血管性痴呆肾虚血瘀证早期的中医综合治疗方案分析-analysis of comprehensive treatment plan of traditional chinese medicine in early stage of vascular dementia with kidney deficiency and blood stasis syndrome.docxVIP
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血管性痴呆肾虚血瘀证早期的中医综合治疗方案分析-analysis of comprehensive treatment plan of traditional chinese medicine in early stage of vascular dementia with kidney deficiency and blood stasis syndrome
中文摘要
目的:通过严谨的科学研究,结合导师的临床心得体会,对血管性痴呆(肾虚血 瘀证)早期的中医病机及健脑通脉方的中医内治法结合针灸及康复的综合治疗方案进 行初步的研讨。
方法:临床研究部分,诊断标准参照 2002 年国家卫生部颁布的《中药新药临床 研究指导原则》中诊断标准,并结合采用中国中医药学会内科延缓衰老专业委员会 2002 年制定得“血管性痴呆诊断辨证及疗效评定标准”。痴呆分度及疗效判定根据 FOLSTEIN 简易精神状态检查表(MMSE)、BLESSED 行为量表(BBS)、布里斯托尔 日常生活能力量表(BADLS)、康莱尔痴呆中的抑郁量表(CSDD)、血管性痴呆辨证 量表(SDSVD)。采用随机、单盲、对照的实验方法,根据临床症候积分及量表评定, 确定纳入人选。将入选病例按 1:1 的比例随机分为治疗组和对照组,治疗组服用中 药健脑通脉胶囊合并针灸及康复训练,对照组服用脑复康片和康复训练。
结果:临床研究结果显示 8 周后中医证候积分治疗组总有效率为 83. 33%,
对照组为 56. 67%;MMSE 量表积分治疗组总有效率为 73. 33%,对照组为 56. 67%; BBS 量表积分治疗组总有效率为 80%,对照组为 53. 33%;BADLS 量表积分治疗组 总有效率为 70%,对照组为 53. 33%;CSDD 量表积分治疗组总有效率为 53. 33%, 对照组为 50%,经统计学检验说明两组在改善中医证候、认知功能、非认知能力 方面均有较好疗效,提示健脑通脉方合并针灸康复可较明显改善 VD 患者中医证 候表现、非认知能力,对认知功能、日常生活能力两组之间无显著差异,但从有 效率上可看出治疗组优于对照组,两组间统计学无明显差异可能与样本量较小、 疗程较短相关,两组改善痴呆中的抑郁情况均不佳。
结论:本研究揭示肾虚血瘀是血管性痴呆的主要病机,具有补肾活血功效之 健脑通脉胶囊合并针灸康复的综合治疗方案治疗血管性痴呆具有较为确切的临 床疗效。
关键词:血管性痴呆 ;肾虚血瘀;健脑通脉胶囊;针灸;康复;综合方 案;临床研究
Abstract
Obj ect i ve: Based on my tutors long-term clinical experience, through a precise scientific way,this paper studies the main TCM pathogenesis of Vascular Dementia
(VD) and the integrated treatment consist of Jiannaotongmai Capsule, acupuncture and rehabilitation on VD on its early stage .
Methods: In clinical study, the “Guiding Principles of Clinical TCM Medicine Research” promulgated by the Ministry of Health in 2002 serves as the diagnostic criteria combined with the “Diagnosis Differentiation and Clinical Evaluation Standards of VD” established by China Academy of TCM in 2002. The rating and clinical judgement of VD based on the MMSE, BBS, BADLS, CSDD and SDSVD. Random, single-blind and erandomize-controlled methods are adopted to observe the curative effects of 60 patient with VD of mild or middle degree. They are 30 cases in treating group and 30 cases in control group .In the treating group the Jiannaotongmai Capsule with acupuncture and rehabilitation is used, while the control group Naofukang tablets.
Result: Clinical study showed that after 8 weeks’ treatment the total ef
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