“益腎調(diào)督”針刺法治療輕度認(rèn)知功能障礙的臨床觀(guān)察
發(fā)布時(shí)間：2019-03-28 19:04
【摘要】：目的:以輕度認(rèn)知功能障礙患者為研究對(duì)象,比較經(jīng)針刺結(jié)合口服鹽酸多奈哌齊與單純口服鹽酸多奈哌齊治療后的臨床療效,觀(guān)察針刺治療輕度認(rèn)知功能障礙的臨床療效,以此說(shuō)明“益腎調(diào)督”針刺法治療此病的有效性,為其在輕度認(rèn)知障礙的治療及對(duì)癡呆的防治提供臨床依據(jù)。方法:采用隨機(jī)對(duì)照、三分離的研究方法,將來(lái)自于武漢江南腦科醫(yī)院針灸門(mén)診及住院部符合納入標(biāo)準(zhǔn)的62例患者,采用隨機(jī)數(shù)字表的方法隨機(jī)分為針?biāo)幗Y(jié)合組及西藥組,每組31例,各組脫落1人,最終有60人完成本實(shí)驗(yàn)。針?biāo)幗Y(jié)合組采用“益腎調(diào)督”為法,以百會(huì)、四神聰、神庭、風(fēng)池(雙側(cè))、腎俞(雙側(cè))、懸鐘(雙側(cè))、太溪(雙側(cè))等穴位為主穴(頭部穴位分兩組,交替加用電針,頻率2-5Hz,連續(xù)波,留針30min),經(jīng)中醫(yī)整體辨證后對(duì)不同的證型加以配穴(腎精虧耗證加志室,心脾不足證加心俞、脾俞,痰濁擾心證加豐隆,血瘀痹阻證加膈俞)進(jìn)行針刺配合口服鹽酸多奈哌齊治療,每日1次,6次為1個(gè)療程,每個(gè)療程中間休息1天,持續(xù)治療8個(gè)療程。西藥組采用鹽酸多奈哌齊(安理申)口服,每日1片(5mg),于每晚睡前服用,持續(xù)口服8周。觀(guān)察兩組患者治療前后簡(jiǎn)易精神狀態(tài)量表(Mini-mental State Examination,MMSE)及蒙特利爾量表(Montreal Cognitive Assessment,MoCA)的評(píng)分變化,評(píng)估其臨床療效,運(yùn)用SPASS17.0統(tǒng)計(jì)軟件對(duì)相應(yīng)數(shù)據(jù)進(jìn)行對(duì)比分析。結(jié)果:1.兩組治療前與治療后的MMSE評(píng)分和MoCA評(píng)分結(jié)果對(duì)比顯示,差異均有顯著性(P0.05),說(shuō)明兩組都能提高患者M(jìn)MSE量表和MoCA量表的評(píng)分結(jié)果。2.針?biāo)幗Y(jié)合組治療后的MMSE量表和MoCA量表評(píng)分與西藥組治療后的MMSE量表和MoCA量表評(píng)分的對(duì)比顯示,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。說(shuō)明針刺配合西藥口服的治療方法在改善MCI患者認(rèn)知功能上優(yōu)于單純口服西藥。3.針?biāo)幗Y(jié)合組與西藥組總體療效相比較,針?biāo)幗Y(jié)合組總有效率為83.33%,西藥組總有效率為73.33%,兩組都能改善MCI患者的臨床癥狀,且兩組療效相比,有顯著性差異(P0.05),具有統(tǒng)計(jì)學(xué)意義,說(shuō)明針刺配合西藥口服的方法的臨床療效優(yōu)于單純口服西藥,“益腎調(diào)督”針刺法是可以在臨床推廣的一種治療方法。結(jié)論:研究結(jié)果顯示:針刺配合口服鹽酸多奈哌齊的治療方法與單純口服鹽酸多奈哌齊均可改善輕度認(rèn)知障礙患者的病情,且針刺配合口服鹽酸多奈哌齊的方法的療效優(yōu)于單純口服鹽酸多奈哌齊。
[Abstract]:Objective: to compare the clinical efficacy of acupuncture combined with oral Donepezil Hydrochloride and Donepezil Hydrochloride in the treatment of mild cognitive impairment, and to observe the clinical effect of acupuncture on mild cognitive dysfunction. In order to provide clinical basis for the treatment of mild cognitive impairment and the prevention and treatment of dementia, the acupuncture therapy of "tonifying the kidney and regulating the governor" is effective in the treatment of this disease. Methods: 62 patients from acupuncture outpatient department and inpatient department of Wuhan Jiangnan brain Hospital were randomly divided into acupuncture combined group and western medicine group by random numerical table, and 62 patients from Wuhan Jiangnan brain Hospital were randomly divided into two groups: acupuncture combined group and western medicine group by random numerical table, and 62 patients from Wuhan Jiangnan brain Hospital were randomly divided into acupuncture group and western medicine group. There were 31 cases in each group, 1 person fell off in each group, and 60 people completed the experiment. The acupuncture and medicine combination group adopted "tonifying the kidney and regulating the governor" as the method, with Baihui, Sishen Cong, Shenting, Fengchi (bilateral), Shenshu (bilateral), hanging bell (bilateral), Taixi (bilateral) as the main points (head acupoints divided into two groups, alternately using electroacupuncture, etc.). Frequency 2 ~ 5 Hz, continuous wave, needle retention 30min), after the whole syndrome differentiation of traditional Chinese medicine (TCM), the different syndrome types were combined with acupoints (kidney essence deficiency syndrome plus journal room, heart and spleen deficiency syndrome plus Xin Shu, spleen Shu syndrome, phlegm turbidity disturbing heart syndrome plus Fenglong), the syndrome of kidney deficiency and spleen deficiency syndrome plus Xin Shu, spleen Shu syndrome, phlegm turbidity disturbing heart syndrome plus Fenglong, The patients were treated with acupuncture combined with oral administration of Donepezil once a day, 6 times as a course of treatment, one day rest in the middle of each course, and 8 courses of continuous treatment. In the