【摘要】：目的:探討化瘀通絡(luò)法中藥改善血管性癡呆認(rèn)知功能的臨床療效。方法:收集2014年10月—2016年10月在廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院神經(jīng)內(nèi)科、康復(fù)科門診及住院治療的血管性癡呆患者64例,中醫(yī)證型符合瘀血阻絡(luò)證,按照隨機(jī)數(shù)字表法,隨機(jī)分為2組,治療組和對(duì)照組各32例。對(duì)照組予常規(guī)西醫(yī)治療,如抗血小板聚集,調(diào)脂穩(wěn)定斑塊,降血壓、降血脂、降血糖治療,戒煙戒酒等,治療組在對(duì)照組基礎(chǔ)上加用化瘀通絡(luò)的中藥,連續(xù)服用3個(gè)月。分別比較兩組治療前、治療1個(gè)月后及治療3個(gè)月后簡(jiǎn)易智能狀態(tài)檢查量表(MMSE)、長(zhǎng)谷川智能量表(HDS)、日常生活自理能力量表(ADL)、P300及中醫(yī)證候積分的變化,所有數(shù)據(jù)均采用SPSS19.0統(tǒng)計(jì)分析軟件進(jìn)行分析。計(jì)量資料采用t檢驗(yàn),計(jì)數(shù)資料采用X~2檢驗(yàn)。結(jié)果:(1)治療前兩組間比較均無(wú)顯著差異(P0.05),兩組具有可比性;(2)對(duì)照組及治療組治療后1個(gè)月的MMSE、HDS、ADL量表評(píng)分較治療前均稍有改善,但是在統(tǒng)計(jì)學(xué)上無(wú)差異(P0.05);治療后1個(gè)月組間比較無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);(3)對(duì)照組治療后3個(gè)月MMSE、HDS、ADL評(píng)分及P300較治療前均稍有改善,但是無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),治療組治療后3個(gè)月MMSE、HDS、ADL量表評(píng)分及P300較治療前均有顯著差異(P0.05);(4)臨床療效:治療組治療后的總有效率為84.38%,顯著高于對(duì)照組的59.38%,差異有統(tǒng)計(jì)學(xué)意義。提示治療組的療效較對(duì)照組的療效好。(5)治療過(guò)程中未出現(xiàn)與化瘀通絡(luò)法有關(guān)影響治療的不良反應(yīng)。結(jié)論:化瘀通絡(luò)法結(jié)合西醫(yī)基礎(chǔ)治療對(duì)改善血管性癡呆的認(rèn)知功能有一定療效,可明顯改善血管性癡呆患者臨床癥狀,提高認(rèn)知功能,提高認(rèn)知功能量表評(píng)分,提高患者及患者家屬的生活質(zhì)量,值得進(jìn)一步深入研究。
[Abstract]:Objective: to explore the clinical effect of Huayu Tongluo method on improving cognitive function of vascular dementia. Methods: from October 2014 to October 2016, 64 patients with vascular dementia were collected from Department of Neurology, Rehabilitation Clinic and inpatient treatment in Ruikang Hospital of Guangxi University of traditional Chinese Medicine. They were randomly divided into two groups: treatment group (32 cases) and control group (32 cases). The control group was treated with conventional western medicine, such as anti-platelet aggregation, regulating lipid and stabilizing plaque, lowering blood pressure, lowering blood lipid, lowering blood sugar, giving up smoking and alcohol, etc. The treatment group added traditional Chinese medicine to remove blood stasis and clear collaterals on the basis of control group, and took it continuously for 3 months. Before treatment, 1 month after treatment and 3 months after treatment, the changes of (ADL), P300 and TCM syndrome score of (MMSE), Hasegawa Intelligence scale (HDS), daily life self-care ability scale and TCM syndrome score were compared between the two groups. All data were analyzed by SPSS19.0 statistical analysis software. T-test was used to measure the data, and X-2 test was used to count the data. Results: (1) there was no significant difference between the two groups before treatment (P0.05). (2) 1 month after treatment, the MMSE,HDS,ADL scale scores of the control group and the treatment group were slightly improved compared with those before treatment, but there was no statistical difference (P0.05); there was no significant difference between the two groups 1 month after treatment (P0.05); (3) the MMSE,HDS,ADL score and P300 in the control group improved slightly after 3 months treatment compared with those before treatment, but there was no statistical difference (P0.05). In the treatment group, the MMSE,HDS, at 3 months after treatment was slightly improved (P0.05). The scores of ADL scale and P300 were significantly different from those before treatment (P0.05). (4) Clinical efficacy: the total effective rate of the treatment group was 84.38%, which was significantly higher than that of the control group (59.38%). It was suggested that the therapeutic effect of the treatment group was better than that of the control group. (5) there was no adverse reaction related to Huayu Tongluo method in the course of treatment. Conclusion: Huayu Tongluo method combined with basic treatment of western medicine can improve the cognitive function of vascular dementia, improve the clinical symptoms of vascular dementia patients and improve the score of cognitive function scale. It is worth further study to improve the quality of life of patients and their families.
【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)】：R277.7

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