“三焦”针法与“黄地散”方药联合治疗血管性痴呆的随机对照研究

Clinical observation of combination of “Sanjiao” acupuncture with “Huangdisan” on vascular dementia: a randomized controlled trial

关键词:  血管性痴呆  益气调血, 扶本培元  三焦针法  随机对照试验

Key words:  vascular dementia  Yiqi Tiaoxue, Fuben Peiyuan  Sanjiao acupuncture  randomized controlled trial

摘要:

[目的] 评价“三焦”针法结合“黄地散”方药治疗轻中度血管性痴呆(VaD)的有效性,探讨优化治疗方案。[方法] 将270例轻中度VaD患者,随机分为综合治疗组、针刺组和西药组,各组90例。综合治疗组采用“三焦”针法与“黄地散”方药联合治疗;针刺组采用“三焦”针法治疗;西药组采用安理申治疗,共治疗12周,采用简易智能量表(MMSE)、画钟试验(CDT)及血管性痴呆辨证量表(SDSVD)进行评价。 [结果] 1)治疗后3组患者MMSE评分、认知功能均较治疗前有显著改善,差异均有统计学意义(P<0.05);3组组间比较差异无统计学意义(P>0.05)。2)治疗后3组患者CDT评分、执行功能均较治疗前有显著改善,差异均有统计学意义(P<0.05);3组治疗12周后,CDT总分、执行功能疗效组间比较存在差异性(P<0.05),其中综合治疗组优于针刺组和西药组(P<0.05),针刺组与西药组不存在统计学意义(P>0.05)。3)3组患者治疗12周后,中医证候评价疗效综合治疗组优于西药组(P<0.05),针刺组优于西药组(P<0.05),综合治疗组与针刺组不存在统计学意义(P>0.05)。[结论] “三焦”针法配合“黄地散”方药可改善VaD患者的中医证候和认知功能且提升VaD患者执行功能,值得临床推广应用。

Abstract:

[Objective] To evaluate effect of “Sanjiao” acupuncture combined with “Huangdisan” on mild-to-moderate vascular dementia, to explore optimal treatment plan. [Methods] The 270 patients with mild-to-moderate vascular dementia, were randomly divided into treatment group, acupuncture group and western medicine group, each group of 90 cases. Combination of “Sanjiao” acupuncture with “Huangdisan” was used in comprehensive treatment group; acupuncture group was treated by “Sanjiao” acupuncture; Western medicine group was treated by aricept, a total of 12 weeks of treatment, to evaluate effect by MMSE, CDT and SDSVD. [Results] 1) MMSE scores in three groups of patients was improved significantly after treatment, the difference had statistical significance (P<0.05); there was no statistically significant difference between groups (P>0.05). 2) The CDT score and executive function in the three groups of patients after treatment was improved significantly, the difference had statistical significance (P<0.05); after 12 weeks of treatment, differences of the CDT total scores and executive function among three groups was obvious (P<0.05); comprehensive group was better than acupuncture group and Western medicine group (P<0.05); there was no statistical significance between acupuncture group and Western medicine(P> 0.05). 3) After 12 weeks of treatment, traditional Chinese medicine(TCM) syndrome evaluation effect in comprehensive group was better than Western medicine group (P<0.05); acupuncture was superior to western medicine group (P<0.05); there was no statistical significance between acupuncture group and comprehensive group (P>0.05). [Conclusion] Combination of “Sanjiao” acupuncture with “Huangdisan” can improve cognitive function in patients with vascular dementia and improve executive function in patients with vascular dementia, worthy of clinical popularization and application.