中医综合治疗方案治疗血管性痴呆的临床分析-clinical analysis of comprehensive treatment of vascular dementia with traditional chinese medicine.docxVIP

中医综合治疗方案治疗血管性痴呆的临床研究 中 文 摘 要 目的： 观察中医综合治疗方案对血管性痴呆（VD）的临床疗效， 为完善 VD 综合治疗方案提供循证医学的依据。 方法 ： 本研究采用多中心、平行对照临床实验方法，纳入 3 家医 院共 216 例 VD 患者，剔除或脱落 8 例，共 208 例患者进入试验，入选病 例采用随机数字表法分为中医综合治疗组与西医综合治疗对照组，每组 104 例。治疗组和对照组均接受常规内科基础治疗；中医综合治疗组并采 用中医辨证论治和针灸治疗，配合康复训练和护理；西医对照组并采用 西药吡拉西坦治疗，配合康复训练和护理。两组均观察用药 2 个月。主 要观察患者的认知能力(MMSE)、日常生活活动能力(ADL)以及行为能力 (BBS)和中医证侯积分值改善情况。 结果：（1）治疗后治疗组患者 MMSE 评分改善有效率为 79.81%，对 照组有效率为 47.11%，组间差异有显著统计学意义（P0.01）；（2）治 疗后两组患者 ADL 评分均较治疗前明显提高(P0.01)，治疗组较对照组 提高更明显(P0.05)；（3）治疗后治疗组 BBS 评分改善有效率为 73.08%， 对照组有效率为 46.15%，组间差异有显著统计学意义（P0.05），治疗 组综合疗效优于对照组；（4）两组患者治疗前后组内自身比较 P0.01， 说明两组均可以明显改善 VD 患者的中医证侯积分；治疗后两组间比较 P0.05，表明治疗组在改善 VD 患者的中医证侯积分方面优于对照组。 结论：中医综合治疗组在对认知功能的改善方面与西医综合治疗组 对比均有明确的临床疗效，其对 VD 患者 MMSE 评分及 ADL、BBS 和中医证 侯积分都有显著改善作用，治疗 VD 疗效肯定，且优于西医综合治疗组。 关键词：血管性痴呆，辨证治疗，中医综合治疗 Clinical study of treating vascular dementia through comprehensive program in TCM ABSTRACT Objective:In order to provide evidence of evidence-based medicine, the curative effects of comprehensive treating program were observed. Methods:Through multi-center,parallel,randomized,controlled clinical trial methods,216 cases with Vascular Dementia were enrolled in three centers,8 cases were excluded,208 cases randomly were divided into the experimental group(n=104) and the control group(n=104).Both group received standard internal medicine and rehabilitation therapy.The experimental group was given syndrome differential treatment and acupuncture,and the control group was only given Piracetam for 2 months.The main observation of the patients cognitive ability(MMSE), activities of daily living(ADL),capacity assessment scale(BBS),and TCM syndrome score were detected before and after treatment. Results:(1)After two months treatment,effective rate of control group(79.81%) was significantly lower than that of experimental group(47.11%) in MMSE scores(P0.05).(2)At the end of research,the ADL scores of both groups were significantly increased than those before the treatment(P0.01),and the alleviation of