摘要
目的观察补肾益髓汤联合针刺治疗脑梗死后轻度认知障碍的疗效,分析其对患者认知功能、脑红蛋白(Ngb)水平、血管内皮功能、脑血流动力学及微循环的影响。方法选取秦皇岛市中医医院脑病一科2019年8月—2020年8月收治的脑梗死后认知障碍患者80例,根据随机数表法原则将患者分为中医组与西医组,每组40例。两组患者均接受脑梗死对症治疗,西医组加用奥拉西坦胶囊,中医组加用补肾益髓汤联合针刺治疗,治疗3个月后对两组患者临床疗效进行分析比较。结果 (1)中医组疗效显著优于西医组(87.50%vs 72.50%,P<0.05);(2)治疗后,中医组简易智力状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分均显著高于西医组(P<0.05),两组画钟测验(CDT)评分比较差异无统计学意义(P>0.05);(3)治疗后,中医组血清Ngb、一氧化氮(NO)水平均显著高于西医组(P<0.05),内皮素-1(ET-1)水平显著低于西医组(P<0.05);(4)治疗后,两组脑血流动力学指标比较差异无统计学意义(P>0.05);(5)治疗后,中医组颈总动脉平均血流量(Qm)、最小血流速度(Vmin)、临界压力(CP)均显著高于西医组(P<0.05),脉搏速度(Wv)、动态阻力(DR)均显著低于西医组(P<0.05),两组最大血流速度(Vmax)、特性阻抗(Zcv)、外周阻力(Rv)比较差异无统计学意义(P>0.05);(6)两组不良反应发生率比较差异无统计学意义(12.5%vs 2.5%,P>0.05)。结论补肾益髓汤联合针刺治疗可以纠正脑梗死后轻度认知障碍患者血清脑红蛋白水平异常,能够有效增加缺血部位血流量,改善患者的认知功能。
Objective To observe the therapeutic effect of Bushen Yishui Decoction(补肾益髓汤)combined with acupuncture on mild cognitive impairment after cerebral infarction,and analyze its effects on patients’cognitive function,encephaloglobin(Ngb)level,vascular endothelial function,cerebral hemodynamics and microcirculation.Methods 80 patients with cognitive impairment after cerebral infarction admitted to the department of encephalopathy of Qinhuangdao hospital of traditional Chinese medicine from August 2019 to August 2020 were selected.According to the principle of random number table method,the patients were divided into the traditional Chinese medicine group and the Western medicine group,with 40 patients in each group.The two groups of patients received symptomatic treatment of cerebral infarction.The Western medicine group was treated with Orathitan Capsule,while the Chinese medicine group was treated with Bushenyi Yishui Decoction combined with acupuncture.After 3 months of treatment,the clinical efficacy of the two groups of patients was analyzed and compared.Results(1)The effect of traditional Chinese medicine group was significantly better than that of Western medicine group(87.50%vs 72.50%,P<0.05);(2)After treatment,the scores of simple intelligence scale(MMSE)and Montreal cognitive assessment scale(MoCA)in the TCM group were significantly higher than those in the Western medicine group(P<0.05),and there was no significant difference in the scores of CDT between the two groups(P>0.05);(3)After treatment,the levels of serum Ngb and NO in TCM group were significantly higher than those in Western medicine group(P<0.05),and the level of endothelin-1(ET-1)was significantly lower than that in Western medicine group(P<0.05);(4)After treatment,there was no significant difference in cerebral hemodynamic index between the two groups(P>0.05);(5)After treatment,the traditional Chinese medicine group average common carotid artery blood flow(Qm),minimal blood flow velocity(Vmin)and critical pressure(CP)were significantly higher than that of western medicine group(P<0.05),the pulse velocity(Wv),dynamic resistance(DR)were significantly lower than that of western medicine group(P<0.05),two groups of blood flow velocity(Vmax),the biggest characteristic impedance(Zcv),peripheral resistance(Rv)had no significant difference(P>0.05);(6)There was no significant difference in the incidence of adverse reactions between the two groups(12.5%vs 2.5%,P>0.05).Conclusion Bushen Yishui Decoction combined with acupuncture can correct the abnormal level of serum cerebral haemoglobin in patients with mild cognitive impairment after cerebral infarction,effectively increase the blood flow to the ischemic site,and improve the cognitive function of patients.
作者
赵鑫
王珊珊
赵楠楠
杨环玮
张惠利
ZHAO Xin;WANG Shanshan;ZHAO Nannan;YANG Huanwei;ZHANG Huili(Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,Hebei,China)
出处
《辽宁中医药大学学报》
CAS
2022年第2期140-144,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
秦皇岛市科学技术研究与发展计划(202004A095)。
关键词
补肾益髓汤
针刺
脑梗死
认知障碍
脑红蛋白
血流动力学
微循环
Bushen Yishui Decoction(补肾益髓汤)
acupuncture
cerebral infarction
cognitive impairment
encephaloglobin
hemodynamics
microcirculation
