B組)0.01,(A、C組)0.01),B組、C組兩者間有明顯差異(p0.01)。4.治療后三組患者的Hcy較療前有明顯降低,治療前后有顯著差異(p0.01),且A組與B、C兩組間有顯著差異(p(A、B組)0.01,p(A、C組)0.01),B組、C組兩者間無明顯差異(p0.05)。結論:1.于氏頭針能夠有效地提高VCIND患者的MoCA、ADL的量表評分,可以有效縮短其事件相關電位P300的潛伏期且增加其波幅,并能夠明顯降低VCIND患者的危險因素Hcy水平,說明于氏頭針可以有效地改善VCIND患者的認知功能障礙。2.于氏頭針雙側顳區(qū)和單側顳區(qū)長留針的臨床療效基本一致,均能有效地改善患者的認知力和生活自理能力等。3.于氏頭針(雙側顳區(qū))聯(lián)合電針較雙側顳區(qū)和單側顳區(qū)長留針對VCIND患者的療效更好。
[Abstract]:Objective: based on the theory of functional compensation, the curative effect of VCIND was discussed by the difference of the head area of Yu's scalp acupuncture combined with long retention needle, so as to provide more effective treatment method, clinical basis and theoretical basis for clinical treatment. Methods: one hundred and forty-four patients with VCIND were randomly divided into three groups: group A: group B and group C, with 48 patients in each group. Among the three groups, group A selected frontal area of scalp acupuncture, preparietal area, temporal region (double area), electroacupuncture group B selected frontal area of scalp acupuncture, preparietal region, temporal region (double area), long needle retention, intermittent acupuncture group C selected in frontal area of scalp acupuncture, preparietal region, preparietal area. Perteobagrus fulvidraco (affected side), long needle retention, intermittent needle. The frontal region was needled with six needles, the preparietal region with eight needles, and the two sides of the temporal region with three needles. Group A was treated with KWD-808-I type pulse electroacupuncture instrument, with dense waves. For 30 minutes, the frontal area () and the preparietal area (-), the preparietal area () and the temporal region (-) kept the needle for 8 hours. The needle was twirled once every 2 hours. The needle was rotated at a rotational speed of 200 r / min. All the body acupuncture groups were treated by acupuncture after 30min. Group A was treated twice a day with six days as a course of treatment. After each course of treatment, the patients were given a rest day for four weeks. The Montreal Cognitive Assessment scale (MoCA), the (ADL) scale of Daily living scale (ADL), the event-related potential (P300) and the plasma homocysteine (Hcy) were used to evaluate the degree and efficacy of cognitive impairment. The data are processed and analyzed by SPSS 20.0 software. The result is 1: 1. After treatment, the scores of MoCA scale in the three groups were significantly higher than those before and after treatment (p0.01), and there was a significant difference between group A and group B (0.01). There was no significant difference between group B and group B (p0.05) .2.There was no significant difference between group B and group C (p0.05). After treatment, the scores of ADL scale in the three groups were significantly higher than those before and after treatment (p0.01), and there was significant difference between group A and group B (0.01). There was no significant difference between group B and group B (p0.05). After treatment, the latency of P300Q in the three groups was significantly shorter than that before treatment (p0.01), and there was significant difference between group A and group B (P 0.01). There was a significant difference between group A and group B (P < 0.01). The amplitude of wave was significantly higher than that before and after treatment (p0.01), and there was significant difference between group A and group B (P 0.01) and between group A (group A) and group B (group C). There was a significant difference between group C (P 0.01) and group C (P 0.01). After treatment, the Hcy of the three groups was significantly lower than that of before and after treatment (p0.01), and there was a significant difference between group A and group B (0.01). There was no significant difference between group B and group C (p0.05). Conclusion 1. Yu's scalp acupuncture can effectively improve the score of MoCA,ADL in patients with VCIND, shorten the latency and increase the amplitude of P300, and decrease the Hcy level of risk factors in VCIND patients. It shows that Yu's scalp acupuncture can effectively improve the cognitive dysfunction of patients with VCIND. 2. 2. The clinical curative effect of bilateral temporal area and unilateral temporal area retention needle of Yu's scalp acupuncture is basically the same, which can effectively improve the cognitive ability and life self-care ability of patients. 3. The curative effect of Yu's scalp acupuncture (bilateral temporal region) combined with electroacupuncture on VCIND patients was better than that of bilateral temporal area and unilateral temporal area.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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