摘要
目的:观察烙灸督脉联合针刺与单纯运用烙灸、单纯运用针刺治疗血管性痴呆的临床疗效差异。方法:将120例血管性痴呆患者按就诊顺序随机分为烙灸针刺组、督脉烙灸组和常规针刺组,每组40例(各脱落2例,每组38例)。督脉烙灸组采用烙灸治疗,腧穴分为A、B两组,A组:百会、大椎、身柱、至阳、脊中、命门、腰阳关,B组:风府、陶道、神道、筋缩、悬枢、长强,每周一烙灸A组穴位,每周五烙灸B组穴位。常规针刺组采用针刺治疗,主穴取百会、四神聪、内关、足三里、太溪、悬钟,并辨证配穴,每天1次,每次30 min,每周连续治疗5次。烙灸针刺组采用与上述督脉烙灸组的烙灸及常规针刺组的针刺联合治疗。每组均治疗4周。于治疗前后对3组患者进行血管性痴呆中医辨证量表(SDSVD)、简易精神状态量表(MMSE)、日常生活自理能力量表(ADL)评分,评定临床疗效及安全性。结果:治疗后烙灸针刺组总有效率为89.5%(34/38)、督脉烙灸组为65.8%(25/38)、常规针刺组为63.2%(24/38),组间差异有统计学意义(P<0.05),烙灸针刺组疗效优于督脉烙灸组和常规针刺组(均P<0.05),督脉烙灸组和常规针刺组疗效差异无统计学意义(P>0.05)。治疗后各组患者SDSVD评分均低于治疗前,MMSE及ADL评分均高于治疗前(均P<0.01),且烙灸针刺组SDSVD、MMSE、ADL评分均优于其他两组(P<0.05,P<0.01),督脉烙灸组与常规针刺组各项评分比较差异均无统计学意义(均P>0.05)。各组治疗均具有安全性,差异无统计学意义(P>0.05)。结论:回医烙灸督脉联合针刺治疗血管性痴呆在总体疗效方面优于单纯督脉烙灸和单纯常规针刺治疗,且在改善患者的中医证候积分、认知功能,恢复日常活动能力方面优于其他两种治疗方法的单纯治疗。
Objective To observe the difference for vascular dementia among flipping moxibustion of Hui medicine at acupoints in governor vessel combined with acupuncture, simple Hui medicine and simple acupuncture. Methods A total of 120 patients with vascular dementia were randomly assigned into a combination group, a flipping moxibustion group and an acupuncture group, 40 cases in each one, with 2 patients dropping respectively. Flipping moxibustion was used at the acupoints of group A on Monday and at the acupoints of group B on Friday in the flipping moxibustion group. The acupoints of group A were Baihui（GV 20）, Dazhui（GV 14）, Shenzhu（GV 12）, Zhiyang（GV 9）, Jizhong（GV 6）, Mingmen（GV 4）, Yaoyangguan（GV 3）, and the acupoints of group B were Fengfu（GV 16）, Taodao（GV 13）, Shendao（GV 11）, Jinsuo（GV 8）, Xuanshu（GV 5）, Changqiang（GV 1）. Acupuncture was used in the acupuncture group at the main acupoints of Baihui（GV 20）, Sishencong（EX-HN 1）, Neiguan（PC 6）, Zusanli（ST 36）, Taixi（KI 3） and Xuanzhong（GB 39）, matched with the acupoints based on syndrome differentiation, 30 min a time, once a day, continuous 5 times a week. The above two methods were applied in the combination group. All the treaments were for 4 weeks. The indexes were observed before and after treatment, including syndrome differentiationof TCM scale for vascular dementia（SDSVD）, simple mental state scale（MMSE）, self-care ability of daily life scale（ADL）. The clinical effects and safety were evaluated. Results After treatment, the total effective rate in the combination group was 89.5%（34/38）; the rate in the flipping moxibustion group was 65.8%（25/38）; the rate in the acupuncture group was 63.2%（24/38）. The difference among groups was statistically significant（P〈0.05）. The effect in the combination group was better than those in the flipping moxibustion group and in the acupuncture group（both P〈0.05）. There was no statistically significant difference between the flipping moxibustion group and the acupuncture group（P〈0.05）. The SDSVD scores after treatment were lower and the MMSE and ADL scores after treatment were higher than those before treatment in the three groups（all P〈0.01）, with better results on the above three scores in the combination group than those in the other two groups（P〈0.05, P〈0.01）, and the differences on the three scores between the flipping moxibustion group and the acupuncture group were not statiatically significant（all P〈0.05）. The treatment in the three groups was safe, without stastical significance（P〉0.05）. Conclusion The effect of flipping moxibustion combined with acupuncture for vascular dementia is better than those of simple flipping moxibustion and simple acupuncture. The combination treatment achieves better effect on TCM syndrome, cognitive function and daily activity ability than the other two simple treatment.
作者
王顺吉
冶尕西
徐创龙
贾爱民
茹易
关淑婷
任文静
WANG Shunji;YE Gaxi;XU Chuanglong;JIA Aimin;RU Yi;GUAN Shuting;REN Wenjing(Department of Acupuncture and Moxibustion,Ningxia Hui Autonomous Region Hospital of TCM,Yinchuan 750021,China;Institute of TCM,Ningxia Medical University)
出处
《中国针灸》
CAS
CSCD
北大核心
2018年第9期919-924,共6页
Chinese Acupuncture & Moxibustion
基金
银川市科学技术局项目:YCKJ-2015-03
宁夏回族自治区回医示范病区建设项目:201435
宁夏回族自治区科学技术厅科技惠民计划项目:2016 KJHM 94
关键词
血管性痴呆
烙灸
督脉
常规针刺
临床疗效
vascular dementia
flipping moxibustion
governor vessel
conventional acupuncture
clinical effect