western medicine group, Donepezil Hydrochloride (Aristin) was given orally, one tablet per day (5mg), which was taken every night before bedtime, and was given orally for 8 weeks. To observe the changes of mini mental state scale (Mini-mental State Examination,MMSE) and Montreal scale (Montreal Cognitive Assessment,MoCA) before and after treatment in the two groups, to evaluate the clinical efficacy, and to compare and analyze the data with SPASS17.0 statistical software. Results: 1. The comparison of MMSE score and MoCA score between the two groups before and after treatment showed that the difference was significant (P0.05), indicating that the two groups could improve the scores of MMSE and MoCA scales. 2. The scores of MMSE and MoCA in acupuncture combined with medicine group were compared with those of MMSE and MoCA after treatment in western medicine group, and the difference was statistically significant (P0.05). It is indicated that acupuncture combined with oral western medicine is superior to oral western medicine in improving cognitive function in patients with MCI. 3. Compared with the western medicine group, the total effective rate was 83.33% in the acupuncture combined group and 73.33% in the western medicine group. Both groups could improve the clinical symptoms of MCI patients, and the curative effect of the two groups was better than that of the western medicine group, and the total effective rate of the combination group was 83.33%, and that of the western medicine group was 73.33%. There was significant difference (P0.05), with statistical significance, indicating that the clinical efficacy of acupuncture combined with oral western medicine was better than that of oral western medicine alone, and "tonifying the kidney and regulating the governor" acupuncture was a therapeutic method that could be popularized in clinical practice. Conclusion: acupuncture combined with oral Donepezil can improve the condition of patients with mild cognitive impairment. The therapeutic effect of acupuncture combined with oral Donepezil hydrochloride was better than that of oral Donepezil Hydrochloride alone.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R246.6
本文編號(hào)：2449151
[Abstract]:Objective: to compare the clinical efficacy of acupuncture combined with oral Donepezil Hydrochloride and Donepezil Hydrochloride in the treatment of mild cognitive impairment, and to observe the clinical effect of acupuncture on mild cognitive dysfunction. In order to provide clinical basis for the treatment of mild cognitive impairment and the prevention and treatment of dementia, the acupuncture therapy of "tonifying the kidney and regulating the governor" is effective in the treatment of this disease. Methods: 62 patients from acupuncture outpatient department and inpatient department of Wuhan Jiangnan brain Hospital were randomly divided into acupuncture combined group and western medicine group by random numerical table, and 62 patients from Wuhan Jiangnan brain Hospital were randomly divided into two groups: acupuncture combined group and western medicine group by random numerical table, and 62 patients from Wuhan Jiangnan brain Hospital were randomly divided into acupuncture group and western medicine group. There were 31 cases in each group, 1 person fell off in each group, and 60 people completed the experiment. The acupuncture and medicine combination group adopted "tonifying the kidney and regulating the governor" as the method, with Baihui, Sishen Cong, Shenting, Fengchi (bilateral), Shenshu (bilateral), hanging bell (bilateral), Taixi (bilateral) as the main points (head acupoints divided into two groups, alternately using electroacupuncture, etc.). Frequency 2 ~ 5 Hz, continuous wave, needle retention 30min), after the whole syndrome differentiation of traditional Chinese medicine (TCM), the different