补肾开窍汤联合针刺治疗肾虚痰阻血瘀型轻中度血管性痴呆疗效观察

目的观察补肾开窍汤联合针刺治疗轻中度肾虚痰阻血瘀型血管性痴呆的临床疗效。方法将2016年6月—2018年2月兖矿集团总医院收治的120例轻中度肾虚痰阻血瘀型血管性痴呆患者随机分为观察组(60例)和对照组(60例),对照组给予常规西医治疗,观察组在对照组基础上加用补肾开窍汤联合针刺治疗,2组疗程均为12周。比较2组治疗前后中医症状积分、简易精神状态量表(MMSE)评分、血浆同型半胱氨酸(Hcy)水平、日常生活能力(ADL)评分,记录2组中医证候、临床治疗有效率。结果2组治疗后记忆力减退、耳聋耳鸣、齿动发脱、神情呆滞、失认失算、痰多而黏、腰脊酸痛、反应迟钝、夜尿频多积分和总积分均较治疗前显著降低(P均<0.05),观察组治疗后以上积分均显著低于对照组(P均<0.05);2组治疗后MMSE量表中定向力、记忆力、注意力和计算力、回忆能力、语言能力评分和MMSE总分均较治疗前显著升高(P均<0.05),观察组治疗后以上积分均显著高于对照组(P均<0.05);2组治疗4周、8周、12周后血浆Hcy水平均较治疗前显著降低(P均<0.05),观察组以上时间点的Hcy水平均显著低于对照组(P均<0.05);2组治疗后ADL量表分级和评分均较治疗前显著改善(P均<0.05),观察组治疗后以上分级与评分均优于对照组(P均<0.05)。观察组中医证候治疗总有效率、临床总有效率显著高于对照组(P均<0.05)。2组治疗期间均未发生严重不良反应,复查肝肾功能、心电图、血尿便检查均无异常。结论补肾开窍汤联合针刺治疗轻中度肾虚痰阻血瘀型血管性痴呆疗效显著,不仅能够提高患者认知功能,还能降低血浆Hcy水平,提高日常生活能力,且安全性好。

Observation on the effect of Bushen Kaiqiao decoction combined with acupuncture on mild to moderate vascular dementia of type of kidney deficiency,phlegm and blood stasis

Objective It is to observe the clinical effect of Bushen Kaiqiao decoction combined with acupuncture on mild to moderate vascular dementia of type of kidney deficiency,phlegm and blood stasis.Methods 120 patients with mild to moderate vascular dementia of type of kidney deficiency,phlegm and blood stasis treated in Xinlicheng General Hospital of Shandong Yankuang from June 2016 to February 2018 were selected and randomly divided into observation group(60 cases)and control group(60 cases).The control group was given conventional western medicine treatment,and the observation group was treated with Bushen Kaiqiao decoction combined with acupuncture on the basis of the control group.The treatment period of both groups was 12 weeks.The changes in TCM symptom scores,Mini Mental State Scale(MMSE)scores,plasma homocysteine(Hcy)level,and daily living ability(ADL)scores before and after treatment were compared between the two groups,and the curative effects of TCM symptoms and clinical treatment of the two groups were assessed.Results After treatment,the scores of memory loss,deafness and tinnitus,hair loss and tooth movement,dull expression,cognitive impairment,stick sputum,lumbar pain,slow response,nocturia and total scores were significantly lower than those before treatment in the two groups(P<0.05),the above scores in the observation group after treatment were significantly lower than those in the control group(P<0.05);the scores of orientation,memory,attention and computing ability,recall ability,language ability in the MMSE scale and total scores of MMSE were significantly higher than those before treatment in the two groups(P<0.05),and the above scores in the observation group were significantly higher than those in the control group(P<0.05);the plasma level of Hcy after 4 weeks,8 weeks,and 12 weeks of treatment.were significantly lower than those before treatment in the two groups(P<0.05),and Hcy levels at the time points above in the observation group were significantly lower than those in the control group(P<0.05);classification and scores of ADL were improved significantly after treatment in both groups(P<0.05).The above grades and scores in the observation group were better than those in the control group(P<0.05).The total effective rates of TCM symptoms and clinical treatment in the observation group were significantly higher than those in the control group(all P<0.05).No serious adverse reactions occurred during the treatment in the two groups,and the liver and kidney function,electrocardiogram,and hematuria were not abnormal.Conclusion Bushen Kaiqiao decoction combined with acupuncture has obvious curative effect on mild to moderate vascular dementia of type of kidney deficiency,phlegm and blood stasis.It can not only improve patients’cognitive function,but also reduce plasma Hcy level,improve daily living ability,and have good safety.