头穴久留针对血管性痴呆病人认知和生活能力及P_(300)的影响  

Effect of Long-time Retention of Scalp Needle on the Abilities of Cognition,Daily Living Activity and P_(300) in Vascular Dementia Patients

作　　者：楚佳梅[1] 包烨华[1] 邹超[1] 

机构地区：[1]杭州市中医院针灸科,杭州310007

出　　处：《针刺研究》2008年第5期334-338,共5页Acupuncture Research

摘　　要：目的:观察头穴久留针治疗血管性痴呆的临床疗效及对患者P300的影响。方法:将65例血管性痴呆患者随机分成两组,其中对照组32例,针刺组33例。对照组给予都可喜口服,每次1片,每日2次,治疗8周;针刺组在口服都可喜的基础上给予头穴针刺,取顶中线、额中线、双侧顶旁一线,静留针10 h,每日1次,每周休息2 d,共治疗8周。观察两组的临床疗效、治疗前后认知能力和生活能力及P300的变化。结果:对照组基本控制1例,显效4例,有效16例,无效11例,总有效率为68.75%;针刺组基本控制2例,显效9例,有效18例,无效4例,总有效率为87.88%;两组总有效率比较差异有统计学意义(P<0.05)。两组经治疗后认知能力、生活能力及P300(潜伏期缩短,幅度增大)均较治疗前有明显改善(P<0.05,P<0.01),针刺组患者认知能力、生活能力和P300潜伏期的缩短优于对照组(P<0.05,P<0.01)。结论:头穴久留针能提高大脑皮层的兴奋性,从而促进血管性痴呆患者智能和日常生活能力的康复。Objective To observe the curative effect of long-time retention of scalp needle in the treatment of vascular dementia （VD） patients, and its influence on P300. Methods Sixty-five cases of VD patients were randomly divided into acupuncture group （n = 33） and medication group （n = 32）. For patients of acupuncture group, Duxil tablets were taken orally, scalp-points Dingzhongxian （MS 5）, Ezhongxian （MS 1） and bilateral Dingpangxian Ⅰ （MS 8） were punctured separately with the filiform needles retained for 10 h, once daily for 8 weeks. Patients of medication group were asked to take Duxil tablets orally, one tablet/time, twice daily for 8 weeks. Mini-mental state examination （MMSE）, Hastgawa dementia scale （HDS） were used to evaluate the patients＇ abilities of orientation, calculation, immediate and remote memory and speech. Activity of Daily Living （ADL） Scale was used to evaluate their daily life ability. The latency and amplitude of event-related potential P300 of electroencephalograph （EEG） were analyzed before and after the treatment. Results After the treatment, of the 33 and 32 cases in acupuncture and medication groups, the controlled, markedly effective, effective and ineffective cases were 2 and 1, 9 and 4, 18 and 16, 4 and 11, respectively; with the total effective rates being 87.88% and 68.75% separately. The total effective rate of acupuncture group was obviously higher than that of medication group. Self-comparison showed that MMSE and HDS scores of both acupuncture and medication groups increased significantly in comparison with their individual pre-treatment values （P 〈0.05, P〈0.01）, while ADL of both groups decreased significantly （P〈0.05, P〈0.01 ）. Before treatment, compared with normal people, the latencies of P300 in two groups increased significantly （P〈0.01）, while the amplitudes of two groups decreased significantly （P〈0.01 ）. After the treatment, the situations of two groups were corrected apparently （P〈0.05）. The eff

关 键 词：血管性痴呆 针灸疗法 头针 事件相关电位 

分 类 号：R338.8[医药卫生—人体生理学] R749.13[医药卫生—基础医学]