针刺治疗多发脑梗塞性痴呆46例临床观察

目的　探讨针刺治疗多发性脑梗塞的机理。方法　采用“补下清上、调神益智”的治疗原则 ,针刺治疗多发脑梗塞性痴呆 (MID) 4 6例 ,设立药物对照组 30例。于 1个疗程后观察疗效。结果　治疗组治愈 18例 ,治愈率 39 13% ;有效 2 4例 ,有效率 5 2 17% ;总有效率 91 3% ;与对照组比较有显著性差异。观察患者HDS、FAQ积分和神经功能缺损积分变化 ,并分层观察了痴呆症状、中医分证症状的变化 ,其平均有效率分别为 84 2 5 %和 81 39% ,优于对照组 ;显示针刺可有效改善MID患者的智力、社会活动能力及临床症状。同时观察了其中 4 1例患者的血液流变学和 2 6例患者的事件相关电位的变化 ,显示出具有统计学意义的改变。结论　患者血液动力学的变化和通过大脑边缘系统的全脑整和机能的恢复 ,可能是针刺治疗MID的重要作用机制

Clinical Observation of 46 Cases of Mult-Infarct Dementia Treated by Acupuncture

Objective To investigate the mechanisms of the effects of acupuncture on mult infarct dementia (MID). Method According to a TCM treating principle of supplementing the lower and clearing the upper to improve the mentality and enhance intelligence, a group of 46 MID cases was treated by acupuncture and a group of 30 MID cases treated by a drug therapy was used as a control. The curative efficacy was analyzed after one course of treatment. Results In the acupuncture group, 18 cases were fully cured and the cure rate was 39 13%, 24 cases responded to the treatment and the effective rate was 52 17%; the total effective rate was 91 3%; and as far as the effective rate was concerned, there was a significant difference between the acupuncture group and the control group. Analyses of HDS and FAQ scoring and neurographical malfunction scoring showed a mean effective rate of 84 25%, and the observation of the changes in dementia symptoms and the symptoms of the TCM syndromes differentiated showed a mean effective rate of 81 39%, which were better than those in the control group, indicating that acupuncture could improve mentality and the ability to take part in social activities, and relieve the clinical symptoms. And at the same time, the observation of the changes in the blood rheological criteria in 41 cases and the changes in the event related potential P 300 in 26 cases was carried out, and the results were statistically significant. Conclusion The acupuncture induced changes in hemodynamics and the restoration of the cerebral integration function through cerebral limbic system, may be important mechanisms of the effects of acupuncture in treating MID patients.