syndrome types were combined with acupoints (kidney essence deficiency syndrome plus journal room, heart and spleen deficiency syndrome plus Xin Shu, spleen Shu syndrome, phlegm turbidity disturbing heart syndrome plus Fenglong), the syndrome of kidney deficiency and spleen deficiency syndrome plus Xin Shu, spleen Shu syndrome, phlegm turbidity disturbing heart syndrome plus Fenglong, The patients were treated with acupuncture combined with oral administration of Donepezil once a day, 6 times as a course of treatment, one day rest in the middle of each course, and 8 courses of continuous treatment. In the western medicine group, Donepezil Hydrochloride (Aristin) was given orally, one tablet per day (5mg), which was taken every night before bedtime, and was given orally for 8 weeks. To observe the changes of mini mental state scale (Mini-mental State Examination,MMSE) and Montreal scale (Montreal Cognitive Assessment,MoCA) before and after treatment in the two groups, to evaluate the clinical efficacy, and to compare and analyze the data with SPASS17.0 statistical software. Results: 1. The comparison of MMSE score and MoCA score between the two groups before and after treatment showed that the difference was significant (P0.05), indicating that the two groups could improve the scores of MMSE and MoCA scales. 2. The scores of MMSE and MoCA in acupuncture combined with medicine group were compared with those of MMSE and MoCA after treatment in western medicine group, and the difference was statistically significant (P0.05). It is indicated that acupuncture combined with oral western medicine is superior to oral western medicine in improving cognitive function in patients with MCI. 3. Compared with the western medicine group, the total effective rate was 83.33% in the acupuncture combined group and 73.33% in the western medicine group. Both groups could improve the clinical symptoms of MCI patients, and the curative effect of the two groups was better than that of the western medicine group, and the total effective rate of the combination group was 83.33%, and that of the western medicine group was 73.33%. There was significant difference (P0.05), with statistical significance, indicating that the clinical efficacy of acupuncture combined with oral western medicine was better than that of oral western medicine alone, and "tonifying the kidney and regulating the governor" acupuncture was a therapeutic method that could be popularized in clinical practice. Conclusion: acupuncture combined with oral Donepezil can improve the condition of patients with mild cognitive impairment. The therapeutic effect of acupuncture combined with oral Donepezil hydrochloride was better than that of oral Donepezil Hydrochloride alone.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R246.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 林爾正;林丹紅;;針灸治療認(rèn)知功能障礙經(jīng)穴的古代文獻(xiàn)研究[J];中華中醫(yī)藥雜志;2016年11期
2 秦虹云;皮衍玲;楊震;劉科;陳定華;張明;郁東海;顧永紅;;社區(qū)老年人輕度認(rèn)知功能障礙中醫(yī)證候?qū)W特征的橫斷面調(diào)查[J];上海中醫(yī)藥雜志;2015年06期
3 朱才豐;蔡圣朝;徐斌;賀成功;楊成;梁猛軍;;通督調(diào)神針灸療法治療遺忘型輕度認(rèn)知功能障礙臨床觀(guān)察[J];安徽中醫(yī)藥大學(xué)學(xué)報(bào);2015年03期
4 崔韶陽(yáng);許明珠;彭志華;賴(lài)新生;唐純志;王曙輝;鐘非;;針刺結(jié)合康復(fù)訓(xùn)練改善輕度認(rèn)知功能障礙的療效觀(guān)察[J];針灸臨床雜志;2015年04期
5 崔利華;張慧麗;張小年;;腦卒中恢復(fù)期患者簡(jiǎn)易智能狀態(tài)檢查和蒙特利爾認(rèn)知評(píng)估的對(duì)比研究[J];中國(guó)康復(fù)理論與實(shí)踐;2014年08期
6 程小明;曾永青;李惠萍;楊燕瓶;;補(bǔ)腎益腦方治療老年輕度認(rèn)知障礙的療效及對(duì)血清Ach、SOD、MDA的影響[J];中藥材;2014年06期
7 李恬;孫立軍;;從“腎-髓-腦”論體質(zhì)調(diào)理與老年性癡呆的防治[J];四川中醫(yī);2014年04期
8 何迎春;李瑾;劉曉丹;張如富;;從β類(lèi)淀粉樣蛋白等氧化損傷角度探討健脾填精方對(duì)輕度認(rèn)知障礙的作用機(jī)制[J];中西醫(yī)結(jié)合心腦血管病雜志;2013年06期
9 侯俊林;詹向紅;閆國(guó)立;劉永;李偉;楊麗萍;王友杰;韓賀云;;輕度認(rèn)知障礙篩查方案研究進(jìn)展[J];中國(guó)老年學(xué)雜志;2013年10期
10 鮑琳琳;趙紅;張仁澤;周明yN;;阿爾茨海默病患者腦脊液核心生物標(biāo)記與認(rèn)知功能的相關(guān)性[J];中國(guó)老年學(xué)雜志;2013年01期
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