中医药治疗血管性痴呆临床近况

血管性痴呆(VD)是我国中老年人群的常见病、多发病,已严重影响老年人的生活质量。结合科研成果及中医药诊治VD的文献,分析汇总VD在病因病机及临床治疗方面的进展。脏腑虚损、气血失调、痰瘀阻窍为VD发生发展的重要因素,痰瘀蕴积、酿生浊毒、败络损髓是VD发生发展的关键。中医分期治疗包括分为早期、中期、晚期治疗及分为平台期、波动期和下滑期治疗。中医专法专药治疗主要以补肾活血化痰、补肾益气活血、活血通络、活血化痰为主。中医针灸治疗主要包括体针、针药结合以及眼针、耳穴按压配合艾灸、中药穴位敷贴等。今后应充分发挥中医药的优势,除加强对VD的诊治研究外,还应对无痴呆型血管性认知障碍(V-CIND)的发病机制及有效的临床治疗进行探讨,以期达到对VD早预防、早诊断、早干预的目的。

Current situation of treatment of vascular dementia with Chinese medicine

Vascular dementia(VD) is a common and frequently-occurring disease,which is influencing seriously the life quality of aged people.The authors analyzed and summarized the etiology and pathogenesis of VD and therapeutic progress in clinic based on scientific research achievements and literature about treatment of VD with Chinese medicine.They thought that the important factors in the development of VD included deficiency of zang-fu organs,disorder of qi and blood and phlegm-stasis obstructing orifices,and the key points included accumulation of phlegm-stasis,production of turbid-toxin and injury of collaterals and marrow,the therapeutic period was divided into early,middle and late stages or platform,wave and glide stages,TCM therapies for VD included tonifying kidney,activating blood circulation and resolving phlegm,tonifying kidney,tonifying qi and activating blood circulation,activating blood circulation and freeing calleterals,and activating blood circulation and resolving phlegm,and acupuncture therapies for VD included body acupuncture,integration of acupuncture and medicinal,eye acupuncture,ear acupoint pressing combining with moxibustion,and acupoint application with Chinese medicinal.In the future,the pathogenesis and effective therapies for vascular cognitive impairment no dementia(V-CIND) should be explored for preventing,diagnosing and intervening VD early besides improving the study on the diagnosis and treatment of VD